| Esperanza Group Llc | |
|
13195 Sw 134th St Ste 101-103 Miami FL 33186-4499 | |
| (786) 227-6830 | |
| (786) 524-2413 |
| Full Name | Esperanza Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13195 Sw 134th St Ste 101-103, Miami, Florida |
| Authorized Official Name and Position | Andrey Martin (CFO) |
| Authorized Official Contact | 7862276830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Esperanza Group Llc 13195 Sw 134th St Ste 101 Miami FL 33186-4585 Ph: (786) 227-6830 | Esperanza Group Llc 13195 Sw 134th St Ste 101-103 Miami FL 33186-4499 Ph: (786) 227-6830 |
| NPI Number | 1386269496 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 03/18/2025 |
| Certification Date | 03/18/2025 |
| Medicare PECOS PAC ID | 0446649628 |
|---|---|
| Medicare Enrollment ID | O20211109001399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386269496 | NPI | - | NPPES |
| 13060 | Other | FL | AHCA |
| 119514600 | Medicaid | FL | |
| 116149900 | Medicaid | FL | |
| 106329200 | Medicaid | FL | |
| 108915900 | Medicaid | FL |
| Provider Name | Jason Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659802916 PECOS PAC ID: 9335549518 Enrollment ID: I20210609001412 |
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