| Imhotepcx Inc | |
|
1201 N 37th Ave Hollywood FL 33021-5414 | |
| (754) 777-5600 | |
| (510) 281-1437 |
| Full Name | Imhotepcx Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1201 N 37th Ave, Hollywood, Florida |
| Authorized Official Name and Position | Vladimir Alejandro Guevara Vazquez (PHYSICIAN/ PSYCHIATRIST) |
| Authorized Official Contact | 7865388989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imhotepcx Inc 7101 Sw 21st St Miami FL 33155-1622 Ph: (786) 538-8989 | Imhotepcx Inc 1201 N 37th Ave Hollywood FL 33021-5414 Ph: (754) 777-5600 |
| NPI Number | 1316573850 |
|---|---|
| Provider Enumeration Date | 03/17/2020 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Medicare PECOS PAC ID | 8729493903 |
|---|---|
| Medicare Enrollment ID | O20210222000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316573850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Vladimir Alejandro Guevara Vazquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326324443 PECOS PAC ID: 3577830637 Enrollment ID: I20200603002566 |
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