| J & C Network Resource Center, Inc | |
|
1620 Ne 148th St North Miami FL 33181-1021 | |
| (305) 705-6445 | |
| Not Available |
| Full Name | J & C Network Resource Center, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1620 Ne 148th St, North Miami, Florida |
| Authorized Official Name and Position | Terry Leno (PRESIDENT/CEO) |
| Authorized Official Contact | 7862987379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J & C Network Resource Center, Inc 1620 Ne 148th St North Miami FL 33181-1021 Ph: (305) 705-6445 | J & C Network Resource Center, Inc 1620 Ne 148th St North Miami FL 33181-1021 Ph: (305) 705-6445 |
| NPI Number | 1962790535 |
|---|---|
| Provider Enumeration Date | 07/18/2011 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 3779938139 |
|---|---|
| Medicare Enrollment ID | O20231005000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962790535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | David Coradin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386091767 PECOS PAC ID: 0648563833 Enrollment ID: I20200730001714 |
| Provider Name | Carol J Swaby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952025165 PECOS PAC ID: 2668846817 Enrollment ID: I20230329003488 |
| Provider Name | Luis Fernando Rengifo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669102851 PECOS PAC ID: 8325568595 Enrollment ID: I20250219001334 |
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