| Maxima Medical Center Llc | |
|
10540 Nw 26th St Ste G201 Doral FL 33172-5933 | |
| (786) 879-8040 | |
| (786) 879-8050 |
| Full Name | Maxima Medical Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10540 Nw 26th St Ste G201, Doral, Florida |
| Authorized Official Name and Position | Adiaris Valle (OWNER) |
| Authorized Official Contact | 7868798040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxima Medical Center Llc 10540 Nw 26th St Ste G201 Doral FL 33172-5933 Ph: (786) 879-8040 | Maxima Medical Center Llc 10540 Nw 26th St Ste G201 Doral FL 33172-5933 Ph: (786) 879-8040 |
| NPI Number | 1568216422 |
|---|---|
| Provider Enumeration Date | 04/16/2024 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 9032550488 |
|---|---|
| Medicare Enrollment ID | O20240516000220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568216422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jose A Rios |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700863172 PECOS PAC ID: 4284779745 Enrollment ID: I20100308000963 |
| Provider Name | Gerardo Casanova Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962073999 PECOS PAC ID: 4385032341 Enrollment ID: I20211023000125 |
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