| Myclinic Wellness Center Corp | |
|
14201 Sw 120th St Ste 210 Miami FL 33186-7663 | |
| (305) 902-8137 | |
| Not Available |
| Full Name | Myclinic Wellness Center Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 14201 Sw 120th St Ste 210, Miami, Florida |
| Authorized Official Name and Position | Rafael A. Ubeda (PRESIDENT) |
| Authorized Official Contact | 3059028137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myclinic Wellness Center Corp 14201 Sw 120th St Ste 210 Miami FL 33186-7663 Ph: (305) 902-8137 | Myclinic Wellness Center Corp 14201 Sw 120th St Ste 210 Miami FL 33186-7663 Ph: (305) 902-8137 |
| NPI Number | 1811561186 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Certification Date | 05/19/2021 |
| Medicare PECOS PAC ID | 3476952110 |
|---|---|
| Medicare Enrollment ID | O20210528001127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811561186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Rafael A Ubeda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699724005 PECOS PAC ID: 9133180318 Enrollment ID: I20041021000165 |
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