| Pine Island Medical Inc | |
|
7480 Sw 40th St Ste 430 Miami FL 33155-6630 | |
| (786) 606-9387 | |
| Not Available |
| Full Name | Pine Island Medical Inc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 7480 Sw 40th St Ste 430, Miami, Florida |
| Authorized Official Name and Position | Yamil Jacomino (PRESIDENT) |
| Authorized Official Contact | 7866069387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Island Medical Inc 7480 Sw 40th St Ste 430 Miami FL 33155-6630 Ph: (305) 546-3849 | Pine Island Medical Inc 7480 Sw 40th St Ste 430 Miami FL 33155-6630 Ph: (786) 606-9387 |
| NPI Number | 1275184855 |
|---|---|
| Provider Enumeration Date | 09/24/2019 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 4082035035 |
|---|---|
| Medicare Enrollment ID | O20200601000752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275184855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Jose J Gomez Cortes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134177066 PECOS PAC ID: 0749187458 Enrollment ID: I20031218000846 |
| Provider Name | Iliana M Holguin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386694495 PECOS PAC ID: 1658368931 Enrollment ID: I20040428001074 |
| Provider Name | Tony Nguyen |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1861854671 PECOS PAC ID: 7618242397 Enrollment ID: I20171005001419 |
| Provider Name | Alberto Rojas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104357839 PECOS PAC ID: 4385916980 Enrollment ID: I20200625001801 |
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