| Pro Life Medical Center Corp. | |
|
7925 Nw 12th St Ste 315 Doral FL 33126-1846 | |
| (305) 965-1525 | |
| Not Available |
| Full Name | Pro Life Medical Center Corp. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7925 Nw 12th St Ste 315, Doral, Florida |
| Authorized Official Name and Position | Manuel Jose Amigo Guillen (OWNER) |
| Authorized Official Contact | 3059651525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Life Medical Center Corp. 7925 Nw 12th St Ste 315 Doral FL 33126-1846 Ph: (305) 965-1525 | Pro Life Medical Center Corp. 7925 Nw 12th St Ste 315 Doral FL 33126-1846 Ph: (305) 965-1525 |
| NPI Number | 1467045252 |
|---|---|
| Provider Enumeration Date | 02/12/2021 |
| Last Update Date | 03/08/2024 |
| Certification Date | 03/08/2024 |
| Medicare PECOS PAC ID | 2062891047 |
|---|---|
| Medicare Enrollment ID | O20220622000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467045252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nirmal J. Joseph |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790760643 PECOS PAC ID: 5890742654 Enrollment ID: I20050404000693 |
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