| Community Medical Group | |
|
9088 Progress Blvd Unit 2-4 Riverview FL 33578-4886 | |
| (813) 444-0220 | |
| (813) 367-1961 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 9088 Progress Blvd Unit 2-4, Riverview, Florida |
| Authorized Official Name and Position | Rayny Ramirez (PRESIDENT) |
| Authorized Official Contact | 7863227333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Group 6100 Blue Lagoon Dr Ste 365 Miami FL 33126-7010 Ph: (786) 322-7333 | Community Medical Group 9088 Progress Blvd Unit 2-4 Riverview FL 33578-4886 Ph: (813) 444-0220 |
| NPI Number | 1457099582 |
|---|---|
| Provider Enumeration Date | 05/27/2022 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 5597123893 |
|---|---|
| Medicare Enrollment ID | O20230619001631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457099582 | NPI | - | NPPES |
| 117487900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Regla C Gutierrez Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982337390 PECOS PAC ID: 4183068612 Enrollment ID: I20240222003580 |
| Provider Name | Kristina Mabel Nieves Quinones |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053038836 PECOS PAC ID: 9133563190 Enrollment ID: I20240226003295 |
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