| Clinica Hispana | |
|
4990 Golden Gate Pkwy Naples FL 34116-6962 | |
| (239) 692-8309 | |
| (239) 692-8504 |
| Full Name | Clinica Hispana |
|---|---|
| Speciality | Family Medicine |
| Location | 4990 Golden Gate Pkwy, Naples, Florida |
| Authorized Official Name and Position | Tabare D Tabar (PRESIDENT) |
| Authorized Official Contact | 2393319610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Hispana 4990 Golden Gate Pkwy Naples FL 34116-6962 Ph: (239) 692-8309 | Clinica Hispana 4990 Golden Gate Pkwy Naples FL 34116-6962 Ph: (239) 692-8309 |
| NPI Number | 1124450077 |
|---|---|
| Provider Enumeration Date | 08/02/2013 |
| Last Update Date | 11/25/2025 |
| Certification Date | 11/25/2025 |
| Medicare PECOS PAC ID | 5395962195 |
|---|---|
| Medicare Enrollment ID | O20140818001805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124450077 | NPI | - | NPPES |
| Provider Name | Carlos Paisan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609893411 PECOS PAC ID: 0244278463 Enrollment ID: I20050419000934 |
| Provider Name | Tabare D Tabar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891730008 PECOS PAC ID: 1850375874 Enrollment ID: I20110628000602 |
| Provider Name | Jose Luis Elias |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154352300 PECOS PAC ID: 2769658699 Enrollment ID: I20111227000473 |
| Provider Name | Osmani Rico Valdes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356977391 PECOS PAC ID: 7012324197 Enrollment ID: I20210408000851 |
| Provider Name | Sandra E Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023719713 PECOS PAC ID: 5193165504 Enrollment ID: I20240502001965 |
| Provider Name | Yamila Diaz De Villegas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275106239 PECOS PAC ID: 7315387644 Enrollment ID: I20240502003144 |
| Provider Name | Pedro Alexis Carvajal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750081246 PECOS PAC ID: 6800237850 Enrollment ID: I20240508003604 |
| Provider Name | Ignacio Sosa Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346021219 PECOS PAC ID: 8729429782 Enrollment ID: I20240508003951 |
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