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1489 N Military Trail Suite #114 West Palm Beach FL 33409 | |
(561) 557-1908 | |
(561) 444-3421 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1489 N Military Trail, West Palm Beach, Florida |
Authorized Official Name and Position | Juan Carlos Hernandez (OWNER) |
Authorized Official Contact | 5617230143 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1489 N Military Trail Suite #114 West Palm Beach FL 33409 Ph: (561) 557-1908 | 1489 N Military Trail Suite #114 West Palm Beach FL 33409 Ph: (561) 557-1908 |
NPI Number | 1154848042 |
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Provider Enumeration Date | 08/23/2017 |
Last Update Date | 01/14/2025 |
Medicare PECOS PAC ID | 1254867401 |
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Medicare Enrollment ID | O20241211000878 |
Identifier | Type | State | Issuer |
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1154848042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | HCC11131 (Florida) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Jorge Saavedra Gari |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881385912 PECOS PAC ID: 4789110941 Enrollment ID: I20241211001414 |
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