| Community Medical Group | |
|
321 Opa Locka Blvd Opa Locka FL 33054-3526 | |
| (786) 476-3333 | |
| (786) 476-3334 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 321 Opa Locka Blvd, Opa Locka, 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 Suite 365 Miami FL 33126-2079 Ph: (786) 322-7333 | Community Medical Group 321 Opa Locka Blvd Opa Locka FL 33054-3526 Ph: (786) 476-3333 |
| NPI Number | 1790044287 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 1153568985 |
|---|---|
| Medicare Enrollment ID | O20130828000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790044287 | NPI | - | NPPES |
| 009427200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Juana M Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114925427 PECOS PAC ID: 8729162078 Enrollment ID: I20080225000682 |
| Provider Name | Nadia C Echegoyen |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104294958 PECOS PAC ID: 4688975840 Enrollment ID: I20151214001492 |
| Provider Name | Ulises L Rodriguez Avila |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1588191449 PECOS PAC ID: 3577827088 Enrollment ID: I20180509002726 |
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