| Dedicated Pennsylvania Holding, Llc | |
|
5675 N Front St Ste 141 Philadelphia PA 19120-2719 | |
| (305) 628-6117 | |
| Not Available |
| Full Name | Dedicated Pennsylvania Holding, Llc |
|---|---|
| Speciality | Specialist |
| Location | 5675 N Front St Ste 141, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Raymond Jimenez (DIRECTOR OF CLIENT SERVICES) |
| Authorized Official Contact | 3056286117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Pennsylvania Holding, Llc 1395 N.w/ 167th Street Payer Enrollment Department Miami Gardens FL 33169 Ph: (305) 628-6117 | Dedicated Pennsylvania Holding, Llc 5675 N Front St Ste 141 Philadelphia PA 19120-2719 Ph: (305) 628-6117 |
| NPI Number | 1841707965 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 03/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841707965 | NPI | - | NPPES |
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