| Eastern Medical Center Corp | |
|
8900 Sw 24 St. 209 Miami FL 33165 | |
| (305) 392-0765 | |
| (786) 618-5219 |
| Full Name | Eastern Medical Center Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 8900 Sw 24 St., Miami, Florida |
| Authorized Official Name and Position | Christian S Dominguez (C.E.O) |
| Authorized Official Contact | 3053920765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Medical Center Corp 8900 Sw 24 St. 209 Miami FL 33165 Ph: (305) 392-0765 | Eastern Medical Center Corp 8900 Sw 24 St. 209 Miami FL 33165 Ph: (305) 392-0765 |
| NPI Number | 1336707983 |
|---|---|
| Provider Enumeration Date | 05/30/2019 |
| Last Update Date | 05/30/2019 |
| Medicare PECOS PAC ID | 8325473739 |
|---|---|
| Medicare Enrollment ID | O20200113002089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336707983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
| Provider Name | Ratsia M Fernandez Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972377083 PECOS PAC ID: 7618403338 Enrollment ID: I20241204004646 |
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