| Ga Medicorp LLC | |
|
3157 N University Dr Ste 103 Hollywood FL 33024-2258 | |
| (954) 881-9852 | |
| (954) 852-4314 |
| Full Name | Ga Medicorp LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3157 N University Dr Ste 103, Hollywood, Florida |
| Authorized Official Name and Position | Gerardo Aguilera Gonzalez (OWNER) |
| Authorized Official Contact | 9548819852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga Medicorp LLC 3157 N University Dr Ste 103 Davie FL 33024-2258 Ph: (954) 758-4127 | Ga Medicorp LLC 3157 N University Dr Ste 103 Hollywood FL 33024-2258 Ph: (954) 881-9852 |
| NPI Number | 1366380040 |
|---|---|
| Provider Enumeration Date | 03/23/2026 |
| Last Update Date | 08/10/2026 |
| Certification Date | 08/10/2026 |
| Medicare PECOS PAC ID | 6204309693 |
|---|---|
| Medicare Enrollment ID | O20260626001851 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366380040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Gerardo Aguilera Gonzalez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720720261 PECOS PAC ID: 3072959964 Enrollment ID: I20240314000477 |
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