| Gustavo Forteza Md Pa | |
|
10550 Nw 77th Ct Ste 308 Hialeah Gardens FL 33016-2072 | |
| (305) 863-2233 | |
| (305) 504-8813 |
| Full Name | Gustavo Forteza Md Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 10550 Nw 77th Ct Ste 308, Hialeah Gardens, Florida |
| Authorized Official Name and Position | Gustavo Forteza (CEO) |
| Authorized Official Contact | 3059927321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo Forteza Md Pa 10521 Sw 143rd Ave Miami FL 33186-3035 Ph: (305) 889-4978 | Gustavo Forteza Md Pa 10550 Nw 77th Ct Ste 308 Hialeah Gardens FL 33016-2072 Ph: (305) 863-2233 |
| NPI Number | 1205190691 |
|---|---|
| Provider Enumeration Date | 06/29/2012 |
| Last Update Date | 04/29/2022 |
| Medicare PECOS PAC ID | 1052569001 |
|---|---|
| Medicare Enrollment ID | O20120917000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205190691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ME85628 (Florida) | Primary |
| Provider Name | Gustavo Forteza |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1770569196 PECOS PAC ID: 4587812532 Enrollment ID: I20120917000353 |
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