| Icare Mobile Medicine LLC | |
|
1150 Nw 72nd Ave Ste Ph-1 Miami FL 33126-1936 | |
| (786) 661-7830 | |
| (701) 701-9902 |
| Full Name | Icare Mobile Medicine LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1150 Nw 72nd Ave Ste Ph-1, Miami, Florida |
| Authorized Official Name and Position | Ivan Islamaj (PA-C) |
| Authorized Official Contact | 2165026577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icare Mobile Medicine LLC 1150 Nw 72nd Ave Ph 1 Miami FL 33126-1920 Ph: (786) 661-7830 | Icare Mobile Medicine LLC 1150 Nw 72nd Ave Ste Ph-1 Miami FL 33126-1936 Ph: (786) 661-7830 |
| NPI Number | 1376215111 |
|---|---|
| Provider Enumeration Date | 09/30/2021 |
| Last Update Date | 06/12/2026 |
| Certification Date | 06/12/2026 |
| Medicare PECOS PAC ID | 5890193478 |
|---|---|
| Medicare Enrollment ID | O20211012002823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376215111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 208D00000X | General Practice | () | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | () | Secondary |
| Provider Name | Nicholas Da Suite |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447330048 PECOS PAC ID: 8123915576 Enrollment ID: I20040303000028 |
| Provider Name | Rebecca G Block |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881017952 PECOS PAC ID: 1254564149 Enrollment ID: I20150414001180 |
| Provider Name | Mario Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679117451 PECOS PAC ID: 4688003510 Enrollment ID: I20200329000151 |
| Provider Name | Shad Brown |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326387531 PECOS PAC ID: 2466729736 Enrollment ID: I20200929001207 |
| Provider Name | Ivan Islamaj |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174924963 PECOS PAC ID: 7315345998 Enrollment ID: I20211014000408 |
| Provider Name | David Doirin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437745734 PECOS PAC ID: 0244625721 Enrollment ID: I20220319000081 |
| Provider Name | Katia Lauzarique |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851038491 PECOS PAC ID: 2961878798 Enrollment ID: I20221019003350 |
| Provider Name | Miriam Edouard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043355837 PECOS PAC ID: 9335369289 Enrollment ID: I20230216000186 |
| Provider Name | Tuan Minh Pham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972350544 PECOS PAC ID: 1658806567 Enrollment ID: I20241129000520 |
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