| Javier Puentes Pa | |
|
5341 W 20th Ave Hialeah FL 33012-2100 | |
| (786) 541-1882 | |
| (786) 542-1846 |
| Full Name | Javier Puentes Pa |
|---|---|
| Speciality | General Practice |
| Location | 5341 W 20th Ave, Hialeah, Florida |
| Authorized Official Name and Position | Javier Puentes (PRESIDENT) |
| Authorized Official Contact | 7865421882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Javier Puentes Pa 5341 W 20th Ave Hialeah FL 33012-2100 Ph: (786) 541-1882 | Javier Puentes Pa 5341 W 20th Ave Hialeah FL 33012-2100 Ph: (786) 541-1882 |
| NPI Number | 1437658358 |
|---|---|
| Provider Enumeration Date | 02/06/2018 |
| Last Update Date | 04/04/2023 |
| Medicare PECOS PAC ID | 8527320647 |
|---|---|
| Medicare Enrollment ID | O20180329000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437658358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ACN806 (Florida) | Primary |
| Provider Name | Javier Puentes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679946982 PECOS PAC ID: 5698077568 Enrollment ID: I20180329000313 |
| Provider Name | Milkys E Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437615275 PECOS PAC ID: 9537587316 Enrollment ID: I20200910001009 |
| Provider Name | Linette Botana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285207753 PECOS PAC ID: 7416490784 Enrollment ID: I20240615000015 |
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