| Juvensa Llc | |
|
2500 Nw 79th Ave Ste 265 Doral FL 33122-1088 | |
| (786) 504-4626 | |
| (305) 468-6217 |
| Full Name | Juvensa Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2500 Nw 79th Ave Ste 265, Doral, Florida |
| Authorized Official Name and Position | Anneyd Avalos Pena (OWNER) |
| Authorized Official Contact | 7869253143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Juvensa Llc 9803 Sw 134th Pl Miami FL 33186-2265 Ph: (786) 925-3143 | Juvensa Llc 2500 Nw 79th Ave Ste 265 Doral FL 33122-1088 Ph: (786) 504-4626 |
| NPI Number | 1043900798 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 10/16/2023 |
| Medicare PECOS PAC ID | 8325405418 |
|---|---|
| Medicare Enrollment ID | O20230605003236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043900798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Anneyd M Avalos-pena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962863266 PECOS PAC ID: 9436405271 Enrollment ID: I20180709001938 |
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