| Kendall Family Medical Center, Corp. | |
|
11760 Sw 40th St Ste 112 Miami FL 33175-3589 | |
| (305) 552-6969 | |
| (305) 552-6775 |
| Full Name | Kendall Family Medical Center, Corp. |
|---|---|
| Speciality | Family Medicine |
| Location | 11760 Sw 40th St Ste 112, Miami, Florida |
| Authorized Official Name and Position | Jorge Acosta (VICE PRESIDENT) |
| Authorized Official Contact | 3054857979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kendall Family Medical Center, Corp. 11760 Sw 40th St Ste 112 Miami FL 33175-3589 Ph: (305) 552-6969 | Kendall Family Medical Center, Corp. 11760 Sw 40th St Ste 112 Miami FL 33175-3589 Ph: (305) 552-6969 |
| NPI Number | 1376784801 |
|---|---|
| Provider Enumeration Date | 03/12/2009 |
| Last Update Date | 03/12/2009 |
| Medicare PECOS PAC ID | 8628128279 |
|---|---|
| Medicare Enrollment ID | O20090603000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376784801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Juan Duque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124105846 PECOS PAC ID: 1850492190 Enrollment ID: I20070731000165 |
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