| Loyal Medical Group Inc | |
|
8395 W Oakland Park Blvd Ste C Sunrise FL 33351-7346 | |
| (954) 335-6925 | |
| (954) 400-3550 |
| Full Name | Loyal Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 8395 W Oakland Park Blvd Ste C, Sunrise, Florida |
| Authorized Official Name and Position | Ilit Hanna Osher (PRESIDENT) |
| Authorized Official Contact | 9543356925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loyal Medical Group Inc 8391 W Oakland Park Blvd Sunrise FL 33351-7307 Ph: (954) 335-6925 | Loyal Medical Group Inc 8395 W Oakland Park Blvd Ste C Sunrise FL 33351-7346 Ph: (954) 335-6925 |
| NPI Number | 1922787688 |
|---|---|
| Provider Enumeration Date | 07/11/2023 |
| Last Update Date | 03/25/2025 |
| Certification Date | 03/25/2025 |
| Medicare PECOS PAC ID | 4880030733 |
|---|---|
| Medicare Enrollment ID | O20240313003504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922787688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | () | Secondary |
| Provider Name | Todd Jacobs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669452264 PECOS PAC ID: 2668578329 Enrollment ID: I20070426000459 |
| Provider Name | Barbara Joseph- Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578005765 PECOS PAC ID: 9537418223 Enrollment ID: I20180813003302 |
| Provider Name | Sandrah Cleophat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174896112 PECOS PAC ID: 7315338613 Enrollment ID: I20211221001782 |
| Provider Name | Ernesto Chirolde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235690843 PECOS PAC ID: 2567883242 Enrollment ID: I20220106002829 |
| Provider Name | Jasmine Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346991478 PECOS PAC ID: 6002200953 Enrollment ID: I20220218001659 |
| Provider Name | Nancy Romero Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932775590 PECOS PAC ID: 3476932823 Enrollment ID: I20220615002401 |
| Provider Name | Pierrela Lebrun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255917266 PECOS PAC ID: 2062896277 Enrollment ID: I20220907000096 |
| Provider Name | Ezequiel Dishmey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003609991 PECOS PAC ID: 8628589488 Enrollment ID: I20250618000904 |
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