| Luz Medical Center Llc | |
|
13032 Sw 133rd Ct Miami FL 33186-5855 | |
| (786) 345-7589 | |
| (786) 396-1466 |
| Full Name | Luz Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 13032 Sw 133rd Ct, Miami, Florida |
| Authorized Official Name and Position | Aimee Leyva Lopez (SOLE MEMBER) |
| Authorized Official Contact | 7863765554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luz Medical Center Llc 8148 Sw 163rd Ct Miami FL 33193-5120 Ph: (786) 376-5554 | Luz Medical Center Llc 13032 Sw 133rd Ct Miami FL 33186-5855 Ph: (786) 345-7589 |
| NPI Number | 1750849568 |
|---|---|
| Provider Enumeration Date | 03/11/2019 |
| Last Update Date | 01/22/2025 |
| Medicare PECOS PAC ID | 0941622534 |
|---|---|
| Medicare Enrollment ID | O20200629001273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750849568 | NPI | - | NPPES |
| APRN11000115 | Other | FL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Aimee Leyva Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619447737 PECOS PAC ID: 6800139452 Enrollment ID: I20190522001092 |
| Provider Name | Miguel Enrique Diaz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811432719 PECOS PAC ID: 5092173054 Enrollment ID: I20230622003474 |
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