| Mi Tierra Medical Group Corp | |
|
14201 Sw 120th St Ste 110 Miami FL 33186-7662 | |
| (786) 238-7492 | |
| (786) 238-7426 |
| Full Name | Mi Tierra Medical Group Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 14201 Sw 120th St Ste 110, Miami, Florida |
| Authorized Official Name and Position | Joan Rodriguez (PRESIDENT) |
| Authorized Official Contact | 7862383054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mi Tierra Medical Group Corp 14201 Sw 120th St Ste 110 Miami FL 33186-7662 Ph: (786) 238-7492 | Mi Tierra Medical Group Corp 14201 Sw 120th St Ste 110 Miami FL 33186-7662 Ph: (786) 238-7492 |
| NPI Number | 1790455053 |
|---|---|
| Provider Enumeration Date | 09/17/2021 |
| Last Update Date | 10/02/2025 |
| Certification Date | 10/02/2025 |
| Medicare PECOS PAC ID | 0042669004 |
|---|---|
| Medicare Enrollment ID | O20231215001878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790455053 | NPI | - | NPPES |
| Provider Name | Tanzeela Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194039610 PECOS PAC ID: 6608018064 Enrollment ID: I20130814000452 |
| Provider Name | Cristina Colon-del Toro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033536131 PECOS PAC ID: 5395074249 Enrollment ID: I20190903000999 |
| Provider Name | Noelia M Quintana |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851490882 PECOS PAC ID: 8224563093 Enrollment ID: I20241203002131 |
| Provider Name | Gleidys Gonzalez Santana |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427577675 PECOS PAC ID: 5890224216 Enrollment ID: I20250130000063 |
| Provider Name | Claudia Calderin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144051467 PECOS PAC ID: 2567971823 Enrollment ID: I20250529004208 |
| Provider Name | Ariamna Ramirez Cueto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982563128 PECOS PAC ID: 1557836848 Enrollment ID: I20260403002721 |
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