| Omederos Md Pa | |
|
15955 Bass Creek Rd Miramar FL 33027-3667 | |
| (786) 553-0177 | |
| Not Available |
| Full Name | Omederos Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 15955 Bass Creek Rd, Miramar, Florida |
| Authorized Official Name and Position | Orestes Mederos Trujillo (CEO) |
| Authorized Official Contact | 7865530177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omederos Md Pa 500 Sw 145th Ave Apt 230 Pembroke Pines FL 33027-6209 Ph: () - | Omederos Md Pa 15955 Bass Creek Rd Miramar FL 33027-3667 Ph: (786) 553-0177 |
| NPI Number | 1427853894 |
|---|---|
| Provider Enumeration Date | 02/18/2025 |
| Last Update Date | 03/03/2025 |
| Medicare PECOS PAC ID | 2466962543 |
|---|---|
| Medicare Enrollment ID | O20250609000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427853894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Orestes Mederos Trujillo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316456528 PECOS PAC ID: 0749514800 Enrollment ID: I20220527001663 |
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