| Pura Vida Medical Center, Llc | |
|
1738 W 49th St Ste 7-12 Hialeah FL 33012-3456 | |
| (305) 698-8432 | |
| (305) 698-8975 |
| Full Name | Pura Vida Medical Center, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1738 W 49th St Ste 7-12, Hialeah, Florida |
| Authorized Official Name and Position | Nury Carbajal (OWNER) |
| Authorized Official Contact | 3058743909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pura Vida Medical Center, Llc 7925 Nw 12th St Ste 201 Doral FL 33126-1821 Ph: (305) 874-3909 | Pura Vida Medical Center, Llc 1738 W 49th St Ste 7-12 Hialeah FL 33012-3456 Ph: (305) 698-8432 |
| NPI Number | 1922523604 |
|---|---|
| Provider Enumeration Date | 08/03/2017 |
| Last Update Date | 06/24/2020 |
| Medicare PECOS PAC ID | 0143582544 |
|---|---|
| Medicare Enrollment ID | O20180323000682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922523604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Armando Segui |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730121252 PECOS PAC ID: 5991692659 Enrollment ID: I20040228000182 |
| Provider Name | Ramon A Berenguer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154307874 PECOS PAC ID: 1557337656 Enrollment ID: I20040909000800 |
| Provider Name | Pedro Caro |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487618096 PECOS PAC ID: 3779514815 Enrollment ID: I20050830000294 |
| Provider Name | Luis G Martinez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629115100 PECOS PAC ID: 3476602616 Enrollment ID: I20090519000421 |
| Provider Name | Ernesto Fernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326289323 PECOS PAC ID: 7416073820 Enrollment ID: I20100922001267 |
| Provider Name | Elizabeth Gamez Pardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104221597 PECOS PAC ID: 1456678861 Enrollment ID: I20150324001508 |
| Provider Name | Dania Gomez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972981876 PECOS PAC ID: 5799076469 Enrollment ID: I20160628001049 |
| Provider Name | Yudith Pando |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568959682 PECOS PAC ID: 2961747357 Enrollment ID: I20181212002138 |
| Provider Name | Yeneysi Notario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700164035 PECOS PAC ID: 8729368840 Enrollment ID: I20181212003229 |
| Provider Name | Moraima Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912429291 PECOS PAC ID: 6103162326 Enrollment ID: I20190109001583 |
| Provider Name | Raul Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891201323 PECOS PAC ID: 9739511155 Enrollment ID: I20191122001075 |
| Provider Name | Pedro Agustin Ferrer Suarez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851987671 PECOS PAC ID: 4880093632 Enrollment ID: I20210527000130 |
| Provider Name | Rogelio Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508480617 PECOS PAC ID: 0042613523 Enrollment ID: I20210721001328 |
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