| Planet Health Medical Center, Corp. | |
|
10305 Nw 41st St Ste 115 Doral FL 33178-2975 | |
| (305) 883-2001 | |
| Not Available |
| Full Name | Planet Health Medical Center, Corp. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10305 Nw 41st St Ste 115, Doral, Florida |
| Authorized Official Name and Position | Nalanys Caridad Roque (OWNER) |
| Authorized Official Contact | 3055864456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Planet Health Medical Center, Corp. 10305 Nw 41st St Ste 115 Doral FL 33178-2975 Ph: (305) 883-2001 | Planet Health Medical Center, Corp. 10305 Nw 41st St Ste 115 Doral FL 33178-2975 Ph: (305) 883-2001 |
| NPI Number | 1942851951 |
|---|---|
| Provider Enumeration Date | 09/23/2019 |
| Last Update Date | 04/07/2022 |
| Medicare PECOS PAC ID | 3971834185 |
|---|---|
| Medicare Enrollment ID | O20191018000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942851951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Arles Perdomo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1033218821 PECOS PAC ID: 8325945793 Enrollment ID: I20031215000394 |
| Provider Name | Minsu D Blanca |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184895914 PECOS PAC ID: 0648229112 Enrollment ID: I20050121000725 |
| Provider Name | Aimee Leyva Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619447737 PECOS PAC ID: 6800139452 Enrollment ID: I20190522001092 |
| Provider Name | Ramon A Fores Pons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669024535 PECOS PAC ID: 7012328727 Enrollment ID: I20201202001401 |
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