| South Dade Primary Care, Llc | |
|
9835 E Hibiscus St Palmetto Bay FL 33157-5406 | |
| (305) 238-8561 | |
| Not Available |
| Full Name | South Dade Primary Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9835 E Hibiscus St, Palmetto Bay, Florida |
| Authorized Official Name and Position | Mark L Mullinix (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7867583135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Dade Primary Care, Llc 1000 Nw 57th Ct Ste 400 Miami FL 33126-3292 Ph: (786) 485-1005 | South Dade Primary Care, Llc 9835 E Hibiscus St Palmetto Bay FL 33157-5406 Ph: (305) 238-8561 |
| NPI Number | 1285748285 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 08/27/2025 |
| Medicare PECOS PAC ID | 6002835360 |
|---|---|
| Medicare Enrollment ID | O20051116000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285748285 | NPI | - | NPPES |
| 01-02953 | Other | UNITED HEALTHCARE | |
| 01-02956 | Other | UNITED HEALTHCARE | |
| 4347956 | Other | AETNA INSURANCE | |
| 71520 | Other | BLUE CROSS BLUE SHIELD FL | |
| 79328 | Other | BLEU CROSS BLUE SHIELD FL | |
| 005597 | Other | NEIGHBORHOOD HEALTH PARTN | |
| 4497709 | Other | AETNA INSURANCE | |
| 15296 | Other | AETNA INSURANCE | |
| 15313 | Other | AETNA INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0027176 (Florida) | Secondary |
| 207Q00000X | Family Medicine | ME0092409 (Florida) | Secondary |
| 207Q00000X | Family Medicine | ME0016658 (Florida) | Primary |
| Provider Name | Scott Judd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821008582 PECOS PAC ID: 0648243550 Enrollment ID: I20040818000911 |
| Provider Name | Sonali K Judd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609886373 PECOS PAC ID: 2466429584 Enrollment ID: I20040916000580 |
| Provider Name | Alison J Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366432957 PECOS PAC ID: 3577512888 Enrollment ID: I20050113000565 |
| Provider Name | Michael Cavanaugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679525836 PECOS PAC ID: 0446280739 Enrollment ID: I20050816001085 |
| Provider Name | Dana Portnoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669473013 PECOS PAC ID: 1153320171 Enrollment ID: I20061220000147 |
| Provider Name | David B Scholl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407994395 PECOS PAC ID: 1951498567 Enrollment ID: I20071030000117 |
| Provider Name | John T Mcadory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104800283 PECOS PAC ID: 1951486026 Enrollment ID: I20080313000329 |
| Provider Name | Roy Forrest |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790863587 PECOS PAC ID: 6204800626 Enrollment ID: I20080917000521 |
| Provider Name | Michael Ehrenman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679522395 PECOS PAC ID: 8022173350 Enrollment ID: I20090219000445 |
| Provider Name | Otto C Concepcion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508002999 PECOS PAC ID: 2466597919 Enrollment ID: I20100308000853 |
| Provider Name | Christopher Dale Patterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417947839 PECOS PAC ID: 8820198559 Enrollment ID: I20100823000833 |
| Provider Name | Alexandra Tracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205118825 PECOS PAC ID: 8022280346 Enrollment ID: I20111011000213 |
| Provider Name | Todd K Rosenthal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760403307 PECOS PAC ID: 1658330907 Enrollment ID: I20120103000305 |
| Provider Name | Jennifer Bruno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265787378 PECOS PAC ID: 4183863459 Enrollment ID: I20130617000621 |
| Provider Name | Amber M Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699184135 PECOS PAC ID: 5597089979 Enrollment ID: I20150112002012 |
| Provider Name | Wiledade Augustin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164809257 PECOS PAC ID: 2466763297 Enrollment ID: I20150622000734 |
| Provider Name | Daisy Saavedra Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740545292 PECOS PAC ID: 8224341508 Enrollment ID: I20150715001281 |
| Provider Name | Kristin Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548687676 PECOS PAC ID: 9133421787 Enrollment ID: I20160113002329 |
| Provider Name | Glenda Y Buyo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841467883 PECOS PAC ID: 0941367262 Enrollment ID: I20160201002720 |
| Provider Name | Glenn Michael Buyo |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1326157553 PECOS PAC ID: 1759387103 Enrollment ID: I20160201002847 |
| Provider Name | Tymur Chepi-ipa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548623432 PECOS PAC ID: 7012206428 Enrollment ID: I20160525000012 |
| Provider Name | Ivonne Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124479217 PECOS PAC ID: 2163701970 Enrollment ID: I20161118001952 |
| Provider Name | Susana Cardoso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770037202 PECOS PAC ID: 8820379316 Enrollment ID: I20161221000062 |
| Provider Name | Carmen Guanipa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669918678 PECOS PAC ID: 7618252198 Enrollment ID: I20170323002641 |
| Provider Name | Oluwole Pitan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831548213 PECOS PAC ID: 9931477106 Enrollment ID: I20170612000828 |
| Provider Name | Miriam Guerra Otero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558729970 PECOS PAC ID: 6507127040 Enrollment ID: I20180226002323 |
| Provider Name | Martha Barzana-fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184017782 PECOS PAC ID: 8426345521 Enrollment ID: I20180918000638 |
| Provider Name | Michel Granados-ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740754720 PECOS PAC ID: 6901235001 Enrollment ID: I20200409003516 |
| Provider Name | Fernando Fuentes Eimil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669032751 PECOS PAC ID: 8527498534 Enrollment ID: I20200415000542 |
| Provider Name | Dunia Pena Salgado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922562701 PECOS PAC ID: 9234561945 Enrollment ID: I20200619002228 |
| Provider Name | Laurie A Canasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760004303 PECOS PAC ID: 3779907373 Enrollment ID: I20200715002234 |
| Provider Name | Hikma Jemal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295267938 PECOS PAC ID: 3577838531 Enrollment ID: I20201012001086 |
| Provider Name | Steven Michael Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720689821 PECOS PAC ID: 2567879349 Enrollment ID: I20210323000603 |
| Provider Name | Verushcka G Pagliari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962810689 PECOS PAC ID: 5294051686 Enrollment ID: I20210824002650 |
| Provider Name | Lazara Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053916163 PECOS PAC ID: 2961892385 Enrollment ID: I20211129001848 |
| Provider Name | Karen K Wies |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609893270 PECOS PAC ID: 1951353523 Enrollment ID: I20211222000969 |
| Provider Name | Renny De La Caridad Mesa Rivero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083360630 PECOS PAC ID: 6507247541 Enrollment ID: I20220721002164 |
| Provider Name | Romel A. Arjona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386730802 PECOS PAC ID: 9638215601 Enrollment ID: I20220801001905 |
| Provider Name | Nympha Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215579404 PECOS PAC ID: 6103218136 Enrollment ID: I20220802003586 |
| Provider Name | Dawn Crowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699371799 PECOS PAC ID: 7517334790 Enrollment ID: I20221031002764 |
| Provider Name | Candido Otero Arcis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639877863 PECOS PAC ID: 2860846573 Enrollment ID: I20230929000392 |
| Provider Name | Jamie Castro Mazon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134964786 PECOS PAC ID: 6103357595 Enrollment ID: I20241009003901 |
| Provider Name | Mariam Maria Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164285797 PECOS PAC ID: 3375077829 Enrollment ID: I20241106004267 |
| Provider Name | Keila Ines Prewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578306171 PECOS PAC ID: 6103344726 Enrollment ID: I20250519000341 |
Regions Praxis Care Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9299 Sw 152nd St Ste 200n, Palmetto Bay, FL 33157 Phone: 786-634-1952 Fax: 786-565-3940 | |
Nova Community Services Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9867 Sw 184th St, Palmetto Bay, FL 33157 Phone: 786-732-2287 Fax: 786-732-2288 | |
Tmm Consulting Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9780 E Indigo St Ste 202, Palmetto Bay, FL 33157 Phone: 305-252-9485 Fax: 305-252-9485 | |
Public Health Trust Of Dade County Florida Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9333 Sw 152nd St, Palmetto Bay, FL 33157 Phone: 305-251-2500 | |
Guidewell Sanitas I, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8950 Sw 152nd St, Palmetto Bay, FL 33157 Phone: 844-665-4827 | |
Amedica Medical Group South Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18140 Franjo Rd, Palmetto Bay, FL 33157 Phone: 305-972-3590 | |
Lam A, Au, M.d., Ph.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9275 Sw 152nd St, Suite 108a, Palmetto Bay, FL 33157 Phone: 305-255-2505 |