| Ultimate Medical Center & Spa Llc | |
|
12700 Sw 128th St Ste 205 Miami FL 33186-5378 | |
| (305) 278-7579 | |
| (305) 278-7589 |
| Full Name | Ultimate Medical Center & Spa Llc |
|---|---|
| Speciality | General Practice |
| Location | 12700 Sw 128th St Ste 205, Miami, Florida |
| Authorized Official Name and Position | Caridad Fonte Estevez (OWNER) |
| Authorized Official Contact | 3052787579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ultimate Medical Center & Spa Llc 12700 Sw 128th St Ste 205 Miami FL 33186-5378 Ph: (305) 278-7579 | Ultimate Medical Center & Spa Llc 12700 Sw 128th St Ste 205 Miami FL 33186-5378 Ph: (305) 278-7579 |
| NPI Number | 1023663259 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 0648502781 |
|---|---|
| Medicare Enrollment ID | O20191023000688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023663259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Guillermo Nino Alonso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336120708 PECOS PAC ID: 5092812206 Enrollment ID: I20070523000472 |
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