PCC Medical Holdings LLC
Organization Active NPI Internal Medicine Physician · Lake Worth, FL
NPI 1174167993 · NPPES record last updated Apr 4, 2024
Key facts
- NPI
- 1174167993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- PCC MEDICAL HOLDINGS LLC
- Practice address
- 5055 South Congress Avenue
Suite 303
Lake Worth, FL 33461 - Phone
- (561) 385-0731
- Fax
- (561) 629-7302
- NPI assigned
- Nov 5, 2019
- Organization subpart
- No
Authorized official
- Name
- William Steele, CEO
- Title
- Ceo
- Phone
- (561) 385-0731
Practitioners 81
-
Mir a Alikhan, MD
-
Quazi Afroza Bari, M.D.
-
Renes Castor, MD
-
Yolaine M Chamblin, M.D.
-
Giselle Debs, M.D.
-
Elides Dominguez, CACII
-
Juan Galvan, MD
-
Alan Katz, M.D.
-
Anthony Maher, MD
-
Marieli Milagros Mayoral, M.D.
-
Roger Julian Nicosia Jr., D.O.
-
Francisco Rafael Oquendo, M.D.
-
Susana Gema Perez Diaz, M.D.
-
Marina Rabkin, MD
-
Danielle E Reid, MD
-
Jorge L. Vazquez, MD
-
Jose A Aguirre, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2212041 | PCC Medical Holdings, LLC | Certificate of waiver | Feb 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200924001757 | FL | Part B Supplier - Clinic/Group Practice | 0446679468 |
Receives reassigned benefits from 66 practitioners Practice locations: Orlando, FL; Palm Springs, FL; Pembroke Pines, FL; Plantation, FL; Sanford, FL; Stuart, FL; Tamarac, FL; Vero Beach, FL… |
National Provider Directory
Locations (25 of 27)
9878 Clint Moore Rd
Boca Raton, FL 33496
7000 W Palmetto Park Rd
Ste 103
Boca Raton, FL 33433
Phone (561) 347-8122
3880 Coconut Creek Pkwy
Ste 200
Coconut Creek, FL 33066
Phone (954) 320-3322
601 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 942-9233
4849 Lake Worth Rd
Fl 1
Greenacres, FL 33463
4849 Lake Worth Rd
Ste 346
Greenacres, FL 33463
295 Patterson Rd
Haines City, FL 33844
Phone (863) 422-4338
5055 S Congress Ave
Lake Worth, FL 33461
161 John F Kennedy Dr
Lake Worth, FL 33462
5055 S Congress Ave
Ste 303
Lake Worth, FL 33461
Phone (561) 968-1100
100 N State Road 7
Margate, FL 33063
Phone (786) 274-2441
100 N State Road 7
Ste 204
Margate, FL 33063
Phone (954) 971-0330
4100 W New Haven Ave
Ste A
Melbourne, FL 32904
Phone (321) 340-7165
4100 W New Haven Ave
Melbourne, FL 32904
13377 W Dixie Hwy
Ste 1
North Miami, FL 33161
14065 W Dixie Hwy
North Miami, FL 33161
Phone (305) 893-8306
13377 W Dixie Hwy
Fl 1
North Miami, FL 33161
Phone (305) 893-8306
19411 NW 2nd Ave
North Miami Beach, FL 33169
Phone (305) 653-1131
1140 S Semoran Blvd
Ste A
Orlando, FL 32807
1880 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 446-4554
7166 N Nob Hill Rd
Tamarac, FL 33321
Phone (786) 583-5100
1960 Pointe West Dr
Vero Beach, FL 32966
Phone (772) 226-4250
7810 S Dixie Hwy
West Palm Bch, FL 33405
Phone (407) 586-5600
1840 Forest Hill Blvd
Ste 102
West Palm Beach, FL 33406
Phone (561) 766-2373
7700 S Dixie Hwy
West Palm Beach, FL 33405
Phone (561) 619-2843
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes | ||
| Clinic/Center | 261Q00000X | |||
| Health Maintenance Organization | 302R00000X |
Addresses
Primary practice location
5055 South Congress Avenue
Suite 303
Lake Worth, FL 33461
Mailing address
1732 S Congress Ave Ste 346
Palm Springs, FL 33461-2140
Phone (561) 385-0731
Other providers in Lake Worth, FL
- PB Laboratories LLC
- PB Medical Group LLC
- PB Medical LLC
- PBND Care Inc
- PBS
- PCP Specialists of the Palm Beaches, LLC
- Beatriz Pealaez
- Monette Pean
- Kevin Joseph Peckovitch
- Pirkko Pedersen
All providers in Lake Worth, FL · Internal Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.