Access Medical Group of Pembroke Pines, LLC
Organization Active NPI Family Medicine Physician · Pembroke Pines, FL
NPI 1235876004 · NPPES record last updated Oct 19, 2023
Key facts
- NPI
- 1235876004
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ACCESS MEDICAL GROUP OF PEMBROKE PINES, LLC
- Practice address
- 10060 NW 7TH St Unit 10
Pembroke Pines, FL 33024-6158 - Phone
- (954) 606-0110
- Fax
- (954) 495-4162
- NPI assigned
- May 13, 2022
- Organization subpart
- No
Authorized official
- Name
- Mr. Rayny Ramirez
- Title
- President
- Phone
- (786) 322-7333
Practitioners 3
-
Victoria L Diez, APRN
-
Rajiv N Patel, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2270093 | Community Medical Group | Certificate of waiver | Oct 9, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230427003163 | FL | Part B Supplier - Clinic/Group Practice | 0941665848 |
Receives reassigned benefits from 2 practitioners Practice locations: Pembroke Pines, FL |
National Provider Directory
Locations
701 NW 99th Ave
Unit 10
Pembroke Pines, FL 33024
10060 NW 7th St
Unit 10
Pembroke Pines, FL 33024
Phone (954) 606-0110
10060 NW 7th St
Ste 10
Pembroke Pines, FL 33024
Networks
- HealthSun Health Plans Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
10060 NW 7TH St Unit 10
Pembroke Pines, FL 33024-6158
Mailing address
6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117583400 | Medicaid | FL |
Other names
- Community Medical Group
Other providers in Pembroke Pines, FL
- Abys Home Services LLC
- Abz Care Services Corp
- Acadia Neuro-Behavioral Associates PA
- Access Medical Care Inc.
- Access Medical Care Inc.
- Accountable Billing Services & Consulting Firm
- Accuchoice LLC
- Accustat Mobile Labs
- Ace Home Health Corp
- Elsa Marina Acevedo Martinez
All providers in Pembroke Pines, FL · Family 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 Oct 19, 2023. 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.