Blue Medici Corporation
Organization Active NPI Internal Medicine Physician · Pinecrest, FL
NPI 1942927231 · NPPES record last updated Nov 1, 2022
Key facts
- NPI
- 1942927231
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- BLUE MEDICI CORPORATION
- Practice address
- 12780 SW 71St Ave
Pinecrest, FL 33156-6239 - Phone
- (787) 902-2594
- Fax
- (305) 470-1853
- NPI assigned
- Oct 26, 2022
- Organization subpart
- No
Authorized official
- Name
- Luis Hernandez Rosado, MD
- Title
- Owner
- Phone
- (787) 902-2594
Practitioners 2
-
Luis Hernandez Rosado, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221208000577 | FL | Part B Supplier - Clinic/Group Practice | 4587033865 |
Receives reassigned benefits from 2 practitioners Practice locations: Pinecrest, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
12780 SW 71St Ave
Pinecrest, FL 33156-6239
Mailing address
12780 SW 71St Ave
Pinecrest, FL 33156-6239
Phone (787) 902-2594
Other practice location 1
9333 SW 152nd St
Palmetto Bay, FL 33157-1778
Phone (305) 251-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144527466 | Other | FL | INDIVIDUAL NPI |
Other providers in Pinecrest, FL
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- Michele Cherie Benz
- Dorian Bermudez
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- Cynthia Marie Bloom
- Natalie Bollt
- Emily Bortnik
- Ronald Jess Boswell
- Julia Bowman
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All providers in Pinecrest, 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 Nov 1, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.