Look up the most recent NPI and PECOS records

Pena Medical Office

Clinic/Center

Ambulatory Health Care Facilities

PECOS Enrollment

Based on the most recent information from CMS, provider Pena Medical Office does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 4:18 PM.

Profile Details

Provider ID
1639439318
Provider Type
Organization
Full Name
Pena Medical Office

Subpart
No
Enumeration Date
5/29/2012
Last Updated
5/29/2012

Contact Information

Practice Location

3205 W 16th Ave, Hialeah, FL 33012-4640

(786) 380-7465

Unlisted Fax

Mailing Location

3205 W 16th Ave, Hialeah, FL 33012-4640

Unlisted Phone

Unlisted Fax

Authorized Official

Pena, Yosvany (President)

(786) 380-7465

Provider Taxonomies

Code	Description	License
Code 261Q00000X Primary	Description Clinic/Center Ambulatory Health Care Facilities	License Unlisted Issuer
Code 261QH0100X	Description Clinic/Center Ambulatory Health Care Facilities	License Unlisted Issuer

Pena Medical Office

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

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