MEDICARE: AJM MEDICAL CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	261QC1500X	Community Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194406371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJM MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	306 ALCAZAR AVE STE 200
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4318
Country	:	US
Telephone Number	:	305-967-8725
Fax Number	:	305-967-8446

Provider Business Practice Location Address
First Line	:	306 ALCAZAR AVE STE 200
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4318
Country	:	US
Telephone Number	:	305-967-8725
Fax Number	:	305-967-8446

Authorized Official
Title or Position	:	OWNER
Name	:	MARIETA MANRESA
Credential	:	PHD
Telephone Number	:	786-354-3505

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	08/25/2025

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Directions to “AJM MEDICAL CENTER, LLC ” Practice Location

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