MEDICARE: PRIME RECOVERY CONSULTANTS, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1366179293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME RECOVERY CONSULTANTS, INC

Provider Business Mailing Address
First Line	:	12520 RAMIRO ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33156-6354
Country	:	US
Telephone Number	:	305-793-7318
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 SW 74TH ST STE 305
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5163
Country	:	US
Telephone Number	:	305-793-7318
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. OCTAVIO P. FERNANDEZ
Credential	:	DC
Telephone Number	:	305-793-7318

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	05/28/2026

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