Provider Demographics
NPI:1760296180
Name:OPEN GATES MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:OPEN GATES MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILERA ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-724-1119
Mailing Address - Street 1:99 NW 183RD ST STE 133
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4531
Mailing Address - Country:US
Mailing Address - Phone:561-724-1119
Mailing Address - Fax:
Practice Address - Street 1:99 NW 183RD ST STE 133
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4531
Practice Address - Country:US
Practice Address - Phone:561-724-1119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center