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Organization
LEGACY MEDICAL CLINICS
Active
Organization
LEGACY MEDICAL CLINICS
Active
Other names
Success Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD GONCALVES (MANAGER)
(786) 261-3143
Entity
Organization
Contact information
Practice address
830 N KROME AVE, HOMESTEAD, FL 33030-4407
(305) 726-2084
Mailing address
129 SEVILLA AVE, CORAL GABLES, FL 33134-6006
(786) 761-5935
(386) 761-5936
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
09/21/2021
Last updated
04/09/2025
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