| Macdermott Group, Llc | |
|
2940 Mallory Cir Ste 205, Kissimmee, FL 34747-1818 | |
| (407) 507-6976 | |
| Not Available |
| Full Name | Macdermott Group, Llc |
|---|---|
| Type | Facility |
| Speciality | Nurse Practitioner |
| Location | 2940 Mallory Cir Ste 205, Kissimmee, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689902199 | NPI | - | NPPES |
| 1689902199 | Other | FL | GROUP NPI |
| 2201B | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Bret J Macdermott |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417035940 PECOS PAC ID: 9436125648 Enrollment ID: I20091229000025 |
| Provider Name | James T Dishman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689680340 PECOS PAC ID: 2961439047 Enrollment ID: I20120420000403 |
| Provider Name | Luis Alejandro Rosado |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124430301 PECOS PAC ID: 9739474834 Enrollment ID: I20160829002372 |
| Provider Name | Caitlin Reilly Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225623291 PECOS PAC ID: 6901296615 Enrollment ID: I20211210001541 |
| Provider Name | Francesca Alexis St Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508409277 PECOS PAC ID: 2365827458 Enrollment ID: I20220909000887 |
| Provider Name | Jeremy Scott Good |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669632253 PECOS PAC ID: 7214004209 Enrollment ID: I20240912000336 |
| Mailing Address | Practice Location Address |
|---|---|
| Macdermott Group, Llc 2940 Mallory Cir Ste 205, Kissimmee, FL 34747-1818 Ph: (407) 507-6976 | Macdermott Group, Llc 2940 Mallory Cir Ste 205, Kissimmee, FL 34747-1818 Ph: (407) 507-6976 |