| Lateisha Reynolds, | |
|
4300 Sw 13th St, Gainesville, FL 32608-4006 | |
| (352) 374-5600 | |
| (352) 374-5608 |
| Full Name | Lateisha Reynolds |
|---|---|
| Gender | Female |
| Speciality | Counselor |
| Location | 4300 Sw 13th St, Gainesville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477854933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Lateisha Reynolds, 4300 Sw 13th St, Gainesville, FL 32608-4006 Ph: (352) 374-5600 | Lateisha Reynolds, 4300 Sw 13th St, Gainesville, FL 32608-4006 Ph: (352) 374-5600 |
Roger Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 | |
Joseph Palmer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 | |
Kelly Miller, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 Fax: 352-374-5608 | |
Shannon Moser, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 Fax: 352-374-5608 | |
Erica S Mosley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th Street, Gainesville, FL 32608 Phone: 352-374-5600 | |
Kyeesha Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 Fax: 352-374-5600 | |
Crystal Biggers, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 |