| David Dexter, | |
|
8340 Lakewood Ranch Blvd Ste 290, Lakewood Ranch, FL 34202-5182 | |
| (941) 254-6767 | |
| (941) 213-6991 |
| Full Name | David Dexter |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 35 Years |
| Location | 8340 Lakewood Ranch Blvd Ste 290, Lakewood Ranch, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770585655 | NPI | - | NPPES |
| NL667 | Other | FL | PTAN |
| 109521700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD070484L (Pennsylvania) | Secondary |
| 208600000X | Surgery | ME147949 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lakewood Ranch Medical Center | Bradenton, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Manatee Specialty Physician Alliance Llc | 8921473927 | 25 |
| Entity Name | Manatee Specialty Physician Alliance Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881304624 PECOS PAC ID: 8921473927 Enrollment ID: O20230405000041 |
| Mailing Address | Practice Location Address |
|---|---|
| David Dexter, 367 S Gulph Rd, King Of Prussia, PA 19406-3121 Ph: (941) 254-6767 | David Dexter, 8340 Lakewood Ranch Blvd Ste 290, Lakewood Ranch, FL 34202-5182 Ph: (941) 254-6767 |
Dr. Katherine Moore Keeley, MD Surgery Medicare: Medicare Enrolled Practice Location: 8430 Enterprise Cir, Suite 130, Lakewood Ranch, FL 34202 Phone: 941-366-3000 Fax: 941-366-3002 | |
Anna M Widmyer, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6274 Lake Osprey Dr, Lakewood Ranch, FL 34240 Phone: 941-500-3350 Fax: 941-220-4338 |