| Dr Agnes Idicula, | |
|
10065 Cortez Blvd, Weeki Wachee, FL 34613-6389 | |
| (352) 596-4660 | |
| (352) 596-4674 |
| Full Name | Dr Agnes Idicula |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Location | 10065 Cortez Blvd, Weeki Wachee, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568464824 | NPI | - | NPPES |
| 45554 | Other | FL | MEDICARE&BCBS GROUP # |
| 110213555 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME59607 (Florida) | Primary |
| Entity Name | Idicula Medical Associates Md Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982781688 PECOS PAC ID: 0840290730 Enrollment ID: O20061227000081 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Agnes Idicula, 10065 Cortez Blvd, Weeki Wachee, FL 34613-6389 Ph: (352) 596-4660 | Dr Agnes Idicula, 10065 Cortez Blvd, Weeki Wachee, FL 34613-6389 Ph: (352) 596-4660 |
Dr. Gaurav Mathur, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 10065 Cortez Blvd, Weeki Wachee, FL 34613 Phone: 352-596-4660 Fax: 352-596-4674 | |
Durgarao Venkata Parimi, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 10065 Cortez Blvd, Weeki Wachee, FL 34613 Phone: 352-596-4660 Fax: 352-596-4674 | |
Dr. Roger B Lee, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 8562 Delaware Dr, Weeki Wachee, FL 34607 Phone: 352-650-2039 | |
Dr. Randolph Mendoza Nunag, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 10222 Yale Ave, Weeki Wachee, FL 34613 Phone: 352-597-9797 Fax: 352-597-5556 | |
Georges Junior Joseph, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 10065 Cortez Blvd, Weeki Wachee, FL 34613 Phone: 352-596-4660 Fax: 352-596-4674 | |
Mr. Andre M Brooks, M.D Internal Medicine Medicare: Medicare Enrolled Practice Location: 10145 Cortez Blvd, Weeki Wachee, FL 34613 Phone: 352-597-4631 Fax: 352-597-0076 |