| Dr Maxime G Gedeon, MD | |
| 2310 North Blvd W Ste A, Davenport, FL 33837-8988 | |
| (813) 701-5804 | |
| (813) 291-7615 | 
| Full Name | Dr Maxime G Gedeon | 
|---|---|
| Gender | Male | 
| Speciality | Anesthesiology - Pain Medicine | 
| Location | 2310 North Blvd W Ste A, Davenport, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1720074487 | NPI | - | NPPES | 
| 875476 | Other | PA | BLUE SHIELD | 
| 0015959640008 | Medicaid | PA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207LP2900X | Anesthesiology - Pain Medicine | MD059432L (Pennsylvania) | Secondary | 
| 207LP2900X | Anesthesiology - Pain Medicine | ME166986 (Florida) | Primary | 
| Entity Name | Florida Pain And Rehabilitation Associates Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053363457 PECOS PAC ID: 6204732605 Enrollment ID: O20031219000145 | 
| Entity Name | Excel Pain And Spine Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1063028587 PECOS PAC ID: 8123447869 Enrollment ID: O20200930001765 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Maxime G Gedeon, MD 3501 Bessie Coleman Blvd Unit 25201, Tampa, FL 33622-9130 Ph: (813) 701-5804 | Dr Maxime G Gedeon, MD 2310 North Blvd W Ste A, Davenport, FL 33837-8988 Ph: (813) 701-5804 | 
| Tom Porter, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 141 Webb Dr, Ste. 200, Davenport, FL 33837 Phone: 863-422-0020 Fax: 863-422-0021 | |
| Neal Shah, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2310 North Blvd W Ste A, Davenport, FL 33837 Phone: 863-732-7246 Fax: 863-256-2520 | |
| Mark D Tran, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 40100 Highway 27, Davenport, FL 33837 Phone: 863-422-4971 | |
| Janelle Mcneil-masuka, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 2310 North Blvd W Ste A, Davenport, FL 33837 Phone: 813-701-5804 Fax: 813-291-7615 |