| Eugene E Wenthe Jr, MD | |
|
1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | |
| (321) 725-4505 | |
| (321) 409-6823 |
| Full Name | Eugene E Wenthe Jr |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1223 Gateway Dr Ste 1e, Melbourne, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003826918 | NPI | - | NPPES |
| 020057300 | Other | IL | BLACK LUNG |
| 036061047 | Other | IL | IL STATE LICENSE |
| 08421024 | Other | IL | BC/BS |
| 170774 | Other | IL | PERSONAL CARE |
| 036061047 | Medicaid | IL | |
| 054913 | Other | IL | HEALTH ALLIANCE |
| 101343 | Other | IL | HEALTHLINK |
| 6394P | Other | IL | CATERPILLAR |
| CD7143 | Other | IL | RR MEDICARE GROUP |
| 080098256 | Other | IL | RR MEDICARE PIN |
| 133586700 | Other | IL | ACS-OWCP |
| 14D0949277 | Other | IL | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036061047 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | ME117071 (Florida) | Primary |
| Entity Name | Midwest Emergency Sparta, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194162370 PECOS PAC ID: 0345481255 Enrollment ID: O20130718000343 |
| Mailing Address | Practice Location Address |
|---|---|
| Eugene E Wenthe Jr, MD 3300 S Fiske Blvd, Rockledge, FL 32955-4306 Ph: () - | Eugene E Wenthe Jr, MD 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 Ph: (321) 725-4505 |
Marta Cyzio, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1368 Tipperary Dr, Melbourne, FL 32940 Phone: 321-213-5625 | |
Dr. Judy Ann Mayor-davies, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2501 W New Haven Ave, Melbourne, FL 32904 Phone: 321-723-9411 Fax: 321-724-8749 | |
Dr. Sandra Ogata Keefe, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 6619 N Wickham Rd, Melbourne, FL 32940 Phone: 321-259-9500 | |
Alexandra Wolf-defigarelli, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1350 Hickory St, Melbourne, FL 32901 Phone: 321-434-1771 Fax: 321-434-1775 | |
Dr. Shirmeej Singh, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1350 Hickory St, Melbourne, FL 32901 Phone: 321-434-1771 Fax: 321-434-1775 | |
Angela Marie Armellini, APRN Family Medicine Medicare: Medicare Enrolled Practice Location: 6619 N Wickham Rd, Melbourne, FL 32940 Phone: 321-259-9500 |