| Kimberly Grant Mansell, DO | |
|
2500 Harbor Blvd, Port Charlotte, FL 33952-5000 | |
| (941) 625-4155 | |
| (941) 625-4155 |
| Full Name | Kimberly Grant Mansell |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2500 Harbor Blvd, Port Charlotte, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952352239 | NPI | - | NPPES |
| PENDING | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | A-1350-06 (New Mexico) | Primary |
| Entity Name | Emergency Specialists Of Wellington Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720038391 PECOS PAC ID: 7416978135 Enrollment ID: O20051209000314 |
| Entity Name | Solantic/south Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851344378 PECOS PAC ID: 5496762171 Enrollment ID: O20060321000740 |
| Entity Name | Blue Radiology Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174976468 PECOS PAC ID: 9032407382 Enrollment ID: O20161019001652 |
| Entity Name | Em Alliance Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922788959 PECOS PAC ID: 4789039058 Enrollment ID: O20231006002499 |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Grant Mansell, DO Po Box 510209, Punta Gorda, FL 33951-0209 Ph: (941) 347-8317 | Kimberly Grant Mansell, DO 2500 Harbor Blvd, Port Charlotte, FL 33952-5000 Ph: (941) 625-4155 |
Dr. Robert Leyrer, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 305-665-4614 | |
Marc J Farraye, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4125 | |
Kevin J Desantis, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1912 Kings Hwy Unit 700, Port Charlotte, FL 33980 Phone: 941-255-0032 Fax: 941-391-5213 | |
Dr. John Atiyeh, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4125 Fax: 941-766-4101 | |
Raymond Allen James, DO Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 21298 Olean Blvd, Port Charlotte, FL 33952 Phone: 941-627-6130 Fax: 941-627-6146 | |
Dr. Matthew Wiesinger, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4122 | |
Daniel O'leary, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 305-665-4614 |