| Samuel Fitzsimons Ravenel Ii, MD | |
|
6671 Caroline St, Milton, FL 32570-4781 | |
| (850) 981-9433 | |
| (850) 981-9436 |
| Full Name | Samuel Fitzsimons Ravenel Ii |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 6671 Caroline St, Milton, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184679375 | NPI | - | NPPES |
| 017919600 | Medicaid | FL | |
| M8P04 | Other | FL | BCBS FL |
| KD915 | Other | FL | MCR FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | ME128058 (Florida) | Primary |
| Entity Name | Escambia Community Clinics Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518971597 PECOS PAC ID: 9638165806 Enrollment ID: O20040422001135 |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Fitzsimons Ravenel Ii, MD 2315 W Jackson St, Pensacola, FL 32505-7552 Ph: (850) 436-4630 | Samuel Fitzsimons Ravenel Ii, MD 6671 Caroline St, Milton, FL 32570-4781 Ph: (850) 981-9433 |
Dr. John Arthur Vanostenbridge, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5834 Berryhill Rd, Milton, FL 32570 Phone: 850-623-5437 Fax: 850-626-7803 | |
Mary Cross, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 6002 Berryhill Rd, Milton, FL 32570 Phone: 706-575-4800 | |
Dr. Luis A Ghiglino, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5962 Berryhill Rd, Milton, FL 32570 Phone: 850-983-3700 Fax: 850-983-0970 | |
Dr. Lelia F Montes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5962 Berryhill Rd, Milton, FL 32570 Phone: 850-623-0124 Fax: 850-626-9110 | |
Miss Madeline Paige Lemoine, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5834 Berryhill Rd, Milton, FL 32570 Phone: 850-623-5437 Fax: 850-626-7803 |