| Back In Action Medical Center Llc | |
|
2351 Sw Martin Hwy Palm City FL 34990-3222 | |
| (772) 324-9337 | |
| (772) 324-9347 |
| Full Name | Back In Action Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 2351 Sw Martin Hwy, Palm City, Florida |
| Authorized Official Name and Position | Robert Mclaughlin (OWNER) |
| Authorized Official Contact | 7723249337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Back In Action Medical Center Llc 2351 Sw Martin Hwy Palm City FL 34990-3222 Ph: (772) 324-9337 | Back In Action Medical Center Llc 2351 Sw Martin Hwy Palm City FL 34990-3222 Ph: (772) 324-9337 |
| NPI Number | 1093183733 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 7810272473 |
|---|---|
| Medicare Enrollment ID | O20170321002639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093183733 | NPI | - | NPPES |
| 99VRH | Other | FL | BCBS FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (Florida) | Secondary |
| 208D00000X | General Practice | (Florida) | Primary |
| Provider Name | Mark D Polsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265400709 PECOS PAC ID: 8527962596 Enrollment ID: I20031121000168 |
| Provider Name | Robert Denton Mclaughlin |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245354091 PECOS PAC ID: 3577653351 Enrollment ID: I20071217000595 |
| Provider Name | Lauren V Hanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376197921 PECOS PAC ID: 8325379787 Enrollment ID: I20191016001194 |
| Provider Name | Cameale Smart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275799439 PECOS PAC ID: 7012188949 Enrollment ID: I20200528000819 |
| Provider Name | Jeffrey D Laman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871020297 PECOS PAC ID: 3870861685 Enrollment ID: I20200715003351 |
| Provider Name | Patrick Walther |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1629678677 PECOS PAC ID: 1759796311 Enrollment ID: I20210212002372 |
| Provider Name | Misty V Gaddis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841852266 PECOS PAC ID: 7911308341 Enrollment ID: I20210623001517 |
| Provider Name | Kelly Elizabeth Kane |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265057392 PECOS PAC ID: 0042637829 Enrollment ID: I20230601001793 |
| Provider Name | Corey A Stein |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1235306150 PECOS PAC ID: 0446238323 Enrollment ID: I20230719003447 |
| Provider Name | Lara Lyn Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346414745 PECOS PAC ID: 4880097021 Enrollment ID: I20240415000242 |
| Provider Name | Nicholas Tisdale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962023754 PECOS PAC ID: 7012330194 Enrollment ID: I20241230001220 |
| Provider Name | Lyne P Bergeron-miletich |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1396338091 PECOS PAC ID: 2668889312 Enrollment ID: I20250312000939 |
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