| Bird & Thornton Pa | |
|
557 N Wymore Rd Ste 202 Maitland FL 32751-4200 | |
| (407) 794-8000 | |
| (877) 409-1295 |
| Full Name | Bird & Thornton Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 557 N Wymore Rd Ste 202, Maitland, Florida |
| Authorized Official Name and Position | Karen Marie Baker (OWNER) |
| Authorized Official Contact | 4078551073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bird & Thornton Pa Po Box 940973 Maitland FL 32794-0973 Ph: (407) 855-1073 | Bird & Thornton Pa 557 N Wymore Rd Ste 202 Maitland FL 32751-4200 Ph: (407) 794-8000 |
| NPI Number | 1457567711 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 2466577267 |
|---|---|
| Medicare Enrollment ID | O20100916001205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457567711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Karen M Baker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558378885 PECOS PAC ID: 1951438605 Enrollment ID: I20100428000860 |
| Provider Name | Patricia Cheryl Cantillo-kodzis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295089019 PECOS PAC ID: 3274761986 Enrollment ID: I20150903002893 |
| Provider Name | Cathy Ann Karunaratne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649696998 PECOS PAC ID: 3678876836 Enrollment ID: I20160121001021 |
| Provider Name | Samantha Sugerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720522048 PECOS PAC ID: 1557638566 Enrollment ID: I20170523001567 |
| Provider Name | Shane M Drahos |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1952780934 PECOS PAC ID: 9436424603 Enrollment ID: I20171014000256 |
| Provider Name | Mary A Browne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437271376 PECOS PAC ID: 6800174343 Enrollment ID: I20171110000599 |
| Provider Name | Corrie Marie Bigi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992307029 PECOS PAC ID: 2062803430 Enrollment ID: I20211217001648 |
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