| Florida Neurology Group P L | |
|
12670 Whitehall Dr Fort Myers FL 33907-3619 | |
| (239) 936-3554 | |
| (239) 936-8993 |
| Full Name | Florida Neurology Group P L |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12670 Whitehall Dr, Fort Myers, Florida |
| Authorized Official Name and Position | Debbie A King (BUSINESS MANANGER) |
| Authorized Official Contact | 2399363554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Neurology Group P L 12670 Whitehall Dr Fort Myers FL 33907-3619 Ph: (239) 936-3554 | Florida Neurology Group P L 12670 Whitehall Dr Fort Myers FL 33907-3619 Ph: (239) 936-3554 |
| NPI Number | 1962497669 |
|---|---|
| Provider Enumeration Date | 09/19/2005 |
| Last Update Date | 08/25/2014 |
| Medicare PECOS PAC ID | 0840286407 |
|---|---|
| Medicare Enrollment ID | O20050720000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962497669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Jeffrey R Sonn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275587388 PECOS PAC ID: 6204734528 Enrollment ID: I20031223000722 |
| Provider Name | John Rodriguez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558315069 PECOS PAC ID: 1254239429 Enrollment ID: I20031224000087 |
| Provider Name | Geoffrey A Negin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598719197 PECOS PAC ID: 5890693964 Enrollment ID: I20031229000101 |
| Provider Name | Mai F Saif |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033163142 PECOS PAC ID: 6507764602 Enrollment ID: I20031229000265 |
| Provider Name | Thomas G Presbrey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801834940 PECOS PAC ID: 0941108062 Enrollment ID: I20031229000399 |
| Provider Name | Joseph E Tienstra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366499329 PECOS PAC ID: 8628976677 Enrollment ID: I20031229000609 |
| Provider Name | Ann Wood Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194775148 PECOS PAC ID: 9335122035 Enrollment ID: I20040612000033 |
| Provider Name | Gregory Michaels |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821044553 PECOS PAC ID: 3072588201 Enrollment ID: I20040831000689 |
| Provider Name | Lane R Carlin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033112263 PECOS PAC ID: 0042247124 Enrollment ID: I20060131000616 |
| Provider Name | Paul F Driscoll |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376546598 PECOS PAC ID: 4688601768 Enrollment ID: I20060131000661 |
| Provider Name | Chris J Marino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417950635 PECOS PAC ID: 9537173380 Enrollment ID: I20060131000706 |
| Provider Name | Sharik Rathur |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538243555 PECOS PAC ID: 0143229005 Enrollment ID: I20061204000475 |
| Provider Name | Gerardo A Gamez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245240829 PECOS PAC ID: 6204939275 Enrollment ID: I20070312000469 |
| Provider Name | Gail M Santucci |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235187808 PECOS PAC ID: 1658380688 Enrollment ID: I20070906000473 |
| Provider Name | Louis T Magas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366646424 PECOS PAC ID: 5890860845 Enrollment ID: I20080826000593 |
| Provider Name | Jamal Samih Ksar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801007646 PECOS PAC ID: 5193880268 Enrollment ID: I20100922001211 |
| Provider Name | Cory C Duffek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356391908 PECOS PAC ID: 2062604820 Enrollment ID: I20101012000541 |
| Provider Name | Dawn M Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801192919 PECOS PAC ID: 0941420996 Enrollment ID: I20140925001778 |
| Provider Name | John Patrick Sullivan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356353965 PECOS PAC ID: 9335232214 Enrollment ID: I20151117002029 |
| Provider Name | Anthony C Brown |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144486770 PECOS PAC ID: 9537304704 Enrollment ID: I20160726002678 |
| Provider Name | Konstantin Dzamashvili |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174529085 PECOS PAC ID: 7517953607 Enrollment ID: I20160812001746 |
| Provider Name | Sanjeev Maniar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851352181 PECOS PAC ID: 7719967363 Enrollment ID: I20170811003071 |
| Provider Name | Nattasha Acevedo Ramirez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366786451 PECOS PAC ID: 7214217793 Enrollment ID: I20180724000597 |
| Provider Name | Shannon Leigh Mims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457828899 PECOS PAC ID: 5698019396 Enrollment ID: I20181206002825 |
| Provider Name | Estefania Schiavi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811465503 PECOS PAC ID: 3274879929 Enrollment ID: I20190116003572 |
| Provider Name | Nicole J Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639115355 PECOS PAC ID: 6507860731 Enrollment ID: I20190206000094 |
| Provider Name | Nakiya Marissa Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942833017 PECOS PAC ID: 8426486499 Enrollment ID: I20200325002915 |
| Provider Name | Rachel Lynn Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245860410 PECOS PAC ID: 8729417787 Enrollment ID: I20200326003607 |
| Provider Name | Terry Jenard Fox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407275118 PECOS PAC ID: 5597196873 Enrollment ID: I20200521000676 |
| Provider Name | Christopher Thomas Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730705021 PECOS PAC ID: 3476979014 Enrollment ID: I20200813001903 |
| Provider Name | Michael Pfister Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487039970 PECOS PAC ID: 4981000478 Enrollment ID: I20210908004019 |
| Provider Name | Amanda Leigh Dendis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881160695 PECOS PAC ID: 0244571289 Enrollment ID: I20210916000769 |
| Provider Name | Danaya Lopez Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992488324 PECOS PAC ID: 4981051752 Enrollment ID: I20231116000215 |
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