| Partners Family Medicine Practice & Recovery Center Inc | |
|
4453 Highway 90 Pace FL 32571-2066 | |
| (850) 905-0110 | |
| Not Available |
| Full Name | Partners Family Medicine Practice & Recovery Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4453 Highway 90, Pace, Florida |
| Authorized Official Name and Position | Laura Maupin (OWNER) |
| Authorized Official Contact | 8509050110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Partners Family Medicine Practice & Recovery Center Inc 5264 Emerald Dr Pace FL 32571-9067 Ph: () - | Partners Family Medicine Practice & Recovery Center Inc 4453 Highway 90 Pace FL 32571-2066 Ph: (850) 905-0110 |
| NPI Number | 1396364899 |
|---|---|
| Provider Enumeration Date | 04/14/2020 |
| Last Update Date | 09/04/2020 |
| Certification Date | 09/04/2020 |
| Medicare PECOS PAC ID | 6800213851 |
|---|---|
| Medicare Enrollment ID | O20200904001421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396364899 | NPI | - | NPPES |
| Provider Name | Kevin D Maupin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598779811 PECOS PAC ID: 4284652538 Enrollment ID: I20051105000167 |
| Provider Name | Susan L Speropulos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508950478 PECOS PAC ID: 7911911045 Enrollment ID: I20060127000609 |
| Provider Name | Laura Maupin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508383407 PECOS PAC ID: 1850621392 Enrollment ID: I20200904001451 |
| Provider Name | Rosemary Ireri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356793020 PECOS PAC ID: 5395021315 Enrollment ID: I20201030001204 |
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