| Chheng Ly, | |
|
5309 E State Road 64, Bradenton, FL 34208-5534 | |
| (941) 747-9818 | |
| Not Available |
| Full Name | Chheng Ly |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 6 Years |
| Location | 5309 E State Road 64, Bradenton, Florida |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235738204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 58645 (California) | Secondary |
| 363A00000X | Physician Assistant | PA9115734 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| H Lee Moffitt Cancer Center & Research Institute I | Tampa, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc | 2264337021 | 1145 |
| Entity Name | H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306833595 PECOS PAC ID: 2264337021 Enrollment ID: O20031204000575 |
| Entity Name | Smh Physician Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346295292 PECOS PAC ID: 1355240177 Enrollment ID: O20031231000211 |
| Entity Name | Mcr Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255376000 PECOS PAC ID: 7214847995 Enrollment ID: O20040126000213 |
| Mailing Address | Practice Location Address |
|---|---|
| Chheng Ly, 101 Riverfront Blvd Ste 710, Bradenton, FL 34205-8812 Ph: (941) 776-4000 | Chheng Ly, 5309 E State Road 64, Bradenton, FL 34208-5534 Ph: (941) 747-9818 |
Marcie Kroska, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 206 2nd St E, Bradenton, FL 34208 Phone: 941-746-5111 Fax: 941-745-7233 |
Krystina Marian Hadra, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4502 Cortez Rd W Ste 205, Bradenton, FL 34210 Phone: 941-259-8505 Fax: 941-259-8501 |
Mindy Oberley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 59th St W Ste 2200, Bradenton, FL 34209 Phone: 941-794-5621 |
Mr. Daniel H Ober, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 315 75th St W, Bradenton, FL 34209 Phone: 941-761-1616 Fax: 941-761-3807 |
Jamie Lee Miller, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8000 Sr 64 E, Bradenton, FL 34212 Phone: 941-792-1404 Fax: 941-761-0712 |
Georgia Ireland, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5318 34th St West, Bradenton, FL 34210 Phone: 941-758-0205 |
Erin N Allendorfer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 206 2nd St E, Bradenton, FL 34208 Phone: 941-746-5111 Fax: 941-745-7233 |