| Mr Jackson E Tillquist, ARNP | |
|
1840 Mease Dr, Suite 200, Safety Harbor, FL 34695-6602 | |
| (727) 724-8611 | |
| (727) 724-0425 |
| Full Name | Mr Jackson E Tillquist |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 1840 Mease Dr, Safety Harbor, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720442940 | NPI | - | NPPES |
| 018482900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WC0200X | Registered Nurse - Critical Care Medicine | 9258226 (Florida) | Secondary |
| 363L00000X | Nurse Practitioner | ARNP9258226 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Baycare Medical Group, Inc. | 6406753623 | 1356 |
| Entity Name | Baycare Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043269871 PECOS PAC ID: 6406753623 Enrollment ID: O20031216000718 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jackson E Tillquist, ARNP Po Box 10744, Clearwater, FL 33757-8744 Ph: (727) 532-0002 | Mr Jackson E Tillquist, ARNP 1840 Mease Dr, Suite 200, Safety Harbor, FL 34695-6602 Ph: (727) 724-8611 |
Gillian Leeder, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1840 Mease Dr Ste 300, Safety Harbor, FL 34695 Phone: 727-785-6011 Fax: 877-331-6124 | |
Danielle Konrad, APRN-C Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 1840 Mease Dr Ste 402, Safety Harbor, FL 34695 Phone: 727-330-7652 | |
Lena Marie Willis, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 915 Harbor Hill Dr, Safety Harbor, FL 34695 Phone: 727-902-0205 | |
Charlotte Louise Von Holleben, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695 Phone: 727-725-6863 Fax: 727-725-6734 | |
Stephanos Nicholas Tsongranis, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695 Phone: 727-487-4189 | |
Lisa Marie Lauderdale, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1840 Mease Dr, Suite 402, Safety Harbor, FL 34695 Phone: 727-330-7652 | |
Staci Nicole Rosen, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1840 Mease Dr Ste 202, Safety Harbor, FL 34695 Phone: 727-725-6246 |