| Steven Mark Anthony Requena, NP | |
|
1600 Sw Archer Rd, Gainesville, FL 32610-8553 | |
| (352) 273-5159 | |
| Not Available |
| Full Name | Steven Mark Anthony Requena |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 1600 Sw Archer Rd, Gainesville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063258994 | NPI | - | NPPES |
| 126787600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 352149 (New York) | Secondary |
| 363L00000X | Nurse Practitioner | APRN11035022 (Florida) | Primary |
| Entity Name | Flagler Professional Health Care Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023672573 PECOS PAC ID: 4082973953 Enrollment ID: O20190729002457 |
| Entity Name | Villages Regional Hospital Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700669926 PECOS PAC ID: 0244688893 Enrollment ID: O20231121001709 |
| Mailing Address | Practice Location Address |
|---|---|
| Steven Mark Anthony Requena, NP Po Box 740861, Atlanta, GA 30374-0861 Ph: (904) 819-4539 | Steven Mark Anthony Requena, NP 1600 Sw Archer Rd, Gainesville, FL 32610-8553 Ph: (352) 273-5159 |
Susan Lynette Fort, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2528 Nw 32nd St, Gainesville, FL 32605 Phone: 352-224-8161 Fax: 321-320-8780 | |
Xenia T Blount, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Po Box 100224, Gainesville, FL 32610 Phone: 352-273-7832 Fax: 352-273-7849 | |
Mrs. Brandace Michele Kenworthy, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 352-265-0111 | |
Miss Sadaf Nazar Malik, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 904-265-0111 | |
Mrs. Sara Renee West, FNP-C, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 352-273-9000 Fax: 352-392-8413 | |
Sandrie Rose Dieujuste, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 Sw Archer Rd, Gainesville, FL 32610 Phone: 352-265-0045 | |
Holly Willis, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1601 Sw Archer Rd., Gainesville, FL 32608 Phone: 352-548-6000 |