| Access Brandon-riverview LLC | |
|
13111 Us Highway 301 S Riverview FL 33578-7401 | |
| (813) 671-0064 | |
| (813) 672-2153 |
| Full Name | Access Brandon-riverview LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 13111 Us Highway 301 S, Riverview, Florida |
| Authorized Official Name and Position | Karen P Hayes (CFO) |
| Authorized Official Contact | 3527990046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Access Brandon-riverview LLC 14690 Spring Hill Dr Ste 100 Spring Hill FL 34609-8102 Ph: (352) 799-0046 | Access Brandon-riverview LLC 13111 Us Highway 301 S Riverview FL 33578-7401 Ph: (813) 671-0064 |
| NPI Number | 1578335535 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 7517457336 |
|---|---|
| Medicare Enrollment ID | O20251108000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578335535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Jagdeep S. Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528034477 PECOS PAC ID: 1658274352 Enrollment ID: I20120127000222 |
| Provider Name | Ravneet K Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518933456 PECOS PAC ID: 0749183440 Enrollment ID: I20120316000320 |
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