| Alliance Telehealth Network Llc | |
|
3001 E Jackson St Ste A Pensacola FL 32503-6436 | |
| (931) 787-2940 | |
| Not Available |
| Full Name | Alliance Telehealth Network Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3001 E Jackson St Ste A, Pensacola, Florida |
| Authorized Official Name and Position | Debra Barrett Graham (PRESIDENT) |
| Authorized Official Contact | 9317872940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Telehealth Network Llc 40 W Nine Mile Rd Ste 2 Pensacola FL 32534-1267 Ph: (931) 787-2940 | Alliance Telehealth Network Llc 3001 E Jackson St Ste A Pensacola FL 32503-6436 Ph: (931) 787-2940 |
| NPI Number | 1477309789 |
|---|---|
| Provider Enumeration Date | 04/26/2024 |
| Last Update Date | 04/30/2024 |
| Medicare PECOS PAC ID | 2466988308 |
|---|---|
| Medicare Enrollment ID | O20241216001100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477309789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Esha Lestrade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114577392 PECOS PAC ID: 9335569821 Enrollment ID: I20201022001865 |
| Provider Name | Faith Lanette Seck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356512727 PECOS PAC ID: 4880980721 Enrollment ID: I20210930001231 |
| Provider Name | Claire J Lundgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043986276 PECOS PAC ID: 5496143182 Enrollment ID: I20211029000756 |
| Provider Name | Ramon Trinidad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588211627 PECOS PAC ID: 2860829355 Enrollment ID: I20230421000787 |
| Provider Name | Teena-louise Jones White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538462296 PECOS PAC ID: 5799213757 Enrollment ID: I20250106000262 |
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