| Bluegrass Id Associated LLC | |
|
5200 Babcock St Ne Ste 303 Palm Bay FL 32905-4648 | |
| (321) 499-3077 | |
| (888) 440-8238 |
| Full Name | Bluegrass Id Associated LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 5200 Babcock St Ne Ste 303, Palm Bay, Florida |
| Authorized Official Name and Position | Oriana Ramirez (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3214993077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Id Associated LLC 5200 Babcock St Ne Ste 303 Palm Bay FL 32905-4648 Ph: (321) 499-3077 | Bluegrass Id Associated LLC 5200 Babcock St Ne Ste 303 Palm Bay FL 32905-4648 Ph: (321) 499-3077 |
| NPI Number | 1588402044 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 06/17/2026 |
| Certification Date | 06/17/2026 |
| Medicare PECOS PAC ID | 0941749634 |
|---|---|
| Medicare Enrollment ID | O20240826003470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588402044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | () | Primary |
| Provider Name | Sheree Ewar Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942686969 PECOS PAC ID: 2264748839 Enrollment ID: I20150826002686 |
| Provider Name | Ashraf A. M. Ahmed |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679690093 PECOS PAC ID: 7911080262 Enrollment ID: I20200317001507 |
| Provider Name | Gabriel a Vilchez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1407274491 PECOS PAC ID: 6002168192 Enrollment ID: I20230908003416 |
| Provider Name | Oriana Ramirez Alvarado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295257921 PECOS PAC ID: 8224455258 Enrollment ID: I20250723002955 |
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