| Brandon-riverview Medical Associates PA | |
|
519 E Bloomingdale Ave Ste A Brandon FL 33511-8180 | |
| (813) 655-4100 | |
| (813) 655-1775 |
| Full Name | Brandon-riverview Medical Associates PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 519 E Bloomingdale Ave Ste A, Brandon, Florida |
| Authorized Official Name and Position | Jagdeep S Sandhu (OWNER) |
| Authorized Official Contact | 8136554100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon-riverview Medical Associates PA 519 E Bloomingdale Ave Ste A Brandon FL 33511-8180 Ph: (813) 355-4100 | Brandon-riverview Medical Associates PA 519 E Bloomingdale Ave Ste A Brandon FL 33511-8180 Ph: (813) 655-4100 |
| NPI Number | 1235411000 |
|---|---|
| Provider Enumeration Date | 09/16/2011 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 1456518430 |
|---|---|
| Medicare Enrollment ID | O20120202000230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235411000 | NPI | - | NPPES |
| 002M1 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Mindy Teresa Dolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598065211 PECOS PAC ID: 0446432322 Enrollment ID: I20110314000946 |
| 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 |
| Provider Name | Dalisay N Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558382960 PECOS PAC ID: 1850470832 Enrollment ID: I20150825003995 |
| Provider Name | Lori Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558731158 PECOS PAC ID: 5496059867 Enrollment ID: I20160204001180 |
| Provider Name | Chimere Branton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386295541 PECOS PAC ID: 3577895622 Enrollment ID: I20191023001033 |
| Provider Name | Sara Rose Caracostas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134901465 PECOS PAC ID: 4385092568 Enrollment ID: I20231128003737 |
| Provider Name | Crystal Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952155772 PECOS PAC ID: 6002350121 Enrollment ID: I20240701001482 |
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