| Community Medical Group | |
|
5615 S Florida Ave Ste 111 Lakeland FL 33813-2714 | |
| (863) 327-0132 | |
| (863) 777-2320 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 5615 S Florida Ave Ste 111, Lakeland, Florida |
| Authorized Official Name and Position | Rayny Ramirez (PRESIDENT) |
| Authorized Official Contact | 7863227333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Group 6100 Blue Lagoon Dr Ste 365 Miami FL 33126-7010 Ph: (786) 208-3237 | Community Medical Group 5615 S Florida Ave Ste 111 Lakeland FL 33813-2714 Ph: (863) 327-0132 |
| NPI Number | 1396391033 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 3476977406 |
|---|---|
| Medicare Enrollment ID | O20200722003508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396391033 | NPI | - | NPPES |
| 106341600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dwayne Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043522618 PECOS PAC ID: 8628342540 Enrollment ID: I20170915001982 |
| Provider Name | Greisy Ash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861992273 PECOS PAC ID: 0345502027 Enrollment ID: I20180315002385 |
| Provider Name | Ivelisse Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497324396 PECOS PAC ID: 6002201381 Enrollment ID: I20220323002336 |
Adult Primary Care Of Polk County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4740 Exploration Ave, Lakeland, FL 33812 Phone: 863-666-9020 Fax: 863-606-0887 | |
Verimed Health Group Lakeland Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1417 Lakeland Hills Blvd, Suite 204, Lakeland, FL 33805 Phone: 813-415-5038 | |
Ethos Health Lakeland, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 625 Commerce Dr Ste 104, Lakeland, FL 33813 Phone: 352-732-5590 Fax: 352-732-0292 | |
Premier Walk In Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5676 S Florida Ave, Lakeland, FL 33813 Phone: 863-644-3400 Fax: 863-619-2400 | |
Central Florida Health Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 903 Lowry Ave, Lakeland, FL 33801 Phone: 866-234-8534 | |
Bond Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2039 E Edgewood Dr, Lakeland, FL 33803 Phone: 863-293-1191 | |
Lake Miriam Campus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4710 S Florida Ave, Lakeland, FL 33813 Phone: 863-284-6800 Fax: 863-284-6807 |