| Cooper Family Medical Pllc | |
|
5101 4th Avenue Cir E Suite 200 Bradenton FL 34208-5630 | |
| (941) 744-5510 | |
| (941) 744-5166 |
| Full Name | Cooper Family Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5101 4th Avenue Cir E, Bradenton, Florida |
| Authorized Official Name and Position | Catherine Cooper (PHYSICIAN) |
| Authorized Official Contact | 9417445510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooper Family Medical Pllc 5123 4th Avenue Cir E Bradenton FL 34208-5620 Ph: (941) 744-5510 | Cooper Family Medical Pllc 5101 4th Avenue Cir E Suite 200 Bradenton FL 34208-5630 Ph: (941) 744-5510 |
| NPI Number | 1871513192 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 09/25/2023 |
| Medicare PECOS PAC ID | 9931171782 |
|---|---|
| Medicare Enrollment ID | O20040811000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871513192 | NPI | - | NPPES |
| 74797 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Christopher M Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770565467 PECOS PAC ID: 7810969672 Enrollment ID: I20040813000109 |
| Provider Name | Catherine Mauldin Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558343244 PECOS PAC ID: 1456323211 Enrollment ID: I20040901000578 |
| Provider Name | Andrew R Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912988635 PECOS PAC ID: 1951343235 Enrollment ID: I20050526000345 |
| Provider Name | Natalie E Borg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841447364 PECOS PAC ID: 6103969670 Enrollment ID: I20100205000213 |
| Provider Name | James M Pineno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578862447 PECOS PAC ID: 4486832656 Enrollment ID: I20110617000505 |
| Provider Name | Alyson Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790063246 PECOS PAC ID: 5698948529 Enrollment ID: I20111109000331 |
| Provider Name | Tania L Cruickshank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447505425 PECOS PAC ID: 1951545607 Enrollment ID: I20130918000700 |
| Provider Name | Bijal J Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184986663 PECOS PAC ID: 8527286137 Enrollment ID: I20140822002377 |
| Provider Name | Megan E Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023493038 PECOS PAC ID: 8123337912 Enrollment ID: I20151019000172 |
| Provider Name | Michelle G Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245536697 PECOS PAC ID: 1456538503 Enrollment ID: I20160224000136 |
| Provider Name | Cassandra M. Hafner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336562313 PECOS PAC ID: 6103113048 Enrollment ID: I20160921001099 |
| Provider Name | Samuel Dickmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831517317 PECOS PAC ID: 0840418620 Enrollment ID: I20170627000631 |
| Provider Name | Sabrina Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073035622 PECOS PAC ID: 0941573778 Enrollment ID: I20170830001195 |
| Provider Name | Carlina White-youssouf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841693595 PECOS PAC ID: 2365751062 Enrollment ID: I20181231001343 |
| Provider Name | Joseph I Haider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962943746 PECOS PAC ID: 2668896101 Enrollment ID: I20200716003625 |
| Provider Name | Angela Lynn Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528729993 PECOS PAC ID: 0648639542 Enrollment ID: I20230711001077 |
| Provider Name | Jon Michael Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942998513 PECOS PAC ID: 1759744345 Enrollment ID: I20230830000706 |
| Provider Name | Lauren Ricchiuti-jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164042966 PECOS PAC ID: 2466897442 Enrollment ID: I20240229001537 |
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