| Countryside Medical Pa | |
|
7860 Sw 103rd Street Rd Bldg 100 Suite 101 Ocala FL 34476-8623 | |
| (352) 873-4458 | |
| (352) 873-8116 |
| Full Name | Countryside Medical Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 7860 Sw 103rd Street Rd, Ocala, Florida |
| Authorized Official Name and Position | Kenneth Baruch Lee (OWNER PRESIDENT) |
| Authorized Official Contact | 3528734458 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Countryside Medical Pa Po Box 770719 Ocala FL 34477-0719 Ph: (352) 873-4458 | Countryside Medical Pa 7860 Sw 103rd Street Rd Bldg 100 Suite 101 Ocala FL 34476-8623 Ph: (352) 873-4458 |
| NPI Number | 1275610362 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/01/2023 |
| Medicare PECOS PAC ID | 2860460318 |
|---|---|
| Medicare Enrollment ID | O20040922000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275610362 | NPI | - | NPPES |
| CG9421 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kenneth Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023195112 PECOS PAC ID: 3476521923 Enrollment ID: I20100719000309 |
| Provider Name | Clara L Kalil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528218971 PECOS PAC ID: 6002952686 Enrollment ID: I20161202000171 |
| Provider Name | Kayli A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801515416 PECOS PAC ID: 2567838881 Enrollment ID: I20221011002565 |
| Provider Name | Roberto Rodriguez Perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184606618 PECOS PAC ID: 3870767379 Enrollment ID: I20240823000887 |
Siva Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2845 Se 3rd Ct, Ocala, FL 34471 Phone: 352-369-5300 Fax: 352-369-5309 | |
Central Florida Heart Group P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6600 Sw Hwy 200, Suite 300, Ocala, FL 34476 Phone: 352-237-4116 Fax: 352-237-1785 | |
Munroe Regional Health System Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1511 Sw 1st Ave, Ocala, FL 34471 Phone: 352-867-8311 Fax: 352-867-1053 | |
Integrative Health Care And Physical Medicine Ocala Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3256 S Pine Ave Ste 301, Ocala, FL 34471 Phone: 352-369-6325 Fax: 352-369-6329 | |
Poonam Warman M D P A Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1500 Se Magnolia Ext Ste 202, Ocala, FL 34471 Phone: 352-369-6139 | |
Marion Internal Medicine Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1805 Se Lake Weir Ave, Ocala, FL 34471 Phone: 352-629-9634 Fax: 352-629-6350 | |
Ocala Innovative Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5481 Sw 60th St, Unit 302, Ocala, FL 34474 Phone: 352-840-0444 |