| Deerfield Beach Physician Services, Llc | |
|
2626 Capital Medical Blvd Tallahassee FL 32308-4402 | |
| (850) 325-5000 | |
| (850) 656-5198 |
| Full Name | Deerfield Beach Physician Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2626 Capital Medical Blvd, Tallahassee, Florida |
| Authorized Official Name and Position | Lisha C Falk (VP OF CONTRACTING) |
| Authorized Official Contact | 3376091221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deerfield Beach Physician Services, Llc 200 Corporate Blvd Lafayette LA 70508-3870 Ph: (800) 893-9698 | Deerfield Beach Physician Services, Llc 2626 Capital Medical Blvd Tallahassee FL 32308-4402 Ph: (850) 325-5000 |
| NPI Number | 1366100364 |
|---|---|
| Provider Enumeration Date | 12/07/2021 |
| Last Update Date | 09/27/2022 |
| Medicare PECOS PAC ID | 3274928270 |
|---|---|
| Medicare Enrollment ID | O20220520002459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366100364 | NPI | - | NPPES |
| Provider Name | Iftikhar Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063552396 PECOS PAC ID: 0749183887 Enrollment ID: I20040128000298 |
| Provider Name | Ketty Maurice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053368043 PECOS PAC ID: 0446143382 Enrollment ID: I20040205000130 |
| Provider Name | Kiran Narvin Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255334959 PECOS PAC ID: 9133010457 Enrollment ID: I20040324000506 |
| Provider Name | Diego T Yangco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619953007 PECOS PAC ID: 0840287348 Enrollment ID: I20040427001250 |
| Provider Name | Nighat S Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083766687 PECOS PAC ID: 7012924442 Enrollment ID: I20060309000611 |
| Provider Name | Madelaine Vilme |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841391729 PECOS PAC ID: 1355340290 Enrollment ID: I20061204000345 |
| Provider Name | Richard R Thacker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114920261 PECOS PAC ID: 9638271471 Enrollment ID: I20070224000141 |
| Provider Name | Farzana A Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902922727 PECOS PAC ID: 5597843797 Enrollment ID: I20080429000163 |
| Provider Name | Moses N Izuegbu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205057932 PECOS PAC ID: 0446392179 Enrollment ID: I20100119000552 |
| Provider Name | Linda L Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083856256 PECOS PAC ID: 3072645928 Enrollment ID: I20100713000515 |
| Provider Name | Simon Jesus Kassis Hadid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548410590 PECOS PAC ID: 5193917136 Enrollment ID: I20101008000105 |
| Provider Name | Suma S Dondapati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336370428 PECOS PAC ID: 6608059084 Enrollment ID: I20110322000846 |
| Provider Name | Aaron Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093973786 PECOS PAC ID: 7719163211 Enrollment ID: I20110518000309 |
| Provider Name | Marino A Martinez Vargas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750680856 PECOS PAC ID: 4183893720 Enrollment ID: I20110816000357 |
| Provider Name | Yawen Ping |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467734681 PECOS PAC ID: 2466623236 Enrollment ID: I20110928000024 |
| Provider Name | Bethsaida Jean Gillum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902189376 PECOS PAC ID: 0143492439 Enrollment ID: I20111010000511 |
| Provider Name | Wayne Sampson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306897582 PECOS PAC ID: 2163695388 Enrollment ID: I20111103000882 |
| Provider Name | Omar Khashaba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942467576 PECOS PAC ID: 5294996492 Enrollment ID: I20120416000463 |
| Provider Name | William F Geers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992828461 PECOS PAC ID: 5496848004 Enrollment ID: I20120622000262 |
| Provider Name | Christina Miki Araya Osorio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710188453 PECOS PAC ID: 0143372144 Enrollment ID: I20120813000093 |
| Provider Name | Nathalie J Narcisse |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255309001 PECOS PAC ID: 0749258788 Enrollment ID: I20120924000250 |
| Provider Name | Thomas F King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912955733 PECOS PAC ID: 1254405558 Enrollment ID: I20130307000188 |
| Provider Name | Nimae N Awantang |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124156468 PECOS PAC ID: 6002052909 Enrollment ID: I20130419000401 |
| Provider Name | Justin L Cummings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598722670 PECOS PAC ID: 5496800443 Enrollment ID: I20140613001135 |
| Provider Name | Nicola S Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477963833 PECOS PAC ID: 8224253919 Enrollment ID: I20140714002106 |
| Provider Name | Joseph N Rawls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518385913 PECOS PAC ID: 6103042767 Enrollment ID: I20140717001360 |
| Provider Name | Tanesh Sadarangani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992955488 PECOS PAC ID: 4789841248 Enrollment ID: I20140806001999 |
| Provider Name | Anthony Roosevelt Washington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093002768 PECOS PAC ID: 7517186695 Enrollment ID: I20140923000998 |
| Provider Name | Muhammad A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669621215 PECOS PAC ID: 7517003932 Enrollment ID: I20140926000673 |
| Provider Name | Gary Fischer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053427690 PECOS PAC ID: 6103846282 Enrollment ID: I20150305001601 |
| Provider Name | Allison Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225463649 PECOS PAC ID: 9234440884 Enrollment ID: I20150623001952 |
| Provider Name | Benise Artus Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265827430 PECOS PAC ID: 4183936461 Enrollment ID: I20150629002084 |
| Provider Name | Alysha Lynn Bredemus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104187194 PECOS PAC ID: 6103134663 Enrollment ID: I20151001003148 |
| Provider Name | Abby Brockelbank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043694656 PECOS PAC ID: 0345541447 Enrollment ID: I20151215000734 |
| Provider Name | Mike M Supplice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689000101 PECOS PAC ID: 9830493949 Enrollment ID: I20160210002299 |
| Provider Name | Christine Kathy Noel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750787057 PECOS PAC ID: 6204085392 Enrollment ID: I20160318000665 |
| Provider Name | Nadia Parchment |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295056430 PECOS PAC ID: 3678793130 Enrollment ID: I20160406001439 |
| Provider Name | Mary E Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770038093 PECOS PAC ID: 2769761592 Enrollment ID: I20161117001716 |
| Provider Name | Romainda Lubin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013468362 PECOS PAC ID: 2466732904 Enrollment ID: I20161129002062 |
| Provider Name | Samuel Saad Elias-ausi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639432156 PECOS PAC ID: 5092031377 Enrollment ID: I20170426000514 |
| Provider Name | Cindy Yuen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902230477 PECOS PAC ID: 0345510061 Enrollment ID: I20170727002925 |
| Provider Name | Salil T Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467853929 PECOS PAC ID: 5799005781 Enrollment ID: I20170817004033 |
| Provider Name | Samantha Jean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023438512 PECOS PAC ID: 1153543160 Enrollment ID: I20170823001067 |
| Provider Name | Sebastian Puig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295154706 PECOS PAC ID: 1254552292 Enrollment ID: I20171108002406 |
| Provider Name | Amin Elfituri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568898732 PECOS PAC ID: 5597984039 Enrollment ID: I20180413000862 |
| Provider Name | Wael Sankar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477940260 PECOS PAC ID: 8527314806 Enrollment ID: I20180628000754 |
| Provider Name | Clorinda Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861980724 PECOS PAC ID: 5395095558 Enrollment ID: I20180910000758 |
| Provider Name | Kimberly Danielle Abdelkader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609262062 PECOS PAC ID: 3678823887 Enrollment ID: I20180910002542 |
| Provider Name | Tolulope Mathias Olasunkanmi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558500447 PECOS PAC ID: 7012054695 Enrollment ID: I20181212001832 |
| Provider Name | Gerdie Jean-smith |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1346669025 PECOS PAC ID: 0143535369 Enrollment ID: I20190218002663 |
| Provider Name | Adeyinka O Akinbami |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417469941 PECOS PAC ID: 2860757564 Enrollment ID: I20200115002425 |
| Provider Name | Pranav Ravi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881076040 PECOS PAC ID: 0446597694 Enrollment ID: I20200611002165 |
| Provider Name | Charlton E Collie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992123426 PECOS PAC ID: 6305061375 Enrollment ID: I20200924000877 |
| Provider Name | Dejon J Maloney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518499235 PECOS PAC ID: 3072889864 Enrollment ID: I20200929002544 |
| Provider Name | Bilal Sadiq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225529894 PECOS PAC ID: 8527315233 Enrollment ID: I20210812003912 |
| Provider Name | Alena Varantsova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033615208 PECOS PAC ID: 3678979093 Enrollment ID: I20210910001326 |
| Provider Name | Allison Lee Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366104713 PECOS PAC ID: 2860899010 Enrollment ID: I20210930001888 |
| Provider Name | Nadine Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932761764 PECOS PAC ID: 5799011102 Enrollment ID: I20211027002419 |
| Provider Name | Marlene Lorente Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598330938 PECOS PAC ID: 6305235094 Enrollment ID: I20211118001762 |
| Provider Name | Khuzema Mohsin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326535998 PECOS PAC ID: 7012344724 Enrollment ID: I20220317002630 |
| Provider Name | Prashant Baliga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013114305 PECOS PAC ID: 9335336072 Enrollment ID: I20220329002471 |
| Provider Name | Nesreen Zakariya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659045318 PECOS PAC ID: 5092101337 Enrollment ID: I20220413001078 |
| Provider Name | Kristopher Rai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932588449 PECOS PAC ID: 0840593547 Enrollment ID: I20220504000384 |
| Provider Name | Oleksandr Kozlov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801458435 PECOS PAC ID: 0446588123 Enrollment ID: I20220922002371 |
| Provider Name | Vasuki Tikkiwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023670833 PECOS PAC ID: 9739565987 Enrollment ID: I20220926002928 |
| Provider Name | Ummair Aman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215592936 PECOS PAC ID: 9133505407 Enrollment ID: I20221011000365 |
| Provider Name | Svitlana Shapovalova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255829321 PECOS PAC ID: 3971909417 Enrollment ID: I20221012001333 |
| Provider Name | Sankeerth Takkellapati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659936177 PECOS PAC ID: 8628444676 Enrollment ID: I20221018000037 |
| Provider Name | Hamzah Abdullah M Qudah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609466556 PECOS PAC ID: 1355717869 Enrollment ID: I20221024001935 |
| Provider Name | Jonathan Patricio Vivar Acosta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073174314 PECOS PAC ID: 2163890096 Enrollment ID: I20221123002115 |
| Provider Name | Juan Torres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164080909 PECOS PAC ID: 9931437217 Enrollment ID: I20221229001957 |
| Provider Name | Genevieve Sarmiento |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255058616 PECOS PAC ID: 6507239191 Enrollment ID: I20230301002359 |
| Provider Name | Jason Doss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922705524 PECOS PAC ID: 8729448436 Enrollment ID: I20230713000228 |
| Provider Name | Mandeep Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750802930 PECOS PAC ID: 1456698836 Enrollment ID: I20240103004528 |
| Provider Name | Andalib Hossain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063073492 PECOS PAC ID: 9335477355 Enrollment ID: I20240116000652 |
| Provider Name | Ayla Benge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538789433 PECOS PAC ID: 7618374778 Enrollment ID: I20240118000146 |
Healing Hearts Music Therapy, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1862 Newman Ln, Tallahassee, FL 32312 Phone: 229-400-0722 | |
Titan Hospitalist Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2626 Capital Medical Blvd, Tallahassee, FL 32308 Phone: 904-332-4316 Fax: 904-332-4339 | |
Big Bend Hospice, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1723 Mahan Center Blvd, Tallahassee, FL 32308 Phone: 702-960-2272 | |
Guidewell Sanitas I, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Timberlane Rd, Tallahassee, FL 32312 Phone: 844-665-4827 | |
Guidewell Sanitas I, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Timberlane Rd, Tallahassee, FL 32312 Phone: 844-665-4827 | |
Tallahassee Memorial Healthcare Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3900 Esplanade Way, Tallahassee, FL 32311 Phone: 850-431-3867 Fax: 850-431-3879 | |
Transition Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3333 Capital Oaks Dr, Tallahassee, FL 32308 Phone: 850-431-4470 Fax: 850-431-4471 |