| Linda Delo Do Pa | |
|
514 Se Port St Lucie Blvd Port Saint Lucie FL 34984-5150 | |
| (772) 871-5900 | |
| (772) 871-1197 |
| Full Name | Linda Delo Do Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 514 Se Port St Lucie Blvd, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Linda Fay Delo (PRESIDENT) |
| Authorized Official Contact | 7728715900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Linda Delo Do Pa 514 Se Port St Lucie Blvd Port Saint Lucie FL 34984-5150 Ph: (772) 871-5900 | Linda Delo Do Pa 514 Se Port St Lucie Blvd Port Saint Lucie FL 34984-5150 Ph: (772) 871-5900 |
| NPI Number | 1861535726 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 07/09/2010 |
| Medicare PECOS PAC ID | 7618967225 |
|---|---|
| Medicare Enrollment ID | O20040515000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861535726 | NPI | - | NPPES |
| 82976 | Other | FL | BCBS |
| 0112160 | Other | FL | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OS05326 (Florida) | Primary |
| Provider Name | Robert S Cutler |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1942293519 PECOS PAC ID: 6406839968 Enrollment ID: I20040608000303 |
| Provider Name | Nancy A Coppola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760517668 PECOS PAC ID: 4082686522 Enrollment ID: I20040806000362 |
| Provider Name | Luz D Schelmety-henriquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164479564 PECOS PAC ID: 8325014095 Enrollment ID: I20040903000223 |
| Provider Name | Linda Fay Delo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225033848 PECOS PAC ID: 1951391572 Enrollment ID: I20101112000216 |
| Provider Name | Maikhoi Tuong Pham |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811273600 PECOS PAC ID: 0547418964 Enrollment ID: I20130924000716 |
| Provider Name | Mildred Woodruff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629362199 PECOS PAC ID: 5890963193 Enrollment ID: I20150218001029 |
| Provider Name | Maria D Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447587647 PECOS PAC ID: 6608192059 Enrollment ID: I20150303001202 |
| Provider Name | Aurora Jankowiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144823105 PECOS PAC ID: 7810309317 Enrollment ID: I20201207000943 |
| Provider Name | Sandina Samantha Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225623408 PECOS PAC ID: 9234547407 Enrollment ID: I20210428001211 |
| Provider Name | Tricia A Riddle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013660794 PECOS PAC ID: 7517354970 Enrollment ID: I20220504000049 |
| Provider Name | Lilianne Frometa Aleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184302069 PECOS PAC ID: 3577912187 Enrollment ID: I20231207003232 |
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