| Ellenton Urgent Care | |
|
430 8th Ave W Palmetto FL 34221-5120 | |
| (941) 544-0366 | |
| (941) 212-6059 |
| Full Name | Ellenton Urgent Care |
|---|---|
| Speciality | General Practice |
| Location | 430 8th Ave W, Palmetto, Florida |
| Authorized Official Name and Position | Alexander N Petreas (MEMBER) |
| Authorized Official Contact | 9414007051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellenton Urgent Care 7206 16th Ave Nw Bradenton FL 34209-1151 Ph: () - | Ellenton Urgent Care 430 8th Ave W Palmetto FL 34221-5120 Ph: (941) 544-0366 |
| NPI Number | 1366957482 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 08/23/2023 |
| Medicare PECOS PAC ID | 0749542934 |
|---|---|
| Medicare Enrollment ID | O20180328001837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366957482 | NPI | - | NPPES |
| Provider Name | Christina M Mehriary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699812057 PECOS PAC ID: 7517109937 Enrollment ID: I20130815000065 |
| Provider Name | Tracey Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396294971 PECOS PAC ID: 1456630375 Enrollment ID: I20161117001077 |
| Provider Name | Matthew D Heisey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093172272 PECOS PAC ID: 6800169137 Enrollment ID: I20190205003671 |
| Provider Name | Ian M. Kahane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861846263 PECOS PAC ID: 8426390634 Enrollment ID: I20190508000795 |
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