| Glutality Provider Group, P.a. | |
|
401 Fairway Dr Ste 200 Deerfield Beach FL 33441-1800 | |
| (561) 678-2026 | |
| Not Available |
| Full Name | Glutality Provider Group, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 Fairway Dr Ste 200, Deerfield Beach, Florida |
| Authorized Official Name and Position | Mark Anthony Mitchell (MANAGER) |
| Authorized Official Contact | 5616782026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glutality Provider Group, P.a. 401 Fairway Dr Ste 200 Deerfield Beach FL 33441-1800 Ph: (561) 678-2026 | Glutality Provider Group, P.a. 401 Fairway Dr Ste 200 Deerfield Beach FL 33441-1800 Ph: (561) 678-2026 |
| NPI Number | 1083256168 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 06/14/2023 |
| Medicare PECOS PAC ID | 9032549837 |
|---|---|
| Medicare Enrollment ID | O20200419000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083256168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Judson Krosney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831131028 PECOS PAC ID: 1153213053 Enrollment ID: I20041005001200 |
| Provider Name | Christopher N. Hanner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023061660 PECOS PAC ID: 7517983984 Enrollment ID: I20051015000105 |
| Provider Name | David G Stone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548202799 PECOS PAC ID: 2163444639 Enrollment ID: I20051227000445 |
| Provider Name | Marvin C Mengel |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427028455 PECOS PAC ID: 1052322708 Enrollment ID: I20060510000139 |
| Provider Name | Sonia Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477508430 PECOS PAC ID: 8426140104 Enrollment ID: I20070827000202 |
| Provider Name | Sann Yin Htoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538370770 PECOS PAC ID: 6204920051 Enrollment ID: I20070924000541 |
| Provider Name | Khatereh Khatami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619090271 PECOS PAC ID: 5698866580 Enrollment ID: I20080407000592 |
| Provider Name | John M Sortino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194711010 PECOS PAC ID: 5496833642 Enrollment ID: I20080429000213 |
| Provider Name | Shehzad Mehboob Topiwala |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1164684700 PECOS PAC ID: 0547306920 Enrollment ID: I20091015000543 |
| Provider Name | Awais Masood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164607669 PECOS PAC ID: 1951595289 Enrollment ID: I20101101000868 |
| Provider Name | James Tackett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699787804 PECOS PAC ID: 8224934989 Enrollment ID: I20110210001145 |
| Provider Name | Theresa M Collier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205123742 PECOS PAC ID: 9335307479 Enrollment ID: I20120221000847 |
| Provider Name | Frank Duncan Scott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508804733 PECOS PAC ID: 6507879640 Enrollment ID: I20130909000545 |
| Provider Name | Sanaz Benjamin Kashan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154551349 PECOS PAC ID: 0345470381 Enrollment ID: I20140313000458 |
| Provider Name | German Giese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174810295 PECOS PAC ID: 5991920175 Enrollment ID: I20140701001853 |
| Provider Name | Thar Elbaage |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851336341 PECOS PAC ID: 2163316688 Enrollment ID: I20150108001410 |
| Provider Name | Bolajoko R Adeniyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104112036 PECOS PAC ID: 2466771589 Enrollment ID: I20150512000207 |
| Provider Name | Dena Smith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083657498 PECOS PAC ID: 5294633632 Enrollment ID: I20160502000955 |
| Provider Name | Clarke Morton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497789515 PECOS PAC ID: 0345246443 Enrollment ID: I20160512001874 |
| Provider Name | Scarlet R Benson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942521455 PECOS PAC ID: 8820232481 Enrollment ID: I20170410000451 |
| Provider Name | Nestor Maldonado |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982049789 PECOS PAC ID: 0143597666 Enrollment ID: I20170603000133 |
| Provider Name | Joo Yang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851549232 PECOS PAC ID: 2163794926 Enrollment ID: I20170815001334 |
| Provider Name | Andre Michael Pennardt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174502280 PECOS PAC ID: 9537239124 Enrollment ID: I20171110001959 |
| Provider Name | Mark Mitchell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003833633 PECOS PAC ID: 2264333632 Enrollment ID: I20171121000833 |
| Provider Name | Pamela A Herbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649295098 PECOS PAC ID: 7113820341 Enrollment ID: I20180716001304 |
| Provider Name | Anthony Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194037770 PECOS PAC ID: 5597938233 Enrollment ID: I20190418000159 |
| Provider Name | Kerrie Fearon Pounall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598201931 PECOS PAC ID: 4183907835 Enrollment ID: I20200218003177 |
| Provider Name | Collin M Mclaughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215220306 PECOS PAC ID: 2860618642 Enrollment ID: I20200415001117 |
| Provider Name | Rodolfo De Paula Loureiro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265965347 PECOS PAC ID: 6204267784 Enrollment ID: I20200526002659 |
| Provider Name | Nitinkumar Doshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154424372 PECOS PAC ID: 4688675515 Enrollment ID: I20200528001078 |
| Provider Name | Brian Toston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497286546 PECOS PAC ID: 8729419551 Enrollment ID: I20200723000833 |
| Provider Name | Daniel G Funsch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023471547 PECOS PAC ID: 2365789039 Enrollment ID: I20200806002831 |
| Provider Name | Melvyn W Kramer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1306803846 PECOS PAC ID: 8224056478 Enrollment ID: I20200908002386 |
| Provider Name | Christopher Libby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710411459 PECOS PAC ID: 9739507443 Enrollment ID: I20200911002583 |
| Provider Name | Desiree La Charite |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649246570 PECOS PAC ID: 8224188214 Enrollment ID: I20200915002941 |
| Provider Name | Heather E Maddox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578558094 PECOS PAC ID: 1850443896 Enrollment ID: I20200924000427 |
| Provider Name | Pegah Zare |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467957480 PECOS PAC ID: 3375962558 Enrollment ID: I20201008000469 |
| Provider Name | Arash Zarrin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407351729 PECOS PAC ID: 8022438944 Enrollment ID: I20201015000019 |
| Provider Name | Doris Marilu Chavez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316101124 PECOS PAC ID: 9537332572 Enrollment ID: I20201020000778 |
| Provider Name | Harjeet Singh Jhajj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548557440 PECOS PAC ID: 5799908851 Enrollment ID: I20201020001635 |
| Provider Name | Sachin Parekh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285749952 PECOS PAC ID: 6204832314 Enrollment ID: I20201022001883 |
| Provider Name | Teri Noel Bilhartz |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1144426248 PECOS PAC ID: 9032379631 Enrollment ID: I20201023000402 |
| Provider Name | Zachary N Gross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205369527 PECOS PAC ID: 2860762713 Enrollment ID: I20201028000924 |
| Provider Name | Avni Pandya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417078999 PECOS PAC ID: 9537248646 Enrollment ID: I20201028002701 |
| Provider Name | Monika Mamidwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891921706 PECOS PAC ID: 8123261047 Enrollment ID: I20201103002691 |
| Provider Name | Ellena Lois Boddie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689673790 PECOS PAC ID: 0840399515 Enrollment ID: I20201105001302 |
| Provider Name | Christopher J Lundquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013079144 PECOS PAC ID: 1951433911 Enrollment ID: I20201106000173 |
| Provider Name | Dustin Kyle Benyo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942732904 PECOS PAC ID: 7113337734 Enrollment ID: I20201110000255 |
| Provider Name | Wilco Civil |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679099519 PECOS PAC ID: 4183034713 Enrollment ID: I20201110000480 |
| Provider Name | Luis David Figueroa Cabrera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720512031 PECOS PAC ID: 5496165995 Enrollment ID: I20201112002026 |
| Provider Name | Zaid Rana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558801159 PECOS PAC ID: 0840563185 Enrollment ID: I20201112002950 |
| Provider Name | Maryann Sandy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053738971 PECOS PAC ID: 6709165129 Enrollment ID: I20201117001116 |
| Provider Name | Melissa Bruhl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497833784 PECOS PAC ID: 3072688845 Enrollment ID: I20201125002325 |
| Provider Name | Jennifer Spurlock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659531127 PECOS PAC ID: 6709063910 Enrollment ID: I20201201002192 |
| Provider Name | Maria Garcia |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699885202 PECOS PAC ID: 4789676966 Enrollment ID: I20201211001568 |
| Provider Name | Ava Azimi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023252483 PECOS PAC ID: 8022288760 Enrollment ID: I20201216000049 |
| Provider Name | Robert Chandler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922244664 PECOS PAC ID: 4486827532 Enrollment ID: I20201216000140 |
| Provider Name | Nora Bassam Khoury |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1093205114 PECOS PAC ID: 1759794480 Enrollment ID: I20210119001641 |
| Provider Name | Erik Deede |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821036112 PECOS PAC ID: 5092889808 Enrollment ID: I20210420002318 |
| Provider Name | Andrea Morganstein |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1003005422 PECOS PAC ID: 0244639409 Enrollment ID: I20210520002425 |
| Provider Name | Gopichand Naguboyina |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710203161 PECOS PAC ID: 6406040880 Enrollment ID: I20210623000026 |
| Provider Name | Maria Agustina Silberstein Y Tiribelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073075495 PECOS PAC ID: 3072918218 Enrollment ID: I20210825003372 |
| Provider Name | Hari Iyengar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013355973 PECOS PAC ID: 4688989932 Enrollment ID: I20210930001506 |
| Provider Name | Mihaela Suru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093026940 PECOS PAC ID: 6709037765 Enrollment ID: I20211105002622 |
| Provider Name | Jason Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417997909 PECOS PAC ID: 5698742716 Enrollment ID: I20220125002670 |
| Provider Name | Leslee Mcelrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952747396 PECOS PAC ID: 5799913463 Enrollment ID: I20220310000292 |
| Provider Name | Harmandeep Dhillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447749890 PECOS PAC ID: 8022353077 Enrollment ID: I20220525001027 |
| Provider Name | Shawkee Aboualayoui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407236607 PECOS PAC ID: 5890085849 Enrollment ID: I20220811002224 |
| Provider Name | Alemeshet Gudeta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225455140 PECOS PAC ID: 8123317237 Enrollment ID: I20220818002680 |
| Provider Name | Bhavesh Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831534957 PECOS PAC ID: 8224351549 Enrollment ID: I20230303002015 |
| Provider Name | Tiffani Dawn Lemen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760651210 PECOS PAC ID: 1355472671 Enrollment ID: I20230321000008 |
| Provider Name | Ashwin Narayana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245624188 PECOS PAC ID: 4082989207 Enrollment ID: I20230321002229 |
| Provider Name | Nahida Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154585271 PECOS PAC ID: 8921222175 Enrollment ID: I20230322001889 |
| Provider Name | Iwan Nyotowidjojo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578976270 PECOS PAC ID: 3274859970 Enrollment ID: I20230419002902 |
| Provider Name | Hosam Atoom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336593706 PECOS PAC ID: 4284069535 Enrollment ID: I20231004000146 |
| Provider Name | Nicholas A Raubitschek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093101248 PECOS PAC ID: 6002122124 Enrollment ID: I20231113002285 |
Dr.neal F.krouse, D.o.,p.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 W Hillsboro Blvd, Suite 103, Deerfield Beach, FL 33442 Phone: 954-418-9445 Fax: 954-418-9445 | |
Kyron Medical Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3467 W Hillsboro Blvd, Suite A, Deerfield Beach, FL 33442 Phone: 954-257-9423 | |
Isaac Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 823 E Hillsboro Blvd, Deerfield Beach, FL 33441 Phone: 561-467-0701 | |
Md Healthcare Hillsboro Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Sw Natura Ave, Deerfield Beach, FL 33441 Phone: 954-425-9154 Fax: 954-425-9162 | |
Advanced Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1827 W Hillsboro Blvd, Deerfield Beach, FL 33442 Phone: 954-900-6695 Fax: 954-378-9008 | |
Deerfield Health & Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Jim Moran Blvd, Deerfield Beach, FL 33442 Phone: 954-429-2418 Fax: 954-429-2148 |