| Family Doctors of Pasadena | |
|
6800 Gulfport Blvd S Ste 101 South Pasadena FL 33707-2193 | |
| (727) 275-2005 | |
| (727) 498-8951 |
| Full Name | Family Doctors of Pasadena |
|---|---|
| Speciality | Family Medicine |
| Location | 6800 Gulfport Blvd S Ste 101, South Pasadena, Florida |
| Authorized Official Name and Position | Jeffrey Grove (MEMBER) |
| Authorized Official Contact | 7273667343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Doctors of Pasadena 8050 Seminole Blvd Seminole FL 33772-4808 Ph: (727) 275-2005 | Family Doctors of Pasadena 6800 Gulfport Blvd S Ste 101 South Pasadena FL 33707-2193 Ph: (727) 275-2005 |
| NPI Number | 1033720362 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Medicare PECOS PAC ID | 6305257668 |
|---|---|
| Medicare Enrollment ID | O20201118001487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033720362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Randy Shuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477523975 PECOS PAC ID: 7719977701 Enrollment ID: I20040512001636 |
| Provider Name | Ty Tvedten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285626382 PECOS PAC ID: 8022903327 Enrollment ID: I20050225000140 |
| Provider Name | Aaron B Sheets |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124092135 PECOS PAC ID: 2163547654 Enrollment ID: I20100921001039 |
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