| Gulf To Bay Infectious Disease Consultants Pllc | |
|
4129 W Kennedy Blvd Ste 2 Tampa FL 33609-2254 | |
| (813) 541-1466 | |
| (888) 249-3323 |
| Full Name | Gulf To Bay Infectious Disease Consultants Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4129 W Kennedy Blvd Ste 2, Tampa, Florida |
| Authorized Official Name and Position | Mudathiru Buhari (MANAGING MEMBER) |
| Authorized Official Contact | 8135411466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf To Bay Infectious Disease Consultants Pllc Po Box 320546 Tampa FL 33679-2546 Ph: (813) 541-1466 | Gulf To Bay Infectious Disease Consultants Pllc 4129 W Kennedy Blvd Ste 2 Tampa FL 33609-2254 Ph: (813) 541-1466 |
| NPI Number | 1215330824 |
|---|---|
| Provider Enumeration Date | 09/28/2014 |
| Last Update Date | 10/23/2023 |
| Medicare PECOS PAC ID | 6305169160 |
|---|---|
| Medicare Enrollment ID | O20141231000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215330824 | NPI | - | NPPES |
| 505412 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME 111588 (Florida) | Primary |
| Provider Name | Mudathiru Buhari |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154426476 PECOS PAC ID: 8022018191 Enrollment ID: I20120316000754 |
| Provider Name | Wendy Jean Blatchley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114670536 PECOS PAC ID: 6800273558 Enrollment ID: I20220518001019 |
| Provider Name | Ariel Eder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538816459 PECOS PAC ID: 1850779554 Enrollment ID: I20220608003351 |
| Provider Name | Alisha Demmi Fell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154028488 PECOS PAC ID: 2062885767 Enrollment ID: I20230228001501 |
| Provider Name | Angela Stahlman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831816636 PECOS PAC ID: 6901271212 Enrollment ID: I20230418001583 |
| Provider Name | Krysten Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154007565 PECOS PAC ID: 7416319538 Enrollment ID: I20230821003531 |
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