| Health First Privia Medical Group, Llc | |
|
140 6th Ave Indialantic FL 32903-3204 | |
| (321) 312-3501 | |
| Not Available |
| Full Name | Health First Privia Medical Group, Llc |
|---|---|
| Speciality | General Practice |
| Location | 140 6th Ave, Indialantic, Florida |
| Authorized Official Name and Position | Lora Morse (VP) |
| Authorized Official Contact | 3214345482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health First Privia Medical Group, Llc 3300 S Fiske Blvd Rockledge FL 32955-4306 Ph: (321) 434-5055 | Health First Privia Medical Group, Llc 140 6th Ave Indialantic FL 32903-3204 Ph: (321) 312-3501 |
| NPI Number | 1700649043 |
|---|---|
| Provider Enumeration Date | 01/31/2024 |
| Last Update Date | 02/20/2025 |
| Medicare PECOS PAC ID | 3173965993 |
|---|---|
| Medicare Enrollment ID | O20240524002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700649043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jeremy D Mcconnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700871969 PECOS PAC ID: 7810899283 Enrollment ID: I20040126000161 |
| Provider Name | Julian Fernando Naranjo |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1093700015 PECOS PAC ID: 2860389137 Enrollment ID: I20040302000269 |
| Provider Name | Parveen S Vahora |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336112945 PECOS PAC ID: 0446227391 Enrollment ID: I20040911000045 |
| Provider Name | Ernest Chung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265404735 PECOS PAC ID: 6305813338 Enrollment ID: I20040913000435 |
| Provider Name | Shereen I Oloufa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669560751 PECOS PAC ID: 8426012667 Enrollment ID: I20041117000183 |
| Provider Name | Scarlette L Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942232863 PECOS PAC ID: 9032176706 Enrollment ID: I20041214000753 |
| Provider Name | Prakash V Reddy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528043163 PECOS PAC ID: 5395781207 Enrollment ID: I20050630000749 |
| Provider Name | Daniel Sullivan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1255317988 PECOS PAC ID: 0840211512 Enrollment ID: I20051208000889 |
| Provider Name | David P Brown |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346256575 PECOS PAC ID: 5496750655 Enrollment ID: I20060921000132 |
| Provider Name | Michael S Frasure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841380623 PECOS PAC ID: 0547269045 Enrollment ID: I20061211000489 |
| Provider Name | Alamelu Murugappan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033219100 PECOS PAC ID: 7416988290 Enrollment ID: I20070205000029 |
| Provider Name | Jose Alvarez |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1912013699 PECOS PAC ID: 4688778483 Enrollment ID: I20070404000282 |
| Provider Name | Saska F Sookra Winslow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730269556 PECOS PAC ID: 0840398475 Enrollment ID: I20070606000092 |
| Provider Name | Basant Farghaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104945872 PECOS PAC ID: 8921190315 Enrollment ID: I20070815000102 |
| Provider Name | Christopher J Pastore |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255479051 PECOS PAC ID: 4587658570 Enrollment ID: I20070829000500 |
| Provider Name | Krista L Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245439793 PECOS PAC ID: 6406942978 Enrollment ID: I20071013000036 |
| Provider Name | Omar A Aref |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235106675 PECOS PAC ID: 5991711285 Enrollment ID: I20071219000628 |
| Provider Name | Steven E Shepard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528252723 PECOS PAC ID: 8921185083 Enrollment ID: I20080414000505 |
| Provider Name | Patricia Lebron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861504615 PECOS PAC ID: 2668550500 Enrollment ID: I20080417000614 |
| Provider Name | Kevin Makati |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467541953 PECOS PAC ID: 5890756464 Enrollment ID: I20080808000058 |
| Provider Name | Bichngoc T Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033283965 PECOS PAC ID: 8527017078 Enrollment ID: I20080909000520 |
| Provider Name | John Dean Ibrahim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669555470 PECOS PAC ID: 0648331082 Enrollment ID: I20081204000259 |
| Provider Name | Bruce R Wills |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023229853 PECOS PAC ID: 4183787575 Enrollment ID: I20090112000361 |
| Provider Name | Ronald J Stern |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1720191786 PECOS PAC ID: 9335202761 Enrollment ID: I20090112000600 |
| Provider Name | Terreze M Gamble |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861694010 PECOS PAC ID: 1456416783 Enrollment ID: I20090219000377 |
| Provider Name | Luis Allen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720035058 PECOS PAC ID: 2163574146 Enrollment ID: I20090722000670 |
| Provider Name | Andrew F Ogara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861474496 PECOS PAC ID: 4587718630 Enrollment ID: I20090824000690 |
| Provider Name | Craig A Snow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104801653 PECOS PAC ID: 0547333213 Enrollment ID: I20100112000582 |
| Provider Name | Carlos H Ruiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508804766 PECOS PAC ID: 5890899439 Enrollment ID: I20100211000276 |
| Provider Name | Allison Muia Wade |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871601740 PECOS PAC ID: 5294861860 Enrollment ID: I20100407000640 |
| Provider Name | Jeffrey T Obrien |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487627758 PECOS PAC ID: 2668405762 Enrollment ID: I20100416000341 |
| Provider Name | Gonzalo G Valdivia |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669446480 PECOS PAC ID: 5092842443 Enrollment ID: I20100416000461 |
| Provider Name | Celso E. Pineiro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053325118 PECOS PAC ID: 3072645944 Enrollment ID: I20100713000676 |
| Provider Name | Ivelisse C Ruiz Robles |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578591061 PECOS PAC ID: 8224160791 Enrollment ID: I20100719000738 |
| Provider Name | Eduardo Jose Balbona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073506168 PECOS PAC ID: 6608774781 Enrollment ID: I20100813000171 |
| Provider Name | Daniel Lewis King |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831181346 PECOS PAC ID: 1759472905 Enrollment ID: I20100831000018 |
| Provider Name | Adam W Langley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992998736 PECOS PAC ID: 4880718444 Enrollment ID: I20100902001069 |
| Provider Name | Wael A Jamaleddine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972647311 PECOS PAC ID: 4183749419 Enrollment ID: I20100910000042 |
| Provider Name | Niral Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912923079 PECOS PAC ID: 6608870506 Enrollment ID: I20101012001145 |
| Provider Name | Frank X Venzara |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1356451306 PECOS PAC ID: 2062605967 Enrollment ID: I20101025000126 |
| Provider Name | Roberto O Garcia |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1104850692 PECOS PAC ID: 3274436167 Enrollment ID: I20101118000549 |
| Provider Name | Adriana P Suarez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366430829 PECOS PAC ID: 2365401809 Enrollment ID: I20101124000491 |
| Provider Name | Michael B Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396849691 PECOS PAC ID: 0042202111 Enrollment ID: I20110912000634 |
| Provider Name | Gary C Visser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710170568 PECOS PAC ID: 8022289404 Enrollment ID: I20110914000798 |
| Provider Name | Craig Norman Defreese |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992706279 PECOS PAC ID: 9335316074 Enrollment ID: I20120119000811 |
| Provider Name | Jennifer S Mahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457628984 PECOS PAC ID: 6002076502 Enrollment ID: I20120320000804 |
| Provider Name | Vijay Katukuri |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255590261 PECOS PAC ID: 2365606019 Enrollment ID: I20120611000274 |
| Provider Name | Reut Bardach |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780950527 PECOS PAC ID: 5092971200 Enrollment ID: I20120716000251 |
| Provider Name | Nasimul H Siddiqui |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487747010 PECOS PAC ID: 0345492708 Enrollment ID: I20121211000053 |
| Provider Name | Tejas B Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083861017 PECOS PAC ID: 7214005842 Enrollment ID: I20130129000061 |
| Provider Name | Regina Shanese Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740527852 PECOS PAC ID: 2769637511 Enrollment ID: I20130227000326 |
| Provider Name | Achilles Kalnoky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245460690 PECOS PAC ID: 4981859402 Enrollment ID: I20130306000214 |
| Provider Name | Mahathy Katukuri |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1316171036 PECOS PAC ID: 4688814130 Enrollment ID: I20130708000086 |
| Provider Name | Christina Catherine Gomez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851522825 PECOS PAC ID: 1658512793 Enrollment ID: I20130801000089 |
| Provider Name | Maryam Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447578372 PECOS PAC ID: 4688817000 Enrollment ID: I20130903000657 |
| Provider Name | Jessie A Cirolia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548503105 PECOS PAC ID: 9931343688 Enrollment ID: I20130918000717 |
| Provider Name | Anielka R Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487968764 PECOS PAC ID: 1658506225 Enrollment ID: I20131107000430 |
| Provider Name | Kim S Cantello-baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407296734 PECOS PAC ID: 9335376268 Enrollment ID: I20131220000320 |
| Provider Name | Rajen S Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285861443 PECOS PAC ID: 2961659073 Enrollment ID: I20131227001408 |
| Provider Name | Nicole Colon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679904627 PECOS PAC ID: 0941430573 Enrollment ID: I20140227001410 |
| Provider Name | William A Mcclung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356664817 PECOS PAC ID: 2860622826 Enrollment ID: I20140313000941 |
| Provider Name | Mary R Langenstroer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053631333 PECOS PAC ID: 3971748336 Enrollment ID: I20140807001561 |
| Provider Name | Alka Aggarwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467731950 PECOS PAC ID: 5799906269 Enrollment ID: I20141027001312 |
| Provider Name | Jason S Bloom |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851648083 PECOS PAC ID: 2365764230 Enrollment ID: I20141203001549 |
| Provider Name | Mandana Alborzfard Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932420544 PECOS PAC ID: 1052435351 Enrollment ID: I20150302002307 |
| Provider Name | Prashant G Jani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255489993 PECOS PAC ID: 3476788902 Enrollment ID: I20150706000919 |
| Provider Name | Andrea M Lucania |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831570183 PECOS PAC ID: 3971818568 Enrollment ID: I20150811004897 |
| Provider Name | Alejandro Perez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457674822 PECOS PAC ID: 4183939499 Enrollment ID: I20150817000396 |
| Provider Name | Farhana Rahman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033484266 PECOS PAC ID: 8921313099 Enrollment ID: I20150818005977 |
| Provider Name | William G Stephens |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417247446 PECOS PAC ID: 5496061046 Enrollment ID: I20150827002843 |
| Provider Name | Trishanna Crystal Sookdeo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700172210 PECOS PAC ID: 9133429525 Enrollment ID: I20151208002111 |
| Provider Name | Sonita Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497048938 PECOS PAC ID: 6901026400 Enrollment ID: I20160601000913 |
| Provider Name | Gaurav Purani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932530953 PECOS PAC ID: 3870710833 Enrollment ID: I20160810000150 |
| Provider Name | Ameigh V Worley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336466911 PECOS PAC ID: 3476774688 Enrollment ID: I20160811000619 |
| Provider Name | Reynald Lamarre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144668229 PECOS PAC ID: 7012219157 Enrollment ID: I20160906000340 |
| Provider Name | Carolyn D Knopfle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346796612 PECOS PAC ID: 9335422567 Enrollment ID: I20170213001573 |
| Provider Name | Markand J Patel |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1619266806 PECOS PAC ID: 8325270275 Enrollment ID: I20170506000092 |
| Provider Name | Shveta Gupta |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1366881468 PECOS PAC ID: 2769751031 Enrollment ID: I20170629000753 |
| Provider Name | Katie L Shouppe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841710670 PECOS PAC ID: 0749550630 Enrollment ID: I20170726000949 |
| Provider Name | Peter Paythal Ganpat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255650081 PECOS PAC ID: 3779895958 Enrollment ID: I20170822001301 |
| Provider Name | Olga Kaliebe |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003810417 PECOS PAC ID: 5193780344 Enrollment ID: I20170905003244 |
| Provider Name | Erin Abbott Street Mateer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174966998 PECOS PAC ID: 6901170646 Enrollment ID: I20170920000412 |
| Provider Name | Jennifer Tate Gee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205239944 PECOS PAC ID: 7214259837 Enrollment ID: I20171107000081 |
| Provider Name | Sherif Mark Makar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184988149 PECOS PAC ID: 1557671161 Enrollment ID: I20171113003161 |
| Provider Name | Edward Orshansky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285054460 PECOS PAC ID: 8820218548 Enrollment ID: I20171120003394 |
| Provider Name | Kaitlyn E Kamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376900027 PECOS PAC ID: 8628375029 Enrollment ID: I20180104001929 |
| Provider Name | Shane Austin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669899894 PECOS PAC ID: 0446557961 Enrollment ID: I20180119002620 |
| Provider Name | Juan Carlos Cantu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053693580 PECOS PAC ID: 5294985693 Enrollment ID: I20180321002148 |
| Provider Name | Melissa Jo Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396275160 PECOS PAC ID: 5193089969 Enrollment ID: I20180502000999 |
| Provider Name | Harold William Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790170454 PECOS PAC ID: 5193039493 Enrollment ID: I20180514000888 |
| Provider Name | Radha Vijay Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992148027 PECOS PAC ID: 6002194206 Enrollment ID: I20180807003715 |
| Provider Name | Edwin John Raymond Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245624881 PECOS PAC ID: 5092064212 Enrollment ID: I20180822000630 |
| Provider Name | Cory C Dowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285037960 PECOS PAC ID: 6800131947 Enrollment ID: I20181218004007 |
| Provider Name | Megan M Dudley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164944112 PECOS PAC ID: 6709121767 Enrollment ID: I20181219000843 |
| Provider Name | Izdean Mufleh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053707604 PECOS PAC ID: 3173814878 Enrollment ID: I20190131002812 |
| Provider Name | Ashley Ann Kalin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982175030 PECOS PAC ID: 3476890211 Enrollment ID: I20190201001094 |
| Provider Name | Stephanie Newberry-angell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144715871 PECOS PAC ID: 3971843582 Enrollment ID: I20190319000410 |
| Provider Name | Christina H Bovelsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356476626 PECOS PAC ID: 6406918044 Enrollment ID: I20190320001005 |
| Provider Name | Anthony Francis Romano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871076638 PECOS PAC ID: 6608116058 Enrollment ID: I20190320003388 |
| Provider Name | Emily R Delgado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205354214 PECOS PAC ID: 1850652421 Enrollment ID: I20190402001395 |
| Provider Name | Pushpa Chand Daliya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841761673 PECOS PAC ID: 6204162779 Enrollment ID: I20190723000980 |
| Provider Name | Raghav Sharma |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1477872885 PECOS PAC ID: 6406170117 Enrollment ID: I20190813003586 |
| Provider Name | Benjamin Grant Marshall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922369859 PECOS PAC ID: 1456661107 Enrollment ID: I20191008003594 |
| Provider Name | Nichole E Venzara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043875545 PECOS PAC ID: 7012249980 Enrollment ID: I20191025000467 |
| Provider Name | Eyad Rawhi El Far |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285084533 PECOS PAC ID: 7214360460 Enrollment ID: I20191203000459 |
| Provider Name | Miranda B Marshall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083973689 PECOS PAC ID: 3476987587 Enrollment ID: I20191226000796 |
| Provider Name | Lauren N Loftis |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1528222064 PECOS PAC ID: 6608039474 Enrollment ID: I20200207001928 |
| Provider Name | Melanie Lieblang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508392952 PECOS PAC ID: 2365714995 Enrollment ID: I20200211001264 |
| Provider Name | Carl W Mccord |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104836022 PECOS PAC ID: 1254420995 Enrollment ID: I20200303002282 |
| Provider Name | Jacqueline Hoskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316475171 PECOS PAC ID: 6608204730 Enrollment ID: I20200323003505 |
| Provider Name | Stephanie D Antepara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235688763 PECOS PAC ID: 6204265267 Enrollment ID: I20200326003519 |
| Provider Name | Mark E Franke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114934650 PECOS PAC ID: 5395738017 Enrollment ID: I20200331001597 |
| Provider Name | Craig J Philhower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285085076 PECOS PAC ID: 5496038416 Enrollment ID: I20200403001278 |
| Provider Name | Fernando Porter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669785770 PECOS PAC ID: 0941435986 Enrollment ID: I20200514002284 |
| Provider Name | Christopher Rosebrough |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831654599 PECOS PAC ID: 1052742640 Enrollment ID: I20200514003070 |
| Provider Name | Christina Schrack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861891566 PECOS PAC ID: 5092024711 Enrollment ID: I20200602001658 |
| Provider Name | Katherine J Flaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619458221 PECOS PAC ID: 5698008316 Enrollment ID: I20200615002713 |
| Provider Name | Jordan Loftis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477711760 PECOS PAC ID: 0840351359 Enrollment ID: I20200623002183 |
| Provider Name | Rebecca P Spofford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972859858 PECOS PAC ID: 3577710490 Enrollment ID: I20200928002232 |
| Provider Name | Claude Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316507064 PECOS PAC ID: 4486983038 Enrollment ID: I20201007002081 |
| Provider Name | Denise M Marburger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871118455 PECOS PAC ID: 7719306984 Enrollment ID: I20201008000039 |
| Provider Name | Hector Dejesus Rocha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255873063 PECOS PAC ID: 3476963737 Enrollment ID: I20201028001001 |
| Provider Name | Anaidiel Beltran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851947840 PECOS PAC ID: 5294145785 Enrollment ID: I20201112001609 |
| Provider Name | Shishir Kumar Khetan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861497372 PECOS PAC ID: 9335199017 Enrollment ID: I20210202002064 |
| Provider Name | Sharon Resto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861005464 PECOS PAC ID: 3476966359 Enrollment ID: I20210211000068 |
| Provider Name | Jonathan P Keenan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326451733 PECOS PAC ID: 1355637901 Enrollment ID: I20210506001907 |
| Provider Name | Jessica Stone Magnaldi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558965194 PECOS PAC ID: 4789086224 Enrollment ID: I20210707001454 |
| Provider Name | John B Passantino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902301542 PECOS PAC ID: 1658611058 Enrollment ID: I20210707003004 |
| Provider Name | Monique G Monard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164953022 PECOS PAC ID: 3577836659 Enrollment ID: I20210721002201 |
| Provider Name | Michelle Silva |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306377403 PECOS PAC ID: 1355614892 Enrollment ID: I20210812002346 |
| Provider Name | Pasqual Bracero |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003827809 PECOS PAC ID: 2062448343 Enrollment ID: I20210831001157 |
| Provider Name | Vaishali N Geib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114965399 PECOS PAC ID: 0840275798 Enrollment ID: I20210908001014 |
| Provider Name | Camilla Ruth Chacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235783218 PECOS PAC ID: 8729485867 Enrollment ID: I20210916001289 |
| Provider Name | Roxand Tina Villoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891300331 PECOS PAC ID: 8628475969 Enrollment ID: I20210929000595 |
| Provider Name | Kunal Agarwal |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1932497773 PECOS PAC ID: 4082846860 Enrollment ID: I20211006002339 |
| Provider Name | Tamra Jacquelle Lloyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912669896 PECOS PAC ID: 4486045309 Enrollment ID: I20220103000193 |
| Provider Name | Hussein T Anan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386057966 PECOS PAC ID: 2163718180 Enrollment ID: I20220125002967 |
| Provider Name | Shannan M Leonard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497194534 PECOS PAC ID: 9335379742 Enrollment ID: I20220328001099 |
| Provider Name | Anna Lee Woody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093472862 PECOS PAC ID: 6507252152 Enrollment ID: I20220406003041 |
| Provider Name | Elizabeth Emily Ballester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154082246 PECOS PAC ID: 9133515422 Enrollment ID: I20220414000353 |
| Provider Name | Cody Mitchell Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669944971 PECOS PAC ID: 6002145257 Enrollment ID: I20220604000395 |
| Provider Name | Bianca Marie Christmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184363657 PECOS PAC ID: 3678954724 Enrollment ID: I20220720002042 |
| Provider Name | Danielle Mcarthur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104463728 PECOS PAC ID: 2961838826 Enrollment ID: I20220729002960 |
| Provider Name | Karen M Fischborn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447816145 PECOS PAC ID: 2860729605 Enrollment ID: I20220829003318 |
| Provider Name | Jegan Gabbidon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932764685 PECOS PAC ID: 9133455272 Enrollment ID: I20220910000012 |
| Provider Name | Akash Patel |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1134388200 PECOS PAC ID: 4880749738 Enrollment ID: I20220912001566 |
| Provider Name | Qumara Hill-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871906024 PECOS PAC ID: 5597987594 Enrollment ID: I20220921002356 |
| Provider Name | Heather M Redfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366869091 PECOS PAC ID: 3577786904 Enrollment ID: I20221006002908 |
| Provider Name | Jennifer Lynne Cotto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619561560 PECOS PAC ID: 7719353945 Enrollment ID: I20221013000647 |
| Provider Name | Angela Patricia Salazar De Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497338701 PECOS PAC ID: 4082082524 Enrollment ID: I20221115000987 |
| Provider Name | Ronald Negrich |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1376546655 PECOS PAC ID: 8224926191 Enrollment ID: I20230124003357 |
| Provider Name | Chelsea K Robinson Honig |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265138093 PECOS PAC ID: 4284007766 Enrollment ID: I20230303000131 |
| Provider Name | Jessica Soros |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013368281 PECOS PAC ID: 1052604048 Enrollment ID: I20230314001623 |
| Provider Name | Mallory P Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639800634 PECOS PAC ID: 8628443819 Enrollment ID: I20230330001958 |
| Provider Name | Jeffrey Michael Jacobs |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1912081746 PECOS PAC ID: 9234239740 Enrollment ID: I20230331000087 |
| Provider Name | Jenna Macgillivray Rogerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689186900 PECOS PAC ID: 1355716846 Enrollment ID: I20230414002013 |
| Provider Name | Kayla Vliet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508425463 PECOS PAC ID: 3173852316 Enrollment ID: I20230519002974 |
| Provider Name | Daryl Noel Schauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619690823 PECOS PAC ID: 3971969585 Enrollment ID: I20230523002315 |
| Provider Name | Nader Jamaleddine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952939886 PECOS PAC ID: 6002280278 Enrollment ID: I20230608000790 |
| Provider Name | Jeffrey E Vanderbilt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568542082 PECOS PAC ID: 3375533318 Enrollment ID: I20230613000424 |
| Provider Name | Jeremiah D Fabry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316050719 PECOS PAC ID: 9931261989 Enrollment ID: I20230614002344 |
| Provider Name | Mia Mccallum-crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043675325 PECOS PAC ID: 7810276680 Enrollment ID: I20230707002199 |
| Provider Name | Melissa E Mercado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356025548 PECOS PAC ID: 5890159164 Enrollment ID: I20230920000157 |
| Provider Name | Matthew Pierce Ganovsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134758170 PECOS PAC ID: 2062867872 Enrollment ID: I20231014000674 |
| Provider Name | Melissa M Aycock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962286864 PECOS PAC ID: 4880040062 Enrollment ID: I20231024002559 |
| Provider Name | Muriel Veronica Medina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154949824 PECOS PAC ID: 7719333814 Enrollment ID: I20231025003934 |
| Provider Name | Chantel M Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780216390 PECOS PAC ID: 8325495799 Enrollment ID: I20231106003570 |
| Provider Name | Jessica Silver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750161816 PECOS PAC ID: 3072961820 Enrollment ID: I20231205000368 |
| Provider Name | Cyrena Marie Zemaitis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942074182 PECOS PAC ID: 0648621599 Enrollment ID: I20240104004543 |
| Provider Name | Alison Minnehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164294823 PECOS PAC ID: 9931542479 Enrollment ID: I20240212002443 |
| Provider Name | Janki K Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932883766 PECOS PAC ID: 5395188726 Enrollment ID: I20240213001398 |
| Provider Name | Jay Joglekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306890538 PECOS PAC ID: 1052357357 Enrollment ID: I20240322004026 |
| Provider Name | Priya Konda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689379877 PECOS PAC ID: 7214375930 Enrollment ID: I20240401001739 |
| Provider Name | Rachel Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457121022 PECOS PAC ID: 1052759784 Enrollment ID: I20240401002083 |
| Provider Name | Arabinda Behura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164690863 PECOS PAC ID: 0840483509 Enrollment ID: I20240417000382 |
| Provider Name | Shelli Crockett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366548430 PECOS PAC ID: 2769462415 Enrollment ID: I20240430001396 |
| Provider Name | Amanda I Thorngren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659141943 PECOS PAC ID: 3971944802 Enrollment ID: I20240509002629 |
| Provider Name | Irfan Choudhry |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952330920 PECOS PAC ID: 7517308141 Enrollment ID: I20240514003513 |
| Provider Name | Ruth Hey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881459493 PECOS PAC ID: 9830531029 Enrollment ID: I20240520001601 |
| Provider Name | Ronda Toole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467491290 PECOS PAC ID: 5092732313 Enrollment ID: I20240529000904 |
| Provider Name | Sheila Hope Ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023883956 PECOS PAC ID: 4284176207 Enrollment ID: I20240605004110 |
| Provider Name | Krista Leigh Smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093581852 PECOS PAC ID: 6507301371 Enrollment ID: I20240717000136 |
| Provider Name | Haleigh Lillian Andreasen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427754290 PECOS PAC ID: 2163968306 Enrollment ID: I20240723004433 |
| Provider Name | Cristina Marie Palermiti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487399499 PECOS PAC ID: 6406393552 Enrollment ID: I20240807000240 |
| Provider Name | Evelyn Ann Taylor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760241624 PECOS PAC ID: 7416497789 Enrollment ID: I20240912004370 |
| Provider Name | Camila Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508695412 PECOS PAC ID: 9234670134 Enrollment ID: I20240918004826 |
| Provider Name | David F.a. Goodridge |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568865996 PECOS PAC ID: 5496286684 Enrollment ID: I20240928000083 |
| Provider Name | Jessica Eastwood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760006977 PECOS PAC ID: 0547682965 Enrollment ID: I20240930002244 |
| Provider Name | Christine L Ranum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558082412 PECOS PAC ID: 8820457864 Enrollment ID: I20241024004077 |
| Provider Name | Courtney Lace Abramovitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386479582 PECOS PAC ID: 1658804513 Enrollment ID: I20241030002469 |
| Provider Name | Matthew Kyle Mcgowan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598218935 PECOS PAC ID: 9638602436 Enrollment ID: I20241101000097 |
| Provider Name | Cassandra Spielman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235610726 PECOS PAC ID: 2860926441 Enrollment ID: I20241106000711 |
| Provider Name | Stephanie Paige Lopez Orizondo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124604053 PECOS PAC ID: 1951835222 Enrollment ID: I20241108001206 |
| Provider Name | Gabriella Judith Haimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609642701 PECOS PAC ID: 3173057460 Enrollment ID: I20241108001958 |
| Provider Name | Angela Marie Bumpus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003476011 PECOS PAC ID: 9739613571 Enrollment ID: I20241115000710 |
| Provider Name | Monica R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528500733 PECOS PAC ID: 5092090357 Enrollment ID: I20241128000120 |
| Provider Name | Ariana Maria Rosado Maldonado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417512716 PECOS PAC ID: 5496281206 Enrollment ID: I20241203004587 |
| Provider Name | Elizabeth M Everett |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952850182 PECOS PAC ID: 8820524556 Enrollment ID: I20241205000304 |
| Provider Name | Evan Thomas |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1447618350 PECOS PAC ID: 9638449234 Enrollment ID: I20241209001293 |
| Provider Name | Pantaleo Romanelli |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1861271678 PECOS PAC ID: 1355877630 Enrollment ID: I20241210002647 |
| Provider Name | Theresa M Galindo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841934247 PECOS PAC ID: 2365816790 Enrollment ID: I20241211001447 |
| Provider Name | Carrie Cook |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912610551 PECOS PAC ID: 4486183944 Enrollment ID: I20250128004959 |
| Provider Name | Melissa Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275188831 PECOS PAC ID: 1658800958 Enrollment ID: I20250131001651 |
| Provider Name | Saba Haq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669460085 PECOS PAC ID: 4688684913 Enrollment ID: I20250305003645 |
Denny Ragsdale Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 Orlando Blvd, Indialantic, FL 32903 Phone: 321-432-9565 Fax: 321-722-1764 | |
Centre For Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 241 6th Ave, Indialantic, FL 32903 Phone: 321-729-8088 Fax: 321-729-8487 | |
Aalliance Rehab Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Miami Ave, Indialantic, FL 32903 Phone: 321-506-4830 Fax: 321-473-8744 | |
Rhmd Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 417 5th Ave Apt 101, Indialantic, FL 32903 Phone: 321-254-6803 Fax: 321-254-6819 | |
Awa Primary Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 97 Niemira Ave Apt E, Indialantic, FL 32903 Phone: 407-579-1616 Fax: 855-642-2122 | |
Joseph Rabinowitz Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 Nightingale Dr, Indialantic, FL 32903 Phone: 919-352-6223 |