| Humayun Shareef Md Pa | |
|
2401 Frist Blvd Ste 1 Fort Pierce FL 34950-4839 | |
| (772) 465-6979 | |
| (772) 465-4288 |
| Full Name | Humayun Shareef Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2401 Frist Blvd, Fort Pierce, Florida |
| Authorized Official Name and Position | Humayun Shareef (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7724656979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Humayun Shareef Md Pa 2401 Frist Blvd Ste 1 Fort Pierce FL 34950-4839 Ph: (772) 465-6979 | Humayun Shareef Md Pa 2401 Frist Blvd Ste 1 Fort Pierce FL 34950-4839 Ph: (772) 465-6979 |
| NPI Number | 1306147327 |
|---|---|
| Provider Enumeration Date | 11/08/2010 |
| Last Update Date | 08/31/2016 |
| Medicare PECOS PAC ID | 5597943563 |
|---|---|
| Medicare Enrollment ID | O20110621000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306147327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 05870 (Florida) | Primary |
| Provider Name | Humayun Shareef |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790843464 PECOS PAC ID: 5799681904 Enrollment ID: I20031209000729 |
| Provider Name | Santos Ruiz Cordero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598976557 PECOS PAC ID: 0143292797 Enrollment ID: I20141027000459 |
| Provider Name | Kelli Kraaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003275157 PECOS PAC ID: 0648521666 Enrollment ID: I20181001001581 |
| Provider Name | Heather Hedal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922741495 PECOS PAC ID: 6204298623 Enrollment ID: I20230817001276 |
| Provider Name | Jocelyn Willett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760933766 PECOS PAC ID: 8820377302 Enrollment ID: I20231201001071 |
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