| Icon Medical, PLLC | |
|
1251 Rudder Ln Osprey FL 34229-9104 | |
| (941) 999-0241 | |
| (908) 867-0506 |
| Full Name | Icon Medical, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1251 Rudder Ln, Osprey, Florida |
| Authorized Official Name and Position | Josephine Olsen (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9419990241 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icon Medical, PLLC 1251 Rudder Ln Osprey FL 34229-9104 Ph: (941) 999-0241 | Icon Medical, PLLC 1251 Rudder Ln Osprey FL 34229-9104 Ph: (941) 999-0241 |
| NPI Number | 1134019268 |
|---|---|
| Provider Enumeration Date | 07/09/2025 |
| Last Update Date | 07/09/2025 |
| Certification Date | 07/09/2025 |
| Medicare PECOS PAC ID | 1951807072 |
|---|---|
| Medicare Enrollment ID | O20250929002279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134019268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Josephine K Olsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144652975 PECOS PAC ID: 8325268345 Enrollment ID: I20200923000267 |
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