| Impact Medical Group Llc | |
|
2014 Ashley Oaks Cir Wesley Chapel FL 33544-6400 | |
| (813) 953-1002 | |
| Not Available |
| Full Name | Impact Medical Group Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 2014 Ashley Oaks Cir, Wesley Chapel, Florida |
| Authorized Official Name and Position | Melissa N Botbyl (ADMINISTRATOR) |
| Authorized Official Contact | 7272724919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Medical Group Llc Po Box 7982 Seminole FL 33775-7982 Ph: () - | Impact Medical Group Llc 2014 Ashley Oaks Cir Wesley Chapel FL 33544-6400 Ph: (813) 953-1002 |
| NPI Number | 1992263164 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 02/28/2022 |
| Medicare PECOS PAC ID | 4688093396 |
|---|---|
| Medicare Enrollment ID | O20200930000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992263164 | NPI | - | NPPES |
| Provider Name | Brian G Wolstein |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043250376 PECOS PAC ID: 9830091727 Enrollment ID: I20041109001089 |
| Provider Name | Richard B Powell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023103702 PECOS PAC ID: 9830157981 Enrollment ID: I20041222000201 |
| Provider Name | Sean M Woodward |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023052552 PECOS PAC ID: 0042313603 Enrollment ID: I20070320000317 |
| Provider Name | David G Wolstein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235334160 PECOS PAC ID: 5092778423 Enrollment ID: I20110324000576 |
| Provider Name | Sheryl Haynes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1669564241 PECOS PAC ID: 9234413733 Enrollment ID: I20200109001215 |
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