| Indian River Internal Medicine, Llc | |
|
7935 Bay St Suite 3 Sebastian FL 32958-3282 | |
| (772) 581-1881 | |
| (772) 581-1885 |
| Full Name | Indian River Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7935 Bay St, Sebastian, Florida |
| Authorized Official Name and Position | Enio Luis Prieto (SOLE MANAGING MEMBER) |
| Authorized Official Contact | 7725811881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian River Internal Medicine, Llc 7935 Bay St Suite 3 Sebastian FL 32958-3282 Ph: (772) 581-1881 | Indian River Internal Medicine, Llc 7935 Bay St Suite 3 Sebastian FL 32958-3282 Ph: (772) 581-1881 |
| NPI Number | 1811136773 |
|---|---|
| Provider Enumeration Date | 02/16/2009 |
| Last Update Date | 07/16/2021 |
| Medicare PECOS PAC ID | 8123178183 |
|---|---|
| Medicare Enrollment ID | O20090612000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811136773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME80380 (Florida) | Primary |
| Provider Name | Enio L Prieto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063498384 PECOS PAC ID: 7719037779 Enrollment ID: I20090612000172 |
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