| Infectious Diseases Consultants, P.a. | |
|
21205 Olean Blvd Ste A Port Charlotte FL 33952-6756 | |
| (941) 613-2800 | |
| (941) 613-2801 |
| Full Name | Infectious Diseases Consultants, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 21205 Olean Blvd Ste A, Port Charlotte, Florida |
| Authorized Official Name and Position | Eileen Richard (OFFICE MANAGER) |
| Authorized Official Contact | 9416132800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Diseases Consultants, P.a. 21205 Olean Blvd Ste A Port Charlotte FL 33952-6756 Ph: (941) 613-2800 | Infectious Diseases Consultants, P.a. 21205 Olean Blvd Ste A Port Charlotte FL 33952-6756 Ph: (941) 613-2800 |
| NPI Number | 1043308141 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 02/08/2022 |
| Medicare PECOS PAC ID | 2860399680 |
|---|---|
| Medicare Enrollment ID | O20031218000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043308141 | NPI | - | NPPES |
| 440002698 | Other | FL | RR MEDICARE |
| P00338188 | Other | FL | RR MEDICARE |
| 271223700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME0056397 (Florida) | Primary |
| Provider Name | Karl G Damiani |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497743744 PECOS PAC ID: 4284692336 Enrollment ID: I20041221000853 |
| Provider Name | Luong Phu Nguyen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518120005 PECOS PAC ID: 1850540576 Enrollment ID: I20121012000243 |
| Provider Name | Ndubuisi C Edeoga |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497919039 PECOS PAC ID: 9436325495 Enrollment ID: I20130730000906 |
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