| Internal Medicine MD LLC | |
|
14153 Yosemite Dr Ste 104 Hudson FL 34667-8065 | |
| (727) 267-6490 | |
| Not Available |
| Full Name | Internal Medicine MD LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 14153 Yosemite Dr Ste 104, Hudson, Florida |
| Authorized Official Name and Position | John Hanna (MANAGER) |
| Authorized Official Contact | 7272676490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine MD LLC 10642 Firebrick Ct Trinity FL 34655-5030 Ph: (727) 267-6490 | Internal Medicine MD LLC 14153 Yosemite Dr Ste 104 Hudson FL 34667-8065 Ph: (727) 267-6490 |
| NPI Number | 1982332011 |
|---|---|
| Provider Enumeration Date | 08/08/2022 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/14/2022 |
| Medicare PECOS PAC ID | 4688059934 |
|---|---|
| Medicare Enrollment ID | O20220922001587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982332011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | John Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548765464 PECOS PAC ID: 7618224163 Enrollment ID: I20210714000366 |
| Provider Name | Miranda D Mcwhirter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124896766 PECOS PAC ID: 7315489317 Enrollment ID: I20240605003442 |
| Provider Name | Amanda Nicole Durrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003644055 PECOS PAC ID: 1850813239 Enrollment ID: I20260329000069 |
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