| Island Health Concierge Medicine, Inc | |
|
9301 Highway A1a Ste 202 Vero Beach FL 32963-5602 | |
| (772) 205-6361 | |
| (772) 410-5477 |
| Full Name | Island Health Concierge Medicine, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9301 Highway A1a Ste 202, Vero Beach, Florida |
| Authorized Official Name and Position | Latia H Ilyadis (OWNER) |
| Authorized Official Contact | 5187636969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Health Concierge Medicine, Inc Po Box 643608 Vero Beach FL 32964-3608 Ph: (518) 763-6969 | Island Health Concierge Medicine, Inc 9301 Highway A1a Ste 202 Vero Beach FL 32963-5602 Ph: (772) 205-6361 |
| NPI Number | 1689353609 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Medicare PECOS PAC ID | 5597281931 |
|---|---|
| Medicare Enrollment ID | O20250429000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689353609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Latia Holder Ilyadis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861658650 PECOS PAC ID: 2062678576 Enrollment ID: I20131105001616 |
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