| Jack Pfeilsticker M D P A | |
|
4701 Manatee Ave W Bradenton FL 34209-3851 | |
| (941) 747-2282 | |
| (941) 757-0656 |
| Full Name | Jack Pfeilsticker M D P A |
|---|---|
| Speciality | Clinic/Center |
| Location | 4701 Manatee Ave W, Bradenton, Florida |
| Authorized Official Name and Position | John Andrew Pfeilsticker (OWNER) |
| Authorized Official Contact | 9417472282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Pfeilsticker M D P A 4701 Manatee Ave W Bradenton FL 34209-3851 Ph: (941) 747-2282 | Jack Pfeilsticker M D P A 4701 Manatee Ave W Bradenton FL 34209-3851 Ph: (941) 747-2282 |
| NPI Number | 1265573018 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 04/08/2011 |
| Medicare PECOS PAC ID | 5890774947 |
|---|---|
| Medicare Enrollment ID | O20040714000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265573018 | NPI | - | NPPES |
| 266225600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME46226 (Florida) | Primary |
| Provider Name | John A Pfeilsticker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609889567 PECOS PAC ID: 2264320431 Enrollment ID: I20040309000575 |
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