| Family Health Enterprises Inc | |
|
607 Highway 466 Lady Lake FL 32159-3792 | |
| (352) 259-7994 | |
| (352) 259-7992 |
| Full Name | Family Health Enterprises Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 607 Highway 466, Lady Lake, Florida |
| Authorized Official Name and Position | John D Burress (PRESIDENT) |
| Authorized Official Contact | 3522597994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Enterprises Inc Po Box 1777 Lady Lake FL 32158-1777 Ph: (352) 259-7994 | Family Health Enterprises Inc 607 Highway 466 Lady Lake FL 32159-3792 Ph: (352) 259-7994 |
| NPI Number | 1538192075 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 02/06/2013 |
| Medicare PECOS PAC ID | 9830082536 |
|---|---|
| Medicare Enrollment ID | O20040205001125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538192075 | NPI | - | NPPES |
| DC9694 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John Burress |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649295973 PECOS PAC ID: 6800789504 Enrollment ID: I20040206000067 |
| Provider Name | Maria Orrego Bradford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487078200 PECOS PAC ID: 0648403568 Enrollment ID: I20140430001134 |
| Provider Name | Jane Johansson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821353350 PECOS PAC ID: 0244467629 Enrollment ID: I20150303000763 |
| Provider Name | Lana A Ecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982945200 PECOS PAC ID: 8123269362 Enrollment ID: I20160202001865 |
| Provider Name | Ronald E Kope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326463407 PECOS PAC ID: 7517279078 Enrollment ID: I20170330002375 |
| Provider Name | Karen O Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538671672 PECOS PAC ID: 4183983414 Enrollment ID: I20180112001957 |
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