| Cleopatra Gordon Pusey, Md P.a. | |
|
1100 S 56th Ave Hollywood FL 33023-1923 | |
| (954) 392-9026 | |
| (954) 357-2353 |
| Full Name | Cleopatra Gordon Pusey, Md P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1100 S 56th Ave, Hollywood, Florida |
| Authorized Official Name and Position | Cleopatra Tamaria Gordon Pusey (PRESIDENT) |
| Authorized Official Contact | 9543929026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleopatra Gordon Pusey, Md P.a. 222 S Flamingo Rd Pembroke Pines FL 33027-1721 Ph: (954) 392-9026 | Cleopatra Gordon Pusey, Md P.a. 1100 S 56th Ave Hollywood FL 33023-1923 Ph: (954) 392-9026 |
| NPI Number | 1740502228 |
|---|---|
| Provider Enumeration Date | 02/24/2010 |
| Last Update Date | 07/09/2025 |
| Medicare PECOS PAC ID | 6002946605 |
|---|---|
| Medicare Enrollment ID | O20100608000643 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740502228 | NPI | - | NPPES |
| 101833801 | Medicaid | FL | |
| 281390400 | Medicaid | FL | |
| 146LM | Other | FL | BCBS |
| 281390402 | Medicaid | FL | |
| 311776 | Other | FL | AVMED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
| Provider Name | Cleopatra T Gordon-pusey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821275462 PECOS PAC ID: 8921172404 Enrollment ID: I20080731000620 |
| Provider Name | Jennelyn Ipo Moneda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962984104 PECOS PAC ID: 3375881451 Enrollment ID: I20190214003059 |
| Provider Name | Linda Uhunmwangho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952881963 PECOS PAC ID: 5991131740 Enrollment ID: I20200214000937 |
| Provider Name | Vivian Aguiar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205283975 PECOS PAC ID: 8426341686 Enrollment ID: I20200721001225 |
| Provider Name | Jiny Shyju |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104400035 PECOS PAC ID: 8628466547 Enrollment ID: I20211026003371 |
| Provider Name | Shorraine Daubon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649738840 PECOS PAC ID: 9537544994 Enrollment ID: I20220921001149 |
| Provider Name | Sharon Rose Wallace-wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699323287 PECOS PAC ID: 0941666705 Enrollment ID: I20230520000102 |
| Provider Name | Marjorie V Scarlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811720634 PECOS PAC ID: 8325573389 Enrollment ID: I20241127002078 |
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