| Citrus Medical Associates | |
|
2901 W Saint Isabel St Ste F Tampa FL 33607-6371 | |
| (813) 935-4744 | |
| Not Available |
| Full Name | Citrus Medical Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 2901 W Saint Isabel St Ste F, Tampa, Florida |
| Authorized Official Name and Position | Meagan Christine Mane (CFO) |
| Authorized Official Contact | 8139354744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citrus Medical Associates 2901 W Saint Isabel St Ste F Tampa FL 33607-6371 Ph: (813) 935-4744 | Citrus Medical Associates 2901 W Saint Isabel St Ste F Tampa FL 33607-6371 Ph: (813) 935-4744 |
| NPI Number | 1417423344 |
|---|---|
| Provider Enumeration Date | 10/18/2018 |
| Last Update Date | 11/23/2020 |
| Certification Date | 11/23/2020 |
| Medicare PECOS PAC ID | 8325383052 |
|---|---|
| Medicare Enrollment ID | O20181227000349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417423344 | NPI | - | NPPES |
| JI8GZ | Other | FL | BLUE CROSS BLUE SHIELD |
| 435I | Other | FL | AVMED |
| 103843600 | Medicaid | FL | |
| 6986186 | Other | FL | AETNA |
| 7420970 | Other | FL | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Nelson Mane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568520971 PECOS PAC ID: 1658615257 Enrollment ID: I20181210000807 |
| Provider Name | Gregory Disla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376197541 PECOS PAC ID: 4486072170 Enrollment ID: I20200911002087 |
| Provider Name | Cheryl Bray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336877745 PECOS PAC ID: 9739562059 Enrollment ID: I20220819001264 |
| Provider Name | Andrew Paul Barnes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598256752 PECOS PAC ID: 0547638041 Enrollment ID: I20221114002581 |
| Provider Name | Marcelo Farias |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114546108 PECOS PAC ID: 7517388192 Enrollment ID: I20240914000783 |
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