| Medway Medical Centers Llc | |
|
4802 Grand Blvd New Port Richey FL 34652-5106 | |
| (727) 877-8837 | |
| Not Available |
| Full Name | Medway Medical Centers Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4802 Grand Blvd, New Port Richey, Florida |
| Authorized Official Name and Position | Jose V Perez (MGR) |
| Authorized Official Contact | 3053228202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medway Medical Centers Llc 4802 Grand Blvd New Port Richey FL 34652-5106 Ph: (727) 877-8837 | Medway Medical Centers Llc 4802 Grand Blvd New Port Richey FL 34652-5106 Ph: (727) 877-8837 |
| NPI Number | 1669063475 |
|---|---|
| Provider Enumeration Date | 02/03/2021 |
| Last Update Date | 05/05/2021 |
| Medicare PECOS PAC ID | 1850795154 |
|---|---|
| Medicare Enrollment ID | O20210809002993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669063475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Jose V Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528208691 PECOS PAC ID: 9638293384 Enrollment ID: I20100901000476 |
| Provider Name | Abelardo Suarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306380076 PECOS PAC ID: 1850703216 Enrollment ID: I20201209002144 |
| Provider Name | Gelys Gongora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912674805 PECOS PAC ID: 0547336950 Enrollment ID: I20211025001778 |
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