| Nordquist Family Medical Center Md Pa | |
|
1925 Don Wickham Dr Clermont FL 34711-1915 | |
| (352) 638-7900 | |
| (877) 444-2394 |
| Full Name | Nordquist Family Medical Center Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1925 Don Wickham Dr, Clermont, Florida |
| Authorized Official Name and Position | Clay E Nordquist (PRESIDENT) |
| Authorized Official Contact | 3526387900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nordquist Family Medical Center Md Pa 1925 Don Wickham Dr Clermont FL 34711-1915 Ph: (352) 638-7900 | Nordquist Family Medical Center Md Pa 1925 Don Wickham Dr Clermont FL 34711-1915 Ph: (352) 638-7900 |
| NPI Number | 1770867269 |
|---|---|
| Provider Enumeration Date | 10/04/2011 |
| Last Update Date | 10/04/2011 |
| Medicare PECOS PAC ID | 4587838982 |
|---|---|
| Medicare Enrollment ID | O20111121000926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770867269 | NPI | - | NPPES |
| ME103291 | Other | FL | FL MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME103291 (Florida) | Primary |
| Provider Name | Clay E Nordquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952546681 PECOS PAC ID: 5799824785 Enrollment ID: I20091204000226 |
| Provider Name | Cortney Elzabeth Keck Roesch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467161984 PECOS PAC ID: 3375913940 Enrollment ID: I20221227000138 |
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