| Origins Family Medical & Weight Loss Clinic Inc | |
|
206 S Marion Ave Lake City FL 32025-7058 | |
| (386) 755-5014 | |
| (386) 755-3093 |
| Full Name | Origins Family Medical & Weight Loss Clinic Inc |
|---|---|
| Speciality | General Practice |
| Location | 206 S Marion Ave, Lake City, Florida |
| Authorized Official Name and Position | Duane E. Thomas (PRESIDENT/DIRECTOR) |
| Authorized Official Contact | 3867555014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Origins Family Medical & Weight Loss Clinic Inc 194 Sw Wall Ter Lake City FL 32025-5086 Ph: (386) 719-9227 | Origins Family Medical & Weight Loss Clinic Inc 206 S Marion Ave Lake City FL 32025-7058 Ph: (386) 755-5014 |
| NPI Number | 1962835306 |
|---|---|
| Provider Enumeration Date | 08/20/2013 |
| Last Update Date | 09/12/2013 |
| Medicare PECOS PAC ID | 4688808520 |
|---|---|
| Medicare Enrollment ID | O20131220001112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962835306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Rodney L Scyphers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942254651 PECOS PAC ID: 5890768873 Enrollment ID: I20040817001336 |
| Provider Name | Todd A Perla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235146408 PECOS PAC ID: 0840229308 Enrollment ID: I20050805000245 |
| Provider Name | Girish Bhaskar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477599751 PECOS PAC ID: 0143403139 Enrollment ID: I20110329000678 |
| Provider Name | Marina M Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710311337 PECOS PAC ID: 4587893722 Enrollment ID: I20140210000906 |
| Provider Name | Laura Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902008857 PECOS PAC ID: 1355572595 Enrollment ID: I20140401000745 |
| Provider Name | Osayande Stephen Izeiyamu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255698619 PECOS PAC ID: 9739409483 Enrollment ID: I20150520000378 |
Ernest De Leon, Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4225 Nw American Ln, Lake City, FL 32055 Phone: 386-758-6141 | |
Richard Weizenecker, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1297 Sw State Road 47, Lake City, FL 32025 Phone: 386-752-4711 Fax: 386-752-5075 | |
Palms Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 173 Nw Albritton Ln, Lake City, FL 32055 Phone: 386-755-4020 Fax: 386-752-9143 | |
Internal Medicine Of Lake City , Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 334 Sw Commerce Dr, Suite 2, Lake City, FL 32025 Phone: 386-755-1703 Fax: 386-755-1744 | |
Randolph Medical Practices Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1847 Sw Barnett Way, Lake City, FL 32025 Phone: 386-755-1440 Fax: 386-758-5628 | |
Raimah Primary Care Center Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1283 Sw State Road 47, 103, Lake City, FL 32025 Phone: 386-754-0339 Fax: 386-754-0393 | |
Cassidy Health And Wellness Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 S Marion Ave, Lake City, FL 32025 Phone: 386-438-5722 Fax: 386-438-8631 |