| Palm Medical Center Lakeland Llc | |
|
135 E 1st St Lakeland FL 33805-4609 | |
| (863) 686-2728 | |
| Not Available |
| Full Name | Palm Medical Center Lakeland Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 135 E 1st St, Lakeland, Florida |
| Authorized Official Name and Position | Santiago Moises Martin (COO) |
| Authorized Official Contact | 3059139441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Medical Center Lakeland Llc 2600 S Douglas Rd Ste 308 Coral Gables FL 33134-6134 Ph: () - | Palm Medical Center Lakeland Llc 135 E 1st St Lakeland FL 33805-4609 Ph: (863) 686-2728 |
| NPI Number | 1437650579 |
|---|---|
| Provider Enumeration Date | 02/23/2018 |
| Last Update Date | 09/22/2021 |
| Medicare PECOS PAC ID | 9830431188 |
|---|---|
| Medicare Enrollment ID | O20190507000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437650579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Khin M Latt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841274115 PECOS PAC ID: 8224026893 Enrollment ID: I20040503001280 |
| Provider Name | Sanjiv K Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861492100 PECOS PAC ID: 8527029255 Enrollment ID: I20041025001169 |
| Provider Name | Ernesto Aguilera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497730170 PECOS PAC ID: 2062476625 Enrollment ID: I20041115000514 |
| Provider Name | Eric Ranon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861476137 PECOS PAC ID: 8921031766 Enrollment ID: I20050913000850 |
| Provider Name | Zaw Min |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649255373 PECOS PAC ID: 1456442623 Enrollment ID: I20070802000608 |
| Provider Name | Devjit Halder |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962677666 PECOS PAC ID: 5395803894 Enrollment ID: I20081028000585 |
| Provider Name | Himanshu Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164432274 PECOS PAC ID: 7618162348 Enrollment ID: I20101108001213 |
| Provider Name | Louann M Albano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841597549 PECOS PAC ID: 3870778780 Enrollment ID: I20110419000515 |
| Provider Name | Chandravadan Jashbhai Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740280833 PECOS PAC ID: 2163698671 Enrollment ID: I20120105000310 |
| Provider Name | Okoroafor N Maduagwu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1588058325 PECOS PAC ID: 4981914736 Enrollment ID: I20151105002215 |
| Provider Name | Hector Soto-adames |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992881049 PECOS PAC ID: 2466530142 Enrollment ID: I20160629000085 |
| Provider Name | Mariannette Plaza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477535144 PECOS PAC ID: 6800140468 Enrollment ID: I20181116002134 |
| Provider Name | Daymi Cowgill |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437634144 PECOS PAC ID: 2163767146 Enrollment ID: I20181219001685 |
| Provider Name | Bincy Tijo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538643895 PECOS PAC ID: 2466798665 Enrollment ID: I20190109000807 |
| Provider Name | Roberto Cruz Garcia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639733207 PECOS PAC ID: 9931528478 Enrollment ID: I20201001002175 |
| Provider Name | Jennifer Kouromihelakis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235552969 PECOS PAC ID: 7911317763 Enrollment ID: I20201105001347 |
| Provider Name | Fay M Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235663105 PECOS PAC ID: 4486060563 Enrollment ID: I20210316000830 |
| Provider Name | Lorna Hicher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952940900 PECOS PAC ID: 1557761921 Enrollment ID: I20210608000252 |
Adult Primary Care Of Polk County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4740 Exploration Ave, Lakeland, FL 33812 Phone: 863-666-9020 Fax: 863-606-0887 | |
Verimed Health Group Lakeland Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1417 Lakeland Hills Blvd, Suite 204, Lakeland, FL 33805 Phone: 813-415-5038 | |
Ethos Health Lakeland, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 625 Commerce Dr Ste 104, Lakeland, FL 33813 Phone: 352-732-5590 Fax: 352-732-0292 | |
Premier Walk In Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5676 S Florida Ave, Lakeland, FL 33813 Phone: 863-644-3400 Fax: 863-619-2400 | |
Central Florida Health Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 903 Lowry Ave, Lakeland, FL 33801 Phone: 866-234-8534 | |
Bond Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2039 E Edgewood Dr, Lakeland, FL 33803 Phone: 863-293-1191 | |
Lake Miriam Campus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4710 S Florida Ave, Lakeland, FL 33813 Phone: 863-284-6800 Fax: 863-284-6807 |