| Pamela M. Ermine, DO LLC | |
|
10151 Enterprise Ctr Ste 102 Boynton Beach FL 33437-3760 | |
| (561) 536-7884 | |
| (561) 336-3776 |
| Full Name | Pamela M. Ermine, DO LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 10151 Enterprise Ctr Ste 102, Boynton Beach, Florida |
| Authorized Official Name and Position | Pamela Ermine (OWNER) |
| Authorized Official Contact | 5615367884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela M. Ermine, DO LLC 10151 Enterprise Ctr Ste 102 Boynton Beach FL 33437-3760 Ph: (561) 536-7884 | Pamela M. Ermine, DO LLC 10151 Enterprise Ctr Ste 102 Boynton Beach FL 33437-3760 Ph: (561) 536-7884 |
| NPI Number | 1669091666 |
|---|---|
| Provider Enumeration Date | 04/10/2020 |
| Last Update Date | 04/24/2020 |
| Certification Date | 04/24/2020 |
| Medicare PECOS PAC ID | 4981035177 |
|---|---|
| Medicare Enrollment ID | O20200501001615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669091666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Pamela M Ermine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508887506 PECOS PAC ID: 4082612650 Enrollment ID: I20061114000274 |
| Provider Name | Susanne L Smithson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851874069 PECOS PAC ID: 2769885144 Enrollment ID: I20210722001640 |
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