| Peace River Center | |
|
1239 E Main St Bartow FL 33830-5058 | |
| (863) 519-0575 | |
| (863) 582-9251 |
| Full Name | Peace River Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1239 E Main St, Bartow, Florida |
| Authorized Official Name and Position | Jo Deck (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8635190575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace River Center Po Box 1559 Bartow FL 33831-1559 Ph: (863) 519-0575 | Peace River Center 1239 E Main St Bartow FL 33830-5058 Ph: (863) 519-0575 |
| NPI Number | 1821097767 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 12/04/2023 |
| Medicare PECOS PAC ID | 7719877927 |
|---|---|
| Medicare Enrollment ID | O20040319000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821097767 | NPI | - | NPPES |
| 060310405 | Medicaid | FL | |
| 060310406 | Medicaid | FL | |
| 060310417 | Medicaid | FL | |
| 060310424 | Medicaid | FL | |
| 761545101 | Medicaid | FL | |
| 060310401 | Medicaid | FL | |
| 060310410 | Medicaid | FL | |
| 060310425 | Medicaid | FL | |
| 060310437 | Medicaid | FL | |
| 060310409 | Medicaid | FL | |
| 060310414 | Medicaid | FL | |
| 060310416 | Medicaid | FL | |
| 060310421 | Medicaid | FL | |
| 060310422 | Medicaid | FL | |
| 060310423 | Medicaid | FL | |
| 060310404 | Medicaid | FL | |
| 060310418 | Medicaid | FL | |
| 060310428 | Medicaid | FL | |
| 060310432 | Medicaid | FL | |
| 060310434 | Medicaid | FL | |
| 060310411 | Medicaid | FL | |
| 060310412 | Medicaid | FL | |
| 060310420 | Medicaid | FL | |
| 060310400 | Medicaid | FL | |
| 060310413 | Medicaid | FL | |
| 060310415 | Medicaid | FL | |
| 060310419 | Medicaid | FL | |
| 060310426 | Medicaid | FL | |
| 060310429 | Medicaid | FL |
| Provider Name | Charles A Barrios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023232162 PECOS PAC ID: 4183685183 Enrollment ID: I20041022000788 |
| Provider Name | William Sadowsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013982057 PECOS PAC ID: 9335104546 Enrollment ID: I20041130000542 |
| Provider Name | Jorge J Dorta-duque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124053699 PECOS PAC ID: 5092811406 Enrollment ID: I20070501000643 |
| Provider Name | Karen Barber Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700993649 PECOS PAC ID: 4880783869 Enrollment ID: I20071128000357 |
| Provider Name | Ushimbra Buford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568673390 PECOS PAC ID: 8729133087 Enrollment ID: I20090910000178 |
| Provider Name | Lorinda E Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659558096 PECOS PAC ID: 5890879407 Enrollment ID: I20110217000489 |
| Provider Name | Rose I Ogle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649266693 PECOS PAC ID: 6800061748 Enrollment ID: I20111205000765 |
| Provider Name | Adelma Kilgore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063424703 PECOS PAC ID: 8628048667 Enrollment ID: I20120131000229 |
| Provider Name | Sharon M Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487903605 PECOS PAC ID: 1557511524 Enrollment ID: I20121029000322 |
| Provider Name | Patricia A Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114119070 PECOS PAC ID: 8325284029 Enrollment ID: I20130425000358 |
| Provider Name | Olivia J Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023125945 PECOS PAC ID: 4880833599 Enrollment ID: I20130610000312 |
| Provider Name | Amy K Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083904700 PECOS PAC ID: 4587803218 Enrollment ID: I20130610000558 |
| Provider Name | Mavra Eileen Kear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558357418 PECOS PAC ID: 3476793878 Enrollment ID: I20130708000729 |
| Provider Name | Tonya T Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043475395 PECOS PAC ID: 9436373289 Enrollment ID: I20140617001614 |
| Provider Name | Alicia Nicole Carden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942688403 PECOS PAC ID: 6901110576 Enrollment ID: I20150728003840 |
| Provider Name | Heather Ellis Bonfil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962803288 PECOS PAC ID: 2264653997 Enrollment ID: I20150917002382 |
| Provider Name | Monay A Link |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285092742 PECOS PAC ID: 0547567836 Enrollment ID: I20160331002146 |
| Provider Name | Katha Darlene Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841658135 PECOS PAC ID: 4486953031 Enrollment ID: I20160503000965 |
| Provider Name | Jacquelyn Delgado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952775124 PECOS PAC ID: 8729367974 Enrollment ID: I20161111000628 |
| Provider Name | Carolann M Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770807687 PECOS PAC ID: 5092096602 Enrollment ID: I20161219002038 |
| Provider Name | Equilla Vonzetti Cherry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689029480 PECOS PAC ID: 9739474123 Enrollment ID: I20170825003094 |
| Provider Name | Ronald Scott Rathje |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710085006 PECOS PAC ID: 7517005333 Enrollment ID: I20171229002314 |
| Provider Name | Nnenna C Emelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770934127 PECOS PAC ID: 5991063588 Enrollment ID: I20180104000378 |
| Provider Name | Jessica L Dobbertin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053787077 PECOS PAC ID: 7416282157 Enrollment ID: I20190717001857 |
| Provider Name | Jean Baptiste Tropnas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720013295 PECOS PAC ID: 0749171452 Enrollment ID: I20190927001174 |
| Provider Name | Julie J Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801357066 PECOS PAC ID: 6608107628 Enrollment ID: I20191007000016 |
| Provider Name | Briane Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316377997 PECOS PAC ID: 9335489517 Enrollment ID: I20191220001799 |
| Provider Name | Jacinta Okeke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861975575 PECOS PAC ID: 6507270931 Enrollment ID: I20210127000051 |
| Provider Name | Kristy Laine O'neill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841773140 PECOS PAC ID: 6800295635 Enrollment ID: I20210528000363 |
| Provider Name | Lisa M Burgos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871028829 PECOS PAC ID: 6406244409 Enrollment ID: I20211025001503 |
| Provider Name | Orlyne Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710574868 PECOS PAC ID: 6305229998 Enrollment ID: I20220815001726 |
| Provider Name | Yesenia Maria Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194458802 PECOS PAC ID: 5698159101 Enrollment ID: I20220901001803 |
| Provider Name | Samantha Ferguson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265866271 PECOS PAC ID: 5597113159 Enrollment ID: I20231121001865 |
| Provider Name | Adam Bazini |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346467016 PECOS PAC ID: 2961852306 Enrollment ID: I20231227000706 |
| Provider Name | Robert West |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861489288 PECOS PAC ID: 5698125938 Enrollment ID: I20231228001306 |
| Provider Name | Amanda Collister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255723623 PECOS PAC ID: 1658721865 Enrollment ID: I20240102000267 |
| Provider Name | Myriam M Buitrago |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033552260 PECOS PAC ID: 7517317647 Enrollment ID: I20240102001169 |
| Provider Name | Lynn M Repetosky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558486357 PECOS PAC ID: 2668822792 Enrollment ID: I20240102001310 |
| Provider Name | Marcela Isabel Arellano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912281825 PECOS PAC ID: 4789034828 Enrollment ID: I20240102001525 |
| Provider Name | Holly Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699948844 PECOS PAC ID: 3173973187 Enrollment ID: I20240103000056 |
| Provider Name | Sarah Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457762551 PECOS PAC ID: 4587014592 Enrollment ID: I20240103000179 |
| Provider Name | Eric Chatman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508234394 PECOS PAC ID: 8426409475 Enrollment ID: I20240104000645 |
| Provider Name | Simone Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891350336 PECOS PAC ID: 5991156820 Enrollment ID: I20240104003797 |
| Provider Name | Amber Hartman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316329790 PECOS PAC ID: 1759732456 Enrollment ID: I20240107000025 |
| Provider Name | Donna Rininger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518056175 PECOS PAC ID: 5597116293 Enrollment ID: I20240108000128 |
| Provider Name | Luke Bigelow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245721265 PECOS PAC ID: 7012368756 Enrollment ID: I20240108003440 |
| Provider Name | Christopher Kizirian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790308617 PECOS PAC ID: 4880045533 Enrollment ID: I20240108003651 |
| Provider Name | Melissa Fulton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992165427 PECOS PAC ID: 1254782832 Enrollment ID: I20240108005131 |
Digestive Health Physicians Of Central Florida Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1350 E Main St Ste C-2, Bartow, FL 33830 Phone: 863-519-0902 Fax: 863-519-0904 | |
Care 4 All Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 Flamingo Drive, Bartow, FL 33830 Phone: 863-604-0047 Fax: 863-537-7530 | |
Silva Family Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 230 Old Bartow Eagle Lake Rd, Bartow, FL 33830 Phone: 863-800-3741 Fax: 863-800-3742 | |
The Rohr Home Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2120 Marshall Edwards Dr, Bartow, FL 33830 Phone: 863-519-7579 Fax: 863-519-4783 | |
Bartow Medical Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 Flamingo Dr, Bartow, FL 33830 Phone: 863-533-4104 Fax: 863-533-4549 | |
Janivara Umesh Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1350 E Main St, Suite C1, Bartow, FL 33830 Phone: 863-646-7220 Fax: 863-533-0333 | |
Baycare Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2250 Osprey Blvd Ste 102, Bartow, FL 33830 Phone: 863-533-1448 Fax: 863-533-2189 |