| Pst Florida 2009 LLC | |
|
3300 Sw 34th Ave Suite 116 Ocala FL 34474-7448 | |
| (877) 896-9301 | |
| Not Available |
| Full Name | Pst Florida 2009 LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3300 Sw 34th Ave, Ocala, Florida |
| Authorized Official Name and Position | Michael Grischkan (CEO) |
| Authorized Official Contact | 2168969301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pst Florida 2009 LLC 3300 Sw 34th Ave Suite 116 Ocala FL 34474-7448 Ph: (877) 896-9301 | Pst Florida 2009 LLC 3300 Sw 34th Ave Suite 116 Ocala FL 34474-7448 Ph: (877) 896-9301 |
| NPI Number | 1134423072 |
|---|---|
| Provider Enumeration Date | 01/07/2011 |
| Last Update Date | 01/07/2011 |
| Medicare PECOS PAC ID | 0345422531 |
|---|---|
| Medicare Enrollment ID | O20110309000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134423072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Mary R Riedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982035598 PECOS PAC ID: 3072731298 Enrollment ID: I20140902000425 |
| Provider Name | Linda G Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629496278 PECOS PAC ID: 5294049870 Enrollment ID: I20150728004152 |
| Provider Name | Casey S Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558973511 PECOS PAC ID: 5991104457 Enrollment ID: I20210603001097 |
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