| Upwell Medical Clinic | |
|
2949 Allegra Way Lutz FL 33559 | |
| (201) 893-6136 | |
| Not Available |
| Full Name | Upwell Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 2949 Allegra Way, Lutz, Florida |
| Authorized Official Name and Position | Nangalya Tirthala (OWNER) |
| Authorized Official Contact | 2018936136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upwell Medical Clinic 6042 Marsh Trail Dr Odessa FL 33556-4655 Ph: (201) 893-6136 | Upwell Medical Clinic 2949 Allegra Way Lutz FL 33559 Ph: (201) 893-6136 |
| NPI Number | 1588423289 |
|---|---|
| Provider Enumeration Date | 03/15/2024 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 5092155762 |
|---|---|
| Medicare Enrollment ID | O20240429000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588423289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Edward S Kurz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053370114 PECOS PAC ID: 0345130605 Enrollment ID: I20110316000241 |
| Provider Name | Yasmin B Panjwani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194266080 PECOS PAC ID: 2163781584 Enrollment ID: I20180110002688 |
| Provider Name | Nangalya Tirthala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497986897 PECOS PAC ID: 9537315270 Enrollment ID: I20230526001298 |
| Provider Name | Venkateswarlu Muvva |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1942480553 PECOS PAC ID: 2567627425 Enrollment ID: I20240509003312 |
| Provider Name | Albert Elumn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891292025 PECOS PAC ID: 7810242005 Enrollment ID: I20240813000885 |
| Provider Name | Victoria Marie Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760298756 PECOS PAC ID: 8123548443 Enrollment ID: I20250217003301 |
| Provider Name | Margot Krahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033003009 PECOS PAC ID: 4284127127 Enrollment ID: I20251201000605 |
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