| Steinhatchee River Primary Care, Llc | |
|
101 11th Street Se Steinhatchee FL 32359 | |
| (352) 538-1327 | |
| Not Available |
| Full Name | Steinhatchee River Primary Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 11th Street Se, Steinhatchee, Florida |
| Authorized Official Name and Position | Kellie Ann White (OWNER) |
| Authorized Official Contact | 3525381327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steinhatchee River Primary Care, Llc 1400 Ne State Road 47 Trenton FL 32693-5035 Ph: (352) 538-1327 | Steinhatchee River Primary Care, Llc 101 11th Street Se Steinhatchee FL 32359 Ph: (352) 538-1327 |
| NPI Number | 1295419877 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 2466813050 |
|---|---|
| Medicare Enrollment ID | O20230728002545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295419877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kellie Ann White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073130548 PECOS PAC ID: 9133544323 Enrollment ID: I20200805001342 |
Doctors Memorial Hospital Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1209 1st Avenue South, Steinhatchee, FL 32359 Phone: 385-498-5888 Fax: 352-498-7726 |