| Suwannee Oaks Medical Primary And Wellness Clinic | |
|
112 Irvin Ave Sw Live Oak FL 32064-2214 | |
| (386) 647-6144 | |
| Not Available |
| Full Name | Suwannee Oaks Medical Primary And Wellness Clinic |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 112 Irvin Ave Sw, Live Oak, Florida |
| Authorized Official Name and Position | Aymee Wilson (OWNER) |
| Authorized Official Contact | 3863306380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suwannee Oaks Medical Primary And Wellness Clinic 8405 127th Dr Live Oak FL 32060-8835 Ph: (386) 647-6144 | Suwannee Oaks Medical Primary And Wellness Clinic 112 Irvin Ave Sw Live Oak FL 32064-2214 Ph: (386) 647-6144 |
| NPI Number | 1407636582 |
|---|---|
| Provider Enumeration Date | 10/04/2023 |
| Last Update Date | 02/08/2024 |
| Medicare PECOS PAC ID | 8921451469 |
|---|---|
| Medicare Enrollment ID | O20240131002623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407636582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Aymee Jean Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467807347 PECOS PAC ID: 3971883018 Enrollment ID: I20161207002510 |
| Provider Name | Cheryl Renae Abersold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003457623 PECOS PAC ID: 0143663740 Enrollment ID: I20240212000655 |
Acv Community Services Ll Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10820 Marvin E Jones Blvd, Live Oak, FL 32060 Phone: 386-658-5341 | |
Palms Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Ranchera St Nw, Live Oak, FL 32064 Phone: 386-364-1751 Fax: 386-364-1761 | |
Horizon Pediatrics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Demorest St Se, Live Oak, FL 32064 Phone: 386-362-5437 Fax: 386-362-5440 | |
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