| Verimed Health Group Pinellas Park, Llc | |
|
12450 Roosevelt Blvd N Ste 308 St Petersburg FL 33716-1902 | |
| (727) 577-0285 | |
| (727) 577-3870 |
| Full Name | Verimed Health Group Pinellas Park, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12450 Roosevelt Blvd N Ste 308, St Petersburg, Florida |
| Authorized Official Name and Position | Julissa Ortiz (ASSISTANT ADMINISTRATOR) |
| Authorized Official Contact | 7275770285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Verimed Health Group Pinellas Park, Llc 12450 Roosevelt Blvd N St Petersburg FL 33716-1902 Ph: (727) 577-0285 | Verimed Health Group Pinellas Park, Llc 12450 Roosevelt Blvd N Ste 308 St Petersburg FL 33716-1902 Ph: (727) 577-0285 |
| NPI Number | 1043441546 |
|---|---|
| Provider Enumeration Date | 07/31/2009 |
| Last Update Date | 01/22/2023 |
| Medicare PECOS PAC ID | 4688790546 |
|---|---|
| Medicare Enrollment ID | O20100928001344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043441546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS8908 (Florida) | Primary |
| Provider Name | Shari A Berg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538166269 PECOS PAC ID: 5496817645 Enrollment ID: I20081222000445 |
| Provider Name | Camilla Ruth Chacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235783218 PECOS PAC ID: 8729485867 Enrollment ID: I20210916001289 |
| Provider Name | Yuanil Airam Hernandez Torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881292373 PECOS PAC ID: 0446655005 Enrollment ID: I20220831000220 |
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