| Villages Internal Medicine And Senior Clinic Pa | |
|
3351 Wedgewood Ln The Villages FL 32162-7181 | |
| (352) 259-0634 | |
| (352) 259-2174 |
| Full Name | Villages Internal Medicine And Senior Clinic Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3351 Wedgewood Ln, The Villages, Florida |
| Authorized Official Name and Position | Winston Evalle (PRESIDENT) |
| Authorized Official Contact | 3522590364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Villages Internal Medicine And Senior Clinic Pa 3351 Wedgewood Ln The Villages FL 32162-7181 Ph: (352) 259-0634 | Villages Internal Medicine And Senior Clinic Pa 3351 Wedgewood Ln The Villages FL 32162-7181 Ph: (352) 259-0634 |
| NPI Number | 1801939277 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 11/29/2010 |
| Medicare PECOS PAC ID | 8123924081 |
|---|---|
| Medicare Enrollment ID | O20031210001008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801939277 | NPI | - | NPPES |
| 58634 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | ME80483 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME80483 (Florida) | Primary |
| Provider Name | Winston Evalle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265444202 PECOS PAC ID: 0446156319 Enrollment ID: I20031211000072 |
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