| Vipcare | |
|
13940 N Us Highway 441 Ste 102 Lady Lake FL 32159-8909 | |
| (352) 751-9900 | |
| (844) 388-6186 |
| Full Name | Vipcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 13940 N Us Highway 441 Ste 102, Lady Lake, Florida |
| Authorized Official Name and Position | Sriram Sundaramoorthy (VP - OPERATIONS) |
| Authorized Official Contact | 8134445838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vipcare 601 S Harbour Island Blvd Ste 200 Tampa FL 33602-5735 Ph: (813) 444-5838 | Vipcare 13940 N Us Highway 441 Ste 102 Lady Lake FL 32159-8909 Ph: (352) 751-9900 |
| NPI Number | 1336153709 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/05/2025 |
| Certification Date | 08/05/2025 |
| Medicare PECOS PAC ID | 0648271155 |
|---|---|
| Medicare Enrollment ID | O20070126000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336153709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Tonya N Hollinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053366906 PECOS PAC ID: 7517870892 Enrollment ID: I20031112000199 |
| Provider Name | Thomas Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669470746 PECOS PAC ID: 2365347564 Enrollment ID: I20031201000758 |
| Provider Name | Wendy L Worsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497858724 PECOS PAC ID: 5890692149 Enrollment ID: I20031216000215 |
| Provider Name | John Wilker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770540361 PECOS PAC ID: 2466351739 Enrollment ID: I20040107000078 |
| Provider Name | Charles K Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285691881 PECOS PAC ID: 2365341633 Enrollment ID: I20040107000099 |
| Provider Name | John J Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255318572 PECOS PAC ID: 3375437924 Enrollment ID: I20040213000110 |
| Provider Name | Aracelia Bernier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215996400 PECOS PAC ID: 3577557602 Enrollment ID: I20040412001655 |
| Provider Name | Jolanta Tombarkiewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326262320 PECOS PAC ID: 8921095779 Enrollment ID: I20040426001272 |
| Provider Name | Joseph a Sassano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477545663 PECOS PAC ID: 9234128372 Enrollment ID: I20040512000487 |
| Provider Name | Beth D Yedwab Oliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659358604 PECOS PAC ID: 6103808001 Enrollment ID: I20040603001350 |
| Provider Name | Hanimi Challa |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1730111550 PECOS PAC ID: 7214910066 Enrollment ID: I20040611000476 |
| Provider Name | Javier J Urdaneta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063499119 PECOS PAC ID: 1658343603 Enrollment ID: I20040810000787 |
| Provider Name | Israel Caro |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1427031707 PECOS PAC ID: 8628043205 Enrollment ID: I20040827000340 |
| Provider Name | Hoa V Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699769281 PECOS PAC ID: 5698740207 Enrollment ID: I20040827000623 |
| Provider Name | Margaret R Yee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669405114 PECOS PAC ID: 4183678519 Enrollment ID: I20050309000405 |
| Provider Name | Marilyn L Juricic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497758338 PECOS PAC ID: 6204882590 Enrollment ID: I20050330000272 |
| Provider Name | Eladio J Dieguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881631877 PECOS PAC ID: 5991746794 Enrollment ID: I20050520000796 |
| Provider Name | Tayyaba Nadir Tariq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003892498 PECOS PAC ID: 5991749194 Enrollment ID: I20050618000031 |
| Provider Name | Dwaraknadh R Banala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437106614 PECOS PAC ID: 5193764033 Enrollment ID: I20050922000404 |
| Provider Name | Gil F Gutierrez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659427532 PECOS PAC ID: 5597790568 Enrollment ID: I20050928000738 |
| Provider Name | Leslie M Kidd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033127840 PECOS PAC ID: 3072547348 Enrollment ID: I20061129000168 |
| Provider Name | Darrell L Pugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962489427 PECOS PAC ID: 0143262006 Enrollment ID: I20070308000228 |
| Provider Name | Katherine Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093791550 PECOS PAC ID: 9739283441 Enrollment ID: I20070404000516 |
| Provider Name | Claudia Marcela Molina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992713127 PECOS PAC ID: 1557265311 Enrollment ID: I20070712000475 |
| Provider Name | Michael Barimo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598746570 PECOS PAC ID: 9032201926 Enrollment ID: I20070823000245 |
| Provider Name | James Biggerstaff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245239607 PECOS PAC ID: 3072605682 Enrollment ID: I20070827000474 |
| Provider Name | Mariel Gonzalez-mendoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194836825 PECOS PAC ID: 2769457555 Enrollment ID: I20070915000096 |
| Provider Name | Vipinchandra K Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609951623 PECOS PAC ID: 3375639628 Enrollment ID: I20071017000736 |
| Provider Name | Delfin J Fuentes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881727014 PECOS PAC ID: 7012004088 Enrollment ID: I20071107000768 |
| Provider Name | Christopher S Yuvienco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659316925 PECOS PAC ID: 0345326658 Enrollment ID: I20080327000280 |
| Provider Name | Stephen K Seecharan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821160664 PECOS PAC ID: 1850465394 Enrollment ID: I20080801000249 |
| Provider Name | Bennett Feld |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861581977 PECOS PAC ID: 6204902281 Enrollment ID: I20080828000258 |
| Provider Name | Mabel Gonzalez Novo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285643486 PECOS PAC ID: 6305848946 Enrollment ID: I20081216000207 |
| Provider Name | Arlene H Radcliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215172499 PECOS PAC ID: 5092872333 Enrollment ID: I20090331000565 |
| Provider Name | Luis G Martinez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629115100 PECOS PAC ID: 3476602616 Enrollment ID: I20090519000421 |
| Provider Name | Wayne Burnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811977903 PECOS PAC ID: 0042113607 Enrollment ID: I20091111000425 |
| Provider Name | Hector Esteban Guevara Garay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376719971 PECOS PAC ID: 7618015355 Enrollment ID: I20091117000465 |
| Provider Name | Jose Enrique Molina |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407074099 PECOS PAC ID: 1254471584 Enrollment ID: I20091217000652 |
| Provider Name | Kathryn Majarwitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225032824 PECOS PAC ID: 0840335097 Enrollment ID: I20100226000733 |
| Provider Name | Christopher J Grainger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255398798 PECOS PAC ID: 9335274547 Enrollment ID: I20100312000681 |
| Provider Name | Reyna I Lajara |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366503583 PECOS PAC ID: 4082716097 Enrollment ID: I20100505000462 |
| Provider Name | Sandra Faye Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386975845 PECOS PAC ID: 3678602554 Enrollment ID: I20100602000820 |
| Provider Name | Annapurna Pattisapu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972615599 PECOS PAC ID: 2769514215 Enrollment ID: I20100719000463 |
| Provider Name | Stephen Edward Fischer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598758799 PECOS PAC ID: 5597889154 Enrollment ID: I20100902001085 |
| Provider Name | Luz E Peguero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760469654 PECOS PAC ID: 4880719731 Enrollment ID: I20100928000334 |
| Provider Name | Ciceron Lazo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962567156 PECOS PAC ID: 7517159312 Enrollment ID: I20101012000969 |
| Provider Name | Talha Shamim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376573295 PECOS PAC ID: 1052203320 Enrollment ID: I20110215000024 |
| Provider Name | David Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093754657 PECOS PAC ID: 4385695428 Enrollment ID: I20110317000202 |
| Provider Name | Charles R Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295863322 PECOS PAC ID: 2466620141 Enrollment ID: I20110725000205 |
| Provider Name | David B Kuhn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982868303 PECOS PAC ID: 7810027059 Enrollment ID: I20110726000145 |
| Provider Name | Maria F Atkinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538182787 PECOS PAC ID: 7113838731 Enrollment ID: I20111227000648 |
| Provider Name | Raul Ernesto Ayala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710970710 PECOS PAC ID: 8224205356 Enrollment ID: I20120113000065 |
| Provider Name | Jorge A. Figueroa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225100803 PECOS PAC ID: 4789571837 Enrollment ID: I20120201000953 |
| Provider Name | Carla D Fuentes Blanco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972816056 PECOS PAC ID: 0446414312 Enrollment ID: I20120606000420 |
| Provider Name | Marc a Guerrier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124007364 PECOS PAC ID: 5991698680 Enrollment ID: I20120620000757 |
| Provider Name | Sangeeta Hans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447488978 PECOS PAC ID: 2163679176 Enrollment ID: I20120827000750 |
| Provider Name | Laura Zambrana Morales |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235333915 PECOS PAC ID: 5092898627 Enrollment ID: I20120827000854 |
| Provider Name | Thomas Woodrow Smith |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194935825 PECOS PAC ID: 5193972834 Enrollment ID: I20120830000692 |
| Provider Name | Greyson C Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467682104 PECOS PAC ID: 0042467623 Enrollment ID: I20120904000788 |
| Provider Name | Roy G Bassett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922113232 PECOS PAC ID: 3072761352 Enrollment ID: I20120911000365 |
| Provider Name | Ana C Rearte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407022759 PECOS PAC ID: 3779731302 Enrollment ID: I20120924000439 |
| Provider Name | Silvia Veronica Abreu Read |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871523886 PECOS PAC ID: 9931102431 Enrollment ID: I20121231000208 |
| Provider Name | James E Peterzell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487623187 PECOS PAC ID: 4981605953 Enrollment ID: I20130123000132 |
| Provider Name | Rosa E Zapata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255600177 PECOS PAC ID: 7012155237 Enrollment ID: I20130530000173 |
| Provider Name | Linda D Jean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376862987 PECOS PAC ID: 4486895646 Enrollment ID: I20130730000956 |
| Provider Name | Christina M Mehriary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699812057 PECOS PAC ID: 7517109937 Enrollment ID: I20130815000065 |
| Provider Name | Juliann Dwares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235489436 PECOS PAC ID: 2961639406 Enrollment ID: I20131209000964 |
| Provider Name | Yair R Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407286305 PECOS PAC ID: 3072740489 Enrollment ID: I20131210001532 |
| Provider Name | Claudine Frederiks |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1821051764 PECOS PAC ID: 5193728301 Enrollment ID: I20140210000154 |
| Provider Name | Lourdes Colon-cacho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881841237 PECOS PAC ID: 7810173150 Enrollment ID: I20140326002306 |
| Provider Name | Kriselle Torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1740428424 PECOS PAC ID: 1658516398 Enrollment ID: I20140502000156 |
| Provider Name | Jeronimo Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316350697 PECOS PAC ID: 8123246311 Enrollment ID: I20140829001896 |
| Provider Name | Clary Ann Montalvo Galiano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548557168 PECOS PAC ID: 0143543405 Enrollment ID: I20141218000652 |
| Provider Name | Vidya Jaimungal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821493891 PECOS PAC ID: 1759605793 Enrollment ID: I20150121001722 |
| Provider Name | Luis a Ortiz-torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710911243 PECOS PAC ID: 1951386747 Enrollment ID: I20150505002584 |
| Provider Name | Veronica Machado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548213051 PECOS PAC ID: 5698792828 Enrollment ID: I20150601000612 |
| Provider Name | Rebecca M Corcoran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255724712 PECOS PAC ID: 2860703493 Enrollment ID: I20150623001315 |
| Provider Name | John Thomas Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285639047 PECOS PAC ID: 1456664242 Enrollment ID: I20150722006338 |
| Provider Name | William B Schurr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104051770 PECOS PAC ID: 7810042058 Enrollment ID: I20150727001538 |
| Provider Name | Kevin Somai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568782662 PECOS PAC ID: 8628382934 Enrollment ID: I20150730013054 |
| Provider Name | Evelyn Gonzalez-ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245230259 PECOS PAC ID: 3577560192 Enrollment ID: I20151022002314 |
| Provider Name | Nestor Samuel Garcia Ceballos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467779579 PECOS PAC ID: 2668596289 Enrollment ID: I20151110000800 |
| Provider Name | Estrellita Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760850168 PECOS PAC ID: 1658681143 Enrollment ID: I20151112003064 |
| Provider Name | Michael John Simpson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669735577 PECOS PAC ID: 7911137948 Enrollment ID: I20151119001034 |
| Provider Name | Claudia B Gonzalez Matos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114104296 PECOS PAC ID: 0244304699 Enrollment ID: I20151124001495 |
| Provider Name | Gilfredy Acevedo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114997699 PECOS PAC ID: 2961651419 Enrollment ID: I20151222002007 |
| Provider Name | Amy M Balius |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831560085 PECOS PAC ID: 2163724386 Enrollment ID: I20160105002558 |
| Provider Name | Kelechi N Esoga |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477933984 PECOS PAC ID: 0446565428 Enrollment ID: I20160316001439 |
| Provider Name | Mary a Halleck |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174565246 PECOS PAC ID: 9335100445 Enrollment ID: I20160328001823 |
| Provider Name | Yanira Del Rosario Feliciano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962446831 PECOS PAC ID: 2567465339 Enrollment ID: I20160407001194 |
| Provider Name | Nanette a Ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487637476 PECOS PAC ID: 5092753814 Enrollment ID: I20160418001692 |
| Provider Name | Leslie Katherine Garcia Rivera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578773271 PECOS PAC ID: 9032274741 Enrollment ID: I20160519000575 |
| Provider Name | Ivette Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972714855 PECOS PAC ID: 7618951351 Enrollment ID: I20160707002514 |
| Provider Name | Charlene E Dacosta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306802905 PECOS PAC ID: 6002828076 Enrollment ID: I20160718001032 |
| Provider Name | Sarah E Bendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619266947 PECOS PAC ID: 7416125000 Enrollment ID: I20160912000466 |
| Provider Name | Vanessa Seiglie Quinones |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1255647715 PECOS PAC ID: 0244527927 Enrollment ID: I20160923000200 |
| Provider Name | Jose M. Llamas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366996738 PECOS PAC ID: 9830486455 Enrollment ID: I20160926002242 |
| Provider Name | Myriam A. Edwards Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851338099 PECOS PAC ID: 5890892277 Enrollment ID: I20161025003005 |
| Provider Name | Caterina Ciccone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083160212 PECOS PAC ID: 6709164593 Enrollment ID: I20161029000065 |
| Provider Name | Candy L Gott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316397458 PECOS PAC ID: 0244518975 Enrollment ID: I20161031001097 |
| Provider Name | Kelly Martinkus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700290509 PECOS PAC ID: 5496976961 Enrollment ID: I20161121000209 |
| Provider Name | Carlos Olivera Martinez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902845423 PECOS PAC ID: 1759387046 Enrollment ID: I20161205001617 |
| Provider Name | James Goszkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770571739 PECOS PAC ID: 8820095144 Enrollment ID: I20161213002524 |
| Provider Name | Kari K O'neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255887626 PECOS PAC ID: 8123306982 Enrollment ID: I20170202002360 |
| Provider Name | Lidzoe Correa- Mateo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1609040229 PECOS PAC ID: 5698844959 Enrollment ID: I20170418001661 |
| Provider Name | Carmen Milagros Echevarria |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639351380 PECOS PAC ID: 3678707726 Enrollment ID: I20170418002696 |
| Provider Name | Amarilys Colon Tirado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205804259 PECOS PAC ID: 5597730010 Enrollment ID: I20170529000037 |
| Provider Name | Joseph Burnsed Geffen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588081574 PECOS PAC ID: 8921227323 Enrollment ID: I20170602002090 |
| Provider Name | Haidy Carrasquillo Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639119340 PECOS PAC ID: 6901868009 Enrollment ID: I20170710001860 |
| Provider Name | Wanda Berrios |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932216496 PECOS PAC ID: 8426156241 Enrollment ID: I20170817001378 |
| Provider Name | Michelle Bandurka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619093366 PECOS PAC ID: 5698817724 Enrollment ID: I20170824001745 |
| Provider Name | Leah a Majarocon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164706610 PECOS PAC ID: 0042471567 Enrollment ID: I20170829002727 |
| Provider Name | Luciana Oran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053851535 PECOS PAC ID: 6608142146 Enrollment ID: I20171027000430 |
| Provider Name | Richard Dennis Santiago |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164466876 PECOS PAC ID: 3375719966 Enrollment ID: I20171110001329 |
| Provider Name | Janice Marie Rodriguez Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710156096 PECOS PAC ID: 4688852585 Enrollment ID: I20171229001288 |
| Provider Name | Mabel Rosa Sola |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568431419 PECOS PAC ID: 7315850278 Enrollment ID: I20180119000477 |
| Provider Name | Caroline Northrup |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134631062 PECOS PAC ID: 4587924238 Enrollment ID: I20180129001221 |
| Provider Name | Jibril Dixon Skaden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902281025 PECOS PAC ID: 2163782368 Enrollment ID: I20180208001230 |
| Provider Name | Marietta Ongay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427007145 PECOS PAC ID: 9032491261 Enrollment ID: I20180212000794 |
| Provider Name | Gerardo Antonio Pedroza-sierra |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124026117 PECOS PAC ID: 6800822255 Enrollment ID: I20180214000564 |
| Provider Name | Sonia Benitez Cedeno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770010506 PECOS PAC ID: 9032471362 Enrollment ID: I20180326000499 |
| Provider Name | Diana Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124412564 PECOS PAC ID: 6406101880 Enrollment ID: I20180626003395 |
| Provider Name | Jason Acosta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689033201 PECOS PAC ID: 4587912381 Enrollment ID: I20180810001785 |
| Provider Name | Aileen Edith Rosario |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386601284 PECOS PAC ID: 3072785112 Enrollment ID: I20181008000546 |
| Provider Name | Karla Francheska Miranda Medina |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093073454 PECOS PAC ID: 8628320280 Enrollment ID: I20181009001847 |
| Provider Name | Laura Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558842245 PECOS PAC ID: 9537412010 Enrollment ID: I20181031000056 |
| Provider Name | Jose a Pares |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912115445 PECOS PAC ID: 6800780057 Enrollment ID: I20181109000028 |
| Provider Name | Wyned W Morales Morales |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1457582520 PECOS PAC ID: 0941499917 Enrollment ID: I20181231001612 |
| Provider Name | Atiyeh Amer Atiyeh |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437602422 PECOS PAC ID: 9931463387 Enrollment ID: I20190104001960 |
| Provider Name | Johanna M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891260329 PECOS PAC ID: 7810233095 Enrollment ID: I20190109000030 |
| Provider Name | Kelly a Collura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548738248 PECOS PAC ID: 8022357607 Enrollment ID: I20190226000807 |
| Provider Name | Baoquang Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447411525 PECOS PAC ID: 4385962240 Enrollment ID: I20190308001672 |
| Provider Name | Hamidreza Ebneshahidi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710473889 PECOS PAC ID: 4688919954 Enrollment ID: I20190329002192 |
| Provider Name | Lynnette Michele Santana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124582986 PECOS PAC ID: 2860734340 Enrollment ID: I20190502001842 |
| Provider Name | Patrycja Garces |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528448636 PECOS PAC ID: 3476804931 Enrollment ID: I20190604002338 |
| Provider Name | Robert Morris Harpold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134172497 PECOS PAC ID: 5698725836 Enrollment ID: I20190617002356 |
| Provider Name | Suzanne Johnson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912944984 PECOS PAC ID: 1153359864 Enrollment ID: I20190618000513 |
| Provider Name | Blanca Celina Quintanilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306387204 PECOS PAC ID: 2163756248 Enrollment ID: I20190624001344 |
| Provider Name | Robert Harrison Hummer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902886260 PECOS PAC ID: 2062556590 Enrollment ID: I20190731003679 |
| Provider Name | Anthony Espinoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316307242 PECOS PAC ID: 2567794050 Enrollment ID: I20191104000136 |
| Provider Name | Shelly M Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013559061 PECOS PAC ID: 9830522473 Enrollment ID: I20191212000029 |
| Provider Name | Bernardo Francisco Malaga |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386600187 PECOS PAC ID: 6800870189 Enrollment ID: I20191226001138 |
| Provider Name | Maria Margarita Castro Gonzalez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1376001966 PECOS PAC ID: 1759716079 Enrollment ID: I20200115000453 |
| Provider Name | Nela F Ballesteros |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174026348 PECOS PAC ID: 8527493212 Enrollment ID: I20200128000682 |
| Provider Name | Ryan W Novince |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164865259 PECOS PAC ID: 6204062029 Enrollment ID: I20200219002203 |
| Provider Name | William Scott Blanchard |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386101376 PECOS PAC ID: 7618208935 Enrollment ID: I20200224000371 |
| Provider Name | Jackeline Nunez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912032558 PECOS PAC ID: 8123064458 Enrollment ID: I20200226001175 |
| Provider Name | Kathleen R Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780219998 PECOS PAC ID: 3678901071 Enrollment ID: I20200319000045 |
| Provider Name | Luis Silva |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952327686 PECOS PAC ID: 7517236847 Enrollment ID: I20200324002822 |
| Provider Name | Tammy M Helton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760044044 PECOS PAC ID: 7416109509 Enrollment ID: I20200604002607 |
| Provider Name | Amy Jean Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356780787 PECOS PAC ID: 1052614310 Enrollment ID: I20200612002182 |
| Provider Name | Mobola T Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295940138 PECOS PAC ID: 4082702907 Enrollment ID: I20200729003239 |
| Provider Name | Caitlin Elizabeth Leclair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104351170 PECOS PAC ID: 6305189978 Enrollment ID: I20200730003536 |
| Provider Name | Rosa Lia Zapata |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972151876 PECOS PAC ID: 3577980606 Enrollment ID: I20200903000628 |
| Provider Name | John Clarence Ehrmann |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861691032 PECOS PAC ID: 3274801899 Enrollment ID: I20200925000469 |
| Provider Name | Laura Walls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972125482 PECOS PAC ID: 9436112869 Enrollment ID: I20201006000739 |
| Provider Name | Kellie Muniz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245256403 PECOS PAC ID: 1456420298 Enrollment ID: I20201022000701 |
| Provider Name | Gregory Avetisov |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679917280 PECOS PAC ID: 9335470400 Enrollment ID: I20201027000040 |
| Provider Name | Luis Garcia Fresneda |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326539388 PECOS PAC ID: 1456681873 Enrollment ID: I20201112002004 |
| Provider Name | Jackeline Lopez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073174496 PECOS PAC ID: 6305278060 Enrollment ID: I20201130000353 |
| Provider Name | Elisa Gordon Perez Mena |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720680887 PECOS PAC ID: 3678700879 Enrollment ID: I20201210000690 |
| Provider Name | Thomas Auxter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902865470 PECOS PAC ID: 9133023302 Enrollment ID: I20201214002758 |
| Provider Name | Deborah Maria Ball Mora |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245895887 PECOS PAC ID: 6406268291 Enrollment ID: I20201221000679 |
| Provider Name | Edgar Rafael Valdez Quinonez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275130551 PECOS PAC ID: 4082027909 Enrollment ID: I20210113000978 |
| Provider Name | Fabian Alexander Turushina Montano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326658899 PECOS PAC ID: 7517371156 Enrollment ID: I20210122001227 |
| Provider Name | Ulises F Garcia Sanchez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962870741 PECOS PAC ID: 3870907686 Enrollment ID: I20210205000602 |
| Provider Name | Gwendolyn Henson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700128832 PECOS PAC ID: 6709011083 Enrollment ID: I20210331001133 |
| Provider Name | Richard Faust Satriale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306816921 PECOS PAC ID: 7517092430 Enrollment ID: I20210511001871 |
| Provider Name | Cobra Ann Chamblee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366461741 PECOS PAC ID: 9234144114 Enrollment ID: I20210524001039 |
| Provider Name | Lisa a Mattingly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104186907 PECOS PAC ID: 5799091542 Enrollment ID: I20210812002465 |
| Provider Name | Andrea M Prince |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841364577 PECOS PAC ID: 8022187426 Enrollment ID: I20210819000765 |
| Provider Name | Aileen Denisse Velez Ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1538561543 PECOS PAC ID: 1850798356 Enrollment ID: I20210927001513 |
| Provider Name | Amanda Rose Sledz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457828832 PECOS PAC ID: 7719221027 Enrollment ID: I20210929000648 |
| Provider Name | Sylvia Boloczko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063400893 PECOS PAC ID: 1951204221 Enrollment ID: I20211013003174 |
| Provider Name | Yamell Martin Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003404369 PECOS PAC ID: 5092113472 Enrollment ID: I20211015001160 |
| Provider Name | Italo Andres Neira Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235809369 PECOS PAC ID: 0840698114 Enrollment ID: I20211018002191 |
| Provider Name | Allyssa Nicole Koerber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538782321 PECOS PAC ID: 2466840442 Enrollment ID: I20211025000387 |
| Provider Name | Stella Heredia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902475288 PECOS PAC ID: 1951790211 Enrollment ID: I20211109000124 |
| Provider Name | Denitra Bost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356910459 PECOS PAC ID: 9931598943 Enrollment ID: I20211112001788 |
| Provider Name | Natalya Korneyeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871169847 PECOS PAC ID: 8921498122 Enrollment ID: I20211202000321 |
| Provider Name | Danny Abdallah Samara |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1740826635 PECOS PAC ID: 4385034487 Enrollment ID: I20211203001791 |
| Provider Name | Gabriel Szmigiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841462892 PECOS PAC ID: 5597925487 Enrollment ID: I20211209002282 |
| Provider Name | Noel Espinosa Sanchez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841831146 PECOS PAC ID: 4082004767 Enrollment ID: I20211213001257 |
| Provider Name | Wendy M Kingsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346712379 PECOS PAC ID: 7810388725 Enrollment ID: I20220104002229 |
| Provider Name | Raybert Llorente Fuentes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053969691 PECOS PAC ID: 7719373737 Enrollment ID: I20220331000076 |
| Provider Name | Obianuju Amadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538419759 PECOS PAC ID: 0244513414 Enrollment ID: I20220427000632 |
| Provider Name | Juan Maldonado |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518592955 PECOS PAC ID: 8224415591 Enrollment ID: I20220509000144 |
| Provider Name | Lynsey Souther |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730665936 PECOS PAC ID: 4183001837 Enrollment ID: I20220518000981 |
| Provider Name | Todd Hope |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255546941 PECOS PAC ID: 2163551789 Enrollment ID: I20220601001357 |
| Provider Name | Alexzavier Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497384846 PECOS PAC ID: 2961820840 Enrollment ID: I20220601001466 |
| Provider Name | Maribel Lopez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649349697 PECOS PAC ID: 2860408366 Enrollment ID: I20220620000284 |
| Provider Name | Veronica Cordero Fernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639665664 PECOS PAC ID: 8426389065 Enrollment ID: I20220711000167 |
| Provider Name | David Alexander Phillips |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194165688 PECOS PAC ID: 2264721661 Enrollment ID: I20220711000290 |
| Provider Name | James H Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518908045 PECOS PAC ID: 1557456258 Enrollment ID: I20220719004049 |
| Provider Name | Alexis Hernandez Bonilla |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700518735 PECOS PAC ID: 5092196931 Enrollment ID: I20220722002259 |
| Provider Name | Samuel Alfano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588764872 PECOS PAC ID: 7315044013 Enrollment ID: I20220726002306 |
| Provider Name | Tatiana Natalie Hernandez Cabrera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164154183 PECOS PAC ID: 1254713100 Enrollment ID: I20220809002142 |
| Provider Name | Uriel A. Pont Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437353703 PECOS PAC ID: 5698164622 Enrollment ID: I20220818002717 |
| Provider Name | Cruz Ranea |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497409593 PECOS PAC ID: 2163807215 Enrollment ID: I20220910000281 |
| Provider Name | Dawn Marie Jaquish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811632607 PECOS PAC ID: 6103201785 Enrollment ID: I20220919000027 |
| Provider Name | Connie J Braun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194899641 PECOS PAC ID: 7810949914 Enrollment ID: I20220927001348 |
| Provider Name | Michael Lee Carr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063505139 PECOS PAC ID: 3173511516 Enrollment ID: I20221013003082 |
| Provider Name | Angelica Roman Rivera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982110276 PECOS PAC ID: 7214290352 Enrollment ID: I20221014000012 |
| Provider Name | Catherine E Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356763676 PECOS PAC ID: 0648402198 Enrollment ID: I20221108001864 |
| Provider Name | Jason a Waugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629123906 PECOS PAC ID: 2264666247 Enrollment ID: I20221117000910 |
| Provider Name | Lynnette Michele Santana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124582986 PECOS PAC ID: 2860734340 Enrollment ID: I20230203001555 |
| Provider Name | Fara Castillo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578227849 PECOS PAC ID: 8123490463 Enrollment ID: I20230214001554 |
| Provider Name | Yanira Raza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194838904 PECOS PAC ID: 8820068562 Enrollment ID: I20230522003414 |
| Provider Name | Jeanny B Catapia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265121123 PECOS PAC ID: 8022474618 Enrollment ID: I20230524002528 |
| Provider Name | Brian K Shablin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194701771 PECOS PAC ID: 6103717582 Enrollment ID: I20230607000013 |
| Provider Name | Elvira Perez Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902139587 PECOS PAC ID: 7618136722 Enrollment ID: I20230614000121 |
| Provider Name | Jose Gutierrez-holguin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942428826 PECOS PAC ID: 0840336962 Enrollment ID: I20230620001934 |
| Provider Name | Robert Guido |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962898791 PECOS PAC ID: 5698136323 Enrollment ID: I20230727003988 |
| Provider Name | Nathan Henry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497370506 PECOS PAC ID: 5496178642 Enrollment ID: I20230805000145 |
| Provider Name | Shing Ko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144857913 PECOS PAC ID: 3779945324 Enrollment ID: I20230814001472 |
| Provider Name | Raul Breton Gamiotea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750028932 PECOS PAC ID: 3870955917 Enrollment ID: I20230822000375 |
| Provider Name | Amy N Hyma |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437523529 PECOS PAC ID: 7618330358 Enrollment ID: I20230829002778 |
| Provider Name | Kevin Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356423420 PECOS PAC ID: 7517918469 Enrollment ID: I20230830000848 |
| Provider Name | Yolanda Molinaris-gelpi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710984919 PECOS PAC ID: 8123105152 Enrollment ID: I20230830004343 |
| Provider Name | Harison Rafael Parra |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871244848 PECOS PAC ID: 2860856994 Enrollment ID: I20230907004448 |
| Provider Name | Gregory Bahtiarian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295738250 PECOS PAC ID: 2264334986 Enrollment ID: I20230914000819 |
| Provider Name | Anne Butler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629422613 PECOS PAC ID: 0345521050 Enrollment ID: I20230925001945 |
| Provider Name | Valerie a Smith |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134313802 PECOS PAC ID: 3678742632 Enrollment ID: I20230926000806 |
| Provider Name | Michael Fortunato |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841291226 PECOS PAC ID: 5799863965 Enrollment ID: I20231009001596 |
| Provider Name | Shervin Sarmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639524556 PECOS PAC ID: 7911288717 Enrollment ID: I20231023000195 |
| Provider Name | Christine Michel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134733157 PECOS PAC ID: 1254747983 Enrollment ID: I20231025000480 |
| Provider Name | Nikea S Stovall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386369650 PECOS PAC ID: 0042667933 Enrollment ID: I20231115000365 |
| Provider Name | Melissa Yvette Beltre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407492143 PECOS PAC ID: 1759730088 Enrollment ID: I20231212004020 |
| Provider Name | Alejandro Sierra-ocampo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548049562 PECOS PAC ID: 1759733082 Enrollment ID: I20240123000078 |
| Provider Name | Yunior Moya Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790423549 PECOS PAC ID: 4385087329 Enrollment ID: I20240207001455 |
| Provider Name | Shabriel Javier Vazquez Ocasio |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598416265 PECOS PAC ID: 3971984220 Enrollment ID: I20240207001775 |
| Provider Name | Berenice Colon Colon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306414453 PECOS PAC ID: 6800231226 Enrollment ID: I20240226001345 |
| Provider Name | Eillen Victoria Velasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194364158 PECOS PAC ID: 4981041613 Enrollment ID: I20240318001708 |
| Provider Name | Jason Farah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275308157 PECOS PAC ID: 6901245562 Enrollment ID: I20240415003882 |
| Provider Name | Lisa Ramsay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578718110 PECOS PAC ID: 5991950867 Enrollment ID: I20240827003420 |
| Provider Name | Stephen Schloneger |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578160768 PECOS PAC ID: 3678989589 Enrollment ID: I20240829003289 |
| Provider Name | Alexis R Fleites Dominguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295502300 PECOS PAC ID: 0446799597 Enrollment ID: I20240903003150 |
| Provider Name | Dino Romero |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730766114 PECOS PAC ID: 7012325657 Enrollment ID: I20240930001984 |
| Provider Name | Tola Suleiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417475997 PECOS PAC ID: 7618385915 Enrollment ID: I20241002003447 |
| Provider Name | Ben Ju |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629019112 PECOS PAC ID: 9638185655 Enrollment ID: I20241015002295 |
| Provider Name | Jenna Lauren Rebeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114752466 PECOS PAC ID: 3971037102 Enrollment ID: I20241112000039 |
| Provider Name | Charles Timson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750332821 PECOS PAC ID: 3971597543 Enrollment ID: I20241120004437 |
| Provider Name | Anibal Ortiz Rivera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1891441010 PECOS PAC ID: 2466839014 Enrollment ID: I20250107004365 |
| Provider Name | Ivette Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306678065 PECOS PAC ID: 8628506219 Enrollment ID: I20250109003493 |
| Provider Name | Mabel Elena Barral Fumero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306660808 PECOS PAC ID: 0244760825 Enrollment ID: I20250212000726 |
| Provider Name | Tamara Wilson Cisnero |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184166779 PECOS PAC ID: 1850831512 Enrollment ID: I20250321003581 |
| Provider Name | Digna Emerita Sanchez De Vasquez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205351905 PECOS PAC ID: 4688197833 Enrollment ID: I20250327003350 |
| Provider Name | Miguel Angel Tirado Pagan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548008543 PECOS PAC ID: 1052835675 Enrollment ID: I20250404001469 |
| Provider Name | Kristen Collins Gates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992401244 PECOS PAC ID: 9436674454 Enrollment ID: I20250422002448 |
| Provider Name | Jessica M Reyes Giusti |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003301466 PECOS PAC ID: 3274953278 Enrollment ID: I20250805002473 |
| Provider Name | Lady Marie Berrios Acevedo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780335216 PECOS PAC ID: 4688022981 Enrollment ID: I20250910002378 |
| Provider Name | Jose Luis Alvarez Villar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134969561 PECOS PAC ID: 8628574142 Enrollment ID: I20251003000634 |
| Provider Name | Brittany Nichole Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366313769 PECOS PAC ID: 8820586167 Enrollment ID: I20251020001966 |
| Provider Name | Elena Zlochevsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639615776 PECOS PAC ID: 8224462411 Enrollment ID: I20251024004207 |
| Provider Name | Gricarly L Bracho Moran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093686727 PECOS PAC ID: 0547750762 Enrollment ID: I20251106002666 |
| Provider Name | Serina G Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932857786 PECOS PAC ID: 5890144463 Enrollment ID: I20251229002901 |
| Provider Name | Miladys Liste Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831779479 PECOS PAC ID: 6204312374 Enrollment ID: I20260108001046 |
| Provider Name | Zahra Heidari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215934856 PECOS PAC ID: 3476586850 Enrollment ID: I20260112003566 |
| Provider Name | Elizabeth Del Castillo Guerrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669336871 PECOS PAC ID: 8628556834 Enrollment ID: I20260129002568 |
| Provider Name | Cynthia Humenic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881181584 PECOS PAC ID: 1456748987 Enrollment ID: I20260217001046 |
| Provider Name | Sharon Gavette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033599576 PECOS PAC ID: 3678879251 Enrollment ID: I20260309000152 |
| Provider Name | Nancy Yanira Perez Torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780493064 PECOS PAC ID: 4183199110 Enrollment ID: I20260408000292 |
| Provider Name | Sonia Ibarra Arias |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1831945310 PECOS PAC ID: 1254831183 Enrollment ID: I20260425000327 |
| Provider Name | Ariel Lazaro Torres Molina |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710427570 PECOS PAC ID: 8123598984 Enrollment ID: I20260521004589 |
Health First Internal Medicine Associates, LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8562 Ne 138th Ln, Lady Lake, FL 32159 Phone: 352-633-8681 |
Angel E Tafur MD PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1503 Buenos Aires Blvd Ste 160, Lady Lake, FL 32159 Phone: 352-350-6241 |
Mesos, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 757 County Road 466, Lady Lake, FL 32159 Phone: 352-259-8599 Fax: 352-259-8559 |
Pulse Medical Doctors LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 871 County Road 466, Suite 200, Lady Lake, FL 32159 Phone: 352-350-5130 Fax: 352-350-1684 |
Cogent Healthcare of Jacksonville, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Highway 466, Lady Lake, FL 32159 Phone: 352-430-0017 |
Vqol Primary Care Physician Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8550 Ne 138th Ln Ste 102, Lady Lake, FL 32159 Phone: 352-314-2922 |