| Wellmed Medical Management Of Florida Inc | |
|
549 Nw Lake Whitney Place Bldg I, Suite 101 Port St Lucie FL 34986 | |
| (210) 617-4706 | |
| Not Available |
| Full Name | Wellmed Medical Management Of Florida Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 549 Nw Lake Whitney Place, Port St Lucie, Florida |
| Authorized Official Name and Position | Joseph Zimmerman (SECRETARY) |
| Authorized Official Contact | 2106174706 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmed Medical Management Of Florida Inc 19500 Ih-10w, Ms1-5030 Attn: Licensing & Regulatory San Antonio TX 78257 Ph: (210) 617-4706 | Wellmed Medical Management Of Florida Inc 549 Nw Lake Whitney Place Bldg I, Suite 101 Port St Lucie FL 34986 Ph: (210) 617-4706 |
| NPI Number | 1033395397 |
|---|---|
| Provider Enumeration Date | 01/17/2008 |
| Last Update Date | 06/16/2023 |
| Medicare PECOS PAC ID | 3971678558 |
|---|---|
| Medicare Enrollment ID | O20080815000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033395397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Digna M Acosta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639382922 PECOS PAC ID: 1850292822 Enrollment ID: I20040114000434 |
| Provider Name | Debra P Figueroa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518960905 PECOS PAC ID: 5092616995 Enrollment ID: I20040114000654 |
| Provider Name | Giovanni Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023028412 PECOS PAC ID: 8820984875 Enrollment ID: I20040225001135 |
| Provider Name | Thumati G Jagalur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245276096 PECOS PAC ID: 1153219662 Enrollment ID: I20040309001301 |
| Provider Name | Cecil B Sue-wah-sing |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003956616 PECOS PAC ID: 6709778871 Enrollment ID: I20040325000894 |
| Provider Name | Jocelyn D Bueno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952441719 PECOS PAC ID: 2668364738 Enrollment ID: I20040325000927 |
| Provider Name | Maria V De Leon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578573093 PECOS PAC ID: 0446242804 Enrollment ID: I20040402001143 |
| Provider Name | Aftab A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699851584 PECOS PAC ID: 9739172354 Enrollment ID: I20040408000858 |
| Provider Name | Natalie Shnitser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578659579 PECOS PAC ID: 2264413129 Enrollment ID: I20040526001072 |
| Provider Name | Nestor Lacayo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508872037 PECOS PAC ID: 5698759645 Enrollment ID: I20040616001002 |
| Provider Name | Paul A Kostamo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902863236 PECOS PAC ID: 5294719993 Enrollment ID: I20040617001377 |
| Provider Name | Carol A Stewart-francisco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013920305 PECOS PAC ID: 5496730582 Enrollment ID: I20040623000806 |
| Provider Name | Raquel Y Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285769398 PECOS PAC ID: 7618887621 Enrollment ID: I20040714001176 |
| Provider Name | Nasser Moukaddem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124008883 PECOS PAC ID: 1658274683 Enrollment ID: I20040721000396 |
| Provider Name | Cheryl T Winchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407874332 PECOS PAC ID: 6305826041 Enrollment ID: I20040722000939 |
| Provider Name | Ramon M Castillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144230400 PECOS PAC ID: 7618942871 Enrollment ID: I20040831000890 |
| Provider Name | Maria L Quintana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871509547 PECOS PAC ID: 4284601311 Enrollment ID: I20040916000661 |
| Provider Name | Maria Crespo Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093938995 PECOS PAC ID: 0648239723 Enrollment ID: I20041005000666 |
| Provider Name | Jack A Bergh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376506394 PECOS PAC ID: 8224090709 Enrollment ID: I20041027000814 |
| Provider Name | Rajnikant Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679597512 PECOS PAC ID: 6608830575 Enrollment ID: I20041119000301 |
| Provider Name | Renee C Fondren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841289626 PECOS PAC ID: 1557310117 Enrollment ID: I20050120000828 |
| Provider Name | Evelyn C Maningo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205859592 PECOS PAC ID: 3476509456 Enrollment ID: I20050323000276 |
| Provider Name | Larnel P Sultan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457318628 PECOS PAC ID: 5799722161 Enrollment ID: I20050418000168 |
| Provider Name | Kathleen M Spellman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043360142 PECOS PAC ID: 1254361926 Enrollment ID: I20050813000025 |
| Provider Name | Vinay Chandra Srivastava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326054396 PECOS PAC ID: 8123058708 Enrollment ID: I20050818000190 |
| Provider Name | Audrey P Baria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730100082 PECOS PAC ID: 6204726128 Enrollment ID: I20050906000816 |
| Provider Name | Ramon Carrillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548224116 PECOS PAC ID: 8426081043 Enrollment ID: I20050915000184 |
| Provider Name | Rayda Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366406944 PECOS PAC ID: 6709819204 Enrollment ID: I20050915000203 |
| Provider Name | Malathi L Akula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134117120 PECOS PAC ID: 8527092857 Enrollment ID: I20050926000401 |
| Provider Name | Annil C Sawh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346254497 PECOS PAC ID: 4385660174 Enrollment ID: I20051020000817 |
| Provider Name | Ananda Som |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598739534 PECOS PAC ID: 3072531599 Enrollment ID: I20051103000509 |
| Provider Name | Scott J Whittier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629112735 PECOS PAC ID: 3476572900 Enrollment ID: I20051115000030 |
| Provider Name | Satya Madhuri Gullapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568489581 PECOS PAC ID: 8628098472 Enrollment ID: I20051123000189 |
| Provider Name | Floridalia Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871609115 PECOS PAC ID: 2668493404 Enrollment ID: I20051208000582 |
| Provider Name | Vincent J Mamone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750310488 PECOS PAC ID: 5799708509 Enrollment ID: I20060107000005 |
| Provider Name | Amy V Bond-rozelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104914845 PECOS PAC ID: 8123034568 Enrollment ID: I20060222000709 |
| Provider Name | Harpreet Patheja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114984341 PECOS PAC ID: 9537177308 Enrollment ID: I20060405000397 |
| Provider Name | Vrajesh Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295785061 PECOS PAC ID: 3476565623 Enrollment ID: I20060707000071 |
| Provider Name | Michael S Frasure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841380623 PECOS PAC ID: 0547269045 Enrollment ID: I20061211000489 |
| Provider Name | Juan Rodriguez Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447237292 PECOS PAC ID: 9638274327 Enrollment ID: I20070425000551 |
| Provider Name | Michael A. Cromer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326006081 PECOS PAC ID: 2264538057 Enrollment ID: I20070511000359 |
| Provider Name | Nancy Tejedor-velilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477629467 PECOS PAC ID: 9931208097 Enrollment ID: I20070702000019 |
| Provider Name | Deborah F Shultz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154341014 PECOS PAC ID: 7911098512 Enrollment ID: I20070810000816 |
| Provider Name | Julio C Gonzalez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1588762082 PECOS PAC ID: 4082707344 Enrollment ID: I20070904000254 |
| Provider Name | Solangel Pollock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871632497 PECOS PAC ID: 4587750989 Enrollment ID: I20071017000147 |
| Provider Name | Delfin J Fuentes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881727014 PECOS PAC ID: 7012004088 Enrollment ID: I20071107000768 |
| Provider Name | Mario Siervo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881800357 PECOS PAC ID: 1355437567 Enrollment ID: I20071121000393 |
| Provider Name | Jose L Acuna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780879163 PECOS PAC ID: 7911080767 Enrollment ID: I20080216000065 |
| Provider Name | Mark Ford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649232349 PECOS PAC ID: 7416030523 Enrollment ID: I20080318000246 |
| Provider Name | Gregg W Gutowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922061589 PECOS PAC ID: 4789767898 Enrollment ID: I20080402000173 |
| Provider Name | Brian J Korte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063475622 PECOS PAC ID: 4688757792 Enrollment ID: I20080402000542 |
| Provider Name | Robert N Baskin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841252061 PECOS PAC ID: 0143303255 Enrollment ID: I20080428000647 |
| Provider Name | Jermania Estevez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770593253 PECOS PAC ID: 2860448651 Enrollment ID: I20080702000683 |
| Provider Name | Patrick J Justiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629165329 PECOS PAC ID: 5890895726 Enrollment ID: I20080722000709 |
| Provider Name | Helwey Mustafa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093923336 PECOS PAC ID: 9234297144 Enrollment ID: I20081022000172 |
| Provider Name | Dean A Behner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386629590 PECOS PAC ID: 6901967595 Enrollment ID: I20081201000440 |
| Provider Name | Bambi C Petrinic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063549434 PECOS PAC ID: 0143385518 Enrollment ID: I20090218000538 |
| Provider Name | Elba E Masid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023269438 PECOS PAC ID: 4789734088 Enrollment ID: I20090608000566 |
| Provider Name | Raysa A Hache |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366680324 PECOS PAC ID: 0345393773 Enrollment ID: I20090803000632 |
| Provider Name | Robert K Law |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457317489 PECOS PAC ID: 1254479108 Enrollment ID: I20091116000011 |
| Provider Name | Dwight Garfield Dawkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164492005 PECOS PAC ID: 5991849507 Enrollment ID: I20100220000253 |
| Provider Name | Robert Haddad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275571572 PECOS PAC ID: 6507878865 Enrollment ID: I20100309000102 |
| Provider Name | Vigarny A Arguello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356326375 PECOS PAC ID: 9739210386 Enrollment ID: I20100626000302 |
| Provider Name | Rachel Shanale Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952631640 PECOS PAC ID: 9931233244 Enrollment ID: I20100820001091 |
| Provider Name | Richard A Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699771626 PECOS PAC ID: 4082688973 Enrollment ID: I20100831000993 |
| Provider Name | Jeffrey M Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538165428 PECOS PAC ID: 8426172248 Enrollment ID: I20100831000998 |
| Provider Name | Syed F Basheer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508885476 PECOS PAC ID: 9234225962 Enrollment ID: I20100902000748 |
| Provider Name | Jewel R Haran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578876025 PECOS PAC ID: 2264557214 Enrollment ID: I20100914000490 |
| Provider Name | Peter A Jacobson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417915190 PECOS PAC ID: 3476684812 Enrollment ID: I20101022000639 |
| Provider Name | Christopher Blazejowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154388452 PECOS PAC ID: 4486847407 Enrollment ID: I20101022000854 |
| Provider Name | Joseph Springle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194783738 PECOS PAC ID: 0345433280 Enrollment ID: I20101022001161 |
| Provider Name | Mark D Overman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700844347 PECOS PAC ID: 5799978631 Enrollment ID: I20101022001177 |
| Provider Name | Kevin Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023076510 PECOS PAC ID: 1052504990 Enrollment ID: I20101022001183 |
| Provider Name | Martha Ford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376501031 PECOS PAC ID: 7911190814 Enrollment ID: I20101025000177 |
| Provider Name | Monica M Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659405173 PECOS PAC ID: 5698873008 Enrollment ID: I20101025001024 |
| Provider Name | Mark S Weissman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225096597 PECOS PAC ID: 6103957543 Enrollment ID: I20101026000953 |
| Provider Name | Manuel Gil Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568480655 PECOS PAC ID: 3476740465 Enrollment ID: I20101202001074 |
| Provider Name | Cres A Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740213628 PECOS PAC ID: 2163619230 Enrollment ID: I20101215000657 |
| Provider Name | Pedro Ruiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427039387 PECOS PAC ID: 9830160498 Enrollment ID: I20110209000258 |
| Provider Name | Humberto J Jimenez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417278227 PECOS PAC ID: 5597945246 Enrollment ID: I20110211000824 |
| Provider Name | Thomas E Carson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427058791 PECOS PAC ID: 7517908353 Enrollment ID: I20110221000438 |
| Provider Name | Scarleth R Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164727236 PECOS PAC ID: 5698957355 Enrollment ID: I20110316001075 |
| Provider Name | Estuardo E Aroca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134133192 PECOS PAC ID: 4486629821 Enrollment ID: I20110519000618 |
| Provider Name | Rose A Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639462310 PECOS PAC ID: 9638357486 Enrollment ID: I20110624000533 |
| Provider Name | Marie R Prinsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366554107 PECOS PAC ID: 2062480254 Enrollment ID: I20110805000284 |
| Provider Name | Katherine J Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992099782 PECOS PAC ID: 1951572379 Enrollment ID: I20110915000404 |
| Provider Name | Brian Elliot Cadigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982604443 PECOS PAC ID: 4284643214 Enrollment ID: I20110929000395 |
| Provider Name | Marina Barkov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790765469 PECOS PAC ID: 9537340278 Enrollment ID: I20111006000552 |
| Provider Name | Brandy Michelle Roose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417114737 PECOS PAC ID: 6406029917 Enrollment ID: I20111028000300 |
| Provider Name | Kshemal Mankodi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447292172 PECOS PAC ID: 5799942371 Enrollment ID: I20120209000458 |
| Provider Name | Cathy R Kessenich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841271996 PECOS PAC ID: 7517156110 Enrollment ID: I20120417000132 |
| Provider Name | Ernesto Rodriguez-valdes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780971754 PECOS PAC ID: 7517129026 Enrollment ID: I20120430000390 |
| Provider Name | Valdeline I Muehl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457564734 PECOS PAC ID: 6800932856 Enrollment ID: I20120815000699 |
| Provider Name | Ramin Sassani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811952302 PECOS PAC ID: 8022095116 Enrollment ID: I20120816000260 |
| Provider Name | Alisa V Holland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093020414 PECOS PAC ID: 5597914994 Enrollment ID: I20120928000325 |
| Provider Name | Holger Fabrizio Montesdeoca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083905848 PECOS PAC ID: 3274784590 Enrollment ID: I20121115000071 |
| Provider Name | Michelle E De La Riva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114221801 PECOS PAC ID: 1557538758 Enrollment ID: I20130111000269 |
| Provider Name | Deborah A Kicliter-kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144476920 PECOS PAC ID: 2365696101 Enrollment ID: I20130204000264 |
| Provider Name | Francisco Solis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922359991 PECOS PAC ID: 8527213883 Enrollment ID: I20130313000128 |
| Provider Name | Maria Laura Arguello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417932344 PECOS PAC ID: 1557512712 Enrollment ID: I20130506000024 |
| Provider Name | Carol Ann Ives |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295074250 PECOS PAC ID: 2264675354 Enrollment ID: I20130820001027 |
| Provider Name | Jeianti Amin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992139653 PECOS PAC ID: 6103060470 Enrollment ID: I20130926000748 |
| Provider Name | Nyree D Bryant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750652590 PECOS PAC ID: 6800021098 Enrollment ID: I20131023002076 |
| Provider Name | Eddy Capote |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598902082 PECOS PAC ID: 9638236086 Enrollment ID: I20140317000613 |
| Provider Name | Barrie A Mccrimmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851717524 PECOS PAC ID: 5193948909 Enrollment ID: I20140523001759 |
| Provider Name | Alexis Silva-vega |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528374550 PECOS PAC ID: 5698902351 Enrollment ID: I20140922000463 |
| Provider Name | Tara M Calise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548502875 PECOS PAC ID: 6406076678 Enrollment ID: I20141010000599 |
| Provider Name | Bibi K Husain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518205780 PECOS PAC ID: 9436370525 Enrollment ID: I20141014000786 |
| Provider Name | Maria D Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447587647 PECOS PAC ID: 6608192059 Enrollment ID: I20150303001202 |
| Provider Name | Tiffany L. Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992100788 PECOS PAC ID: 9133446925 Enrollment ID: I20150316000054 |
| Provider Name | Danita Trivena Osbourne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699167304 PECOS PAC ID: 0840518452 Enrollment ID: I20150410001683 |
| Provider Name | Gary Lee Hensley-laird |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912917501 PECOS PAC ID: 4981668035 Enrollment ID: I20150731014296 |
| Provider Name | Bryan Roy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558799171 PECOS PAC ID: 2668788167 Enrollment ID: I20150828001259 |
| Provider Name | Elias Shaheen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639305972 PECOS PAC ID: 9830363233 Enrollment ID: I20150910001971 |
| Provider Name | Lazau P Fougere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699088104 PECOS PAC ID: 1355536939 Enrollment ID: I20150914001725 |
| Provider Name | Nydia Arjona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770967978 PECOS PAC ID: 3375852312 Enrollment ID: I20151014001801 |
| Provider Name | Lori Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558731158 PECOS PAC ID: 5496059867 Enrollment ID: I20160204001180 |
| Provider Name | Cassandra R Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679940373 PECOS PAC ID: 3072817709 Enrollment ID: I20160301000199 |
| Provider Name | Mirtha Alvarez Acevedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902268170 PECOS PAC ID: 6507144946 Enrollment ID: I20161105000015 |
| Provider Name | Osman Ibrahim Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639221260 PECOS PAC ID: 6709165871 Enrollment ID: I20161111001516 |
| Provider Name | Kimberly L Burnam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093181497 PECOS PAC ID: 6800176389 Enrollment ID: I20161130000892 |
| Provider Name | Stephanie Marie Jacobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992161061 PECOS PAC ID: 2860776390 Enrollment ID: I20170301001827 |
| Provider Name | Audreylyn Waldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053859454 PECOS PAC ID: 7113295221 Enrollment ID: I20170614000718 |
| Provider Name | Narine Melissa Dawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588104582 PECOS PAC ID: 8820366859 Enrollment ID: I20170616000405 |
| Provider Name | Kia Nissan Mcduffie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992245088 PECOS PAC ID: 7517235351 Enrollment ID: I20170619002845 |
| Provider Name | Christine Newcomer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336464502 PECOS PAC ID: 4880833045 Enrollment ID: I20170713002325 |
| Provider Name | Sandra P Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851824478 PECOS PAC ID: 7517239023 Enrollment ID: I20170817003919 |
| Provider Name | Aparajita Mishra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497975304 PECOS PAC ID: 4082750336 Enrollment ID: I20170919002396 |
| Provider Name | Elizabeth Diaz Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053724997 PECOS PAC ID: 7911272117 Enrollment ID: I20171013000051 |
| Provider Name | Omprakash Pansara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992118988 PECOS PAC ID: 6002182599 Enrollment ID: I20171028000062 |
| Provider Name | Ferdinand Brits |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104239862 PECOS PAC ID: 4284990300 Enrollment ID: I20171106002830 |
| Provider Name | Melissa Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053858563 PECOS PAC ID: 1658632484 Enrollment ID: I20180219001288 |
| Provider Name | Jishamol Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467961094 PECOS PAC ID: 4587925599 Enrollment ID: I20180307001057 |
| Provider Name | Carmen R Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346748688 PECOS PAC ID: 5496017618 Enrollment ID: I20180327001989 |
| Provider Name | Joely Ayes-gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629584289 PECOS PAC ID: 8729341680 Enrollment ID: I20180406001751 |
| Provider Name | Elizabeth A Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760778955 PECOS PAC ID: 8820269228 Enrollment ID: I20180621000345 |
| Provider Name | Evie L Breedlove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194132233 PECOS PAC ID: 2062639719 Enrollment ID: I20180711000721 |
| Provider Name | Rose Marie Telisnor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770097479 PECOS PAC ID: 0749537678 Enrollment ID: I20180723003135 |
| Provider Name | Amanda R Dailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588026728 PECOS PAC ID: 0749554079 Enrollment ID: I20180820000317 |
| Provider Name | Kelley Marie Turco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881192060 PECOS PAC ID: 2264782895 Enrollment ID: I20180831002261 |
| Provider Name | Juliana Caram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477038503 PECOS PAC ID: 4981948106 Enrollment ID: I20181129000147 |
| Provider Name | Hannah M Beavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144774886 PECOS PAC ID: 3870838170 Enrollment ID: I20181214000112 |
| Provider Name | Cory C Merrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285037960 PECOS PAC ID: 6800131947 Enrollment ID: I20181218004007 |
| Provider Name | Megan M Dudley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164944112 PECOS PAC ID: 6709121767 Enrollment ID: I20181219000843 |
| Provider Name | Dominiqua Lint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053882290 PECOS PAC ID: 2264778349 Enrollment ID: I20190110000819 |
| Provider Name | Deborah Ann Vaccarello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336272988 PECOS PAC ID: 1254677297 Enrollment ID: I20190111000140 |
| Provider Name | Sarah L O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225463391 PECOS PAC ID: 9234449950 Enrollment ID: I20190118001627 |
| Provider Name | Laura Deree Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881130870 PECOS PAC ID: 1658618996 Enrollment ID: I20190124003197 |
| Provider Name | Seth William Jelinek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144589854 PECOS PAC ID: 1355651662 Enrollment ID: I20190214000281 |
| Provider Name | Shari Alicia Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699171462 PECOS PAC ID: 6305186354 Enrollment ID: I20190329000057 |
| Provider Name | Teresa Pierre Mcdowall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336649144 PECOS PAC ID: 2466793922 Enrollment ID: I20190410000270 |
| Provider Name | Jocelyn Therese Segal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730566803 PECOS PAC ID: 3375884430 Enrollment ID: I20190418000811 |
| Provider Name | Sabrina Snedaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215423439 PECOS PAC ID: 5991033920 Enrollment ID: I20190828002647 |
| Provider Name | Florence Chavez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396309167 PECOS PAC ID: 1658703277 Enrollment ID: I20191119002397 |
| Provider Name | Lincoln Henry Pitcher Iii |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619453305 PECOS PAC ID: 1658705694 Enrollment ID: I20191227000208 |
| Provider Name | Olukemi A Dada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801386867 PECOS PAC ID: 2264867852 Enrollment ID: I20200108000640 |
| Provider Name | Nakita Louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447899224 PECOS PAC ID: 9234564097 Enrollment ID: I20200124001183 |
| Provider Name | Kathleen R Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780219998 PECOS PAC ID: 3678901071 Enrollment ID: I20200319000045 |
| Provider Name | Denise Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326455536 PECOS PAC ID: 8224467667 Enrollment ID: I20200406001154 |
| Provider Name | Jennifer Sauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942835343 PECOS PAC ID: 3375974975 Enrollment ID: I20200515000110 |
| Provider Name | Yudelka Lopez Pampin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972147775 PECOS PAC ID: 7719300466 Enrollment ID: I20200714000764 |
| Provider Name | Thomas Joseph Drzymala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548799679 PECOS PAC ID: 7810267804 Enrollment ID: I20200715000494 |
| Provider Name | Karoon Smbatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447633920 PECOS PAC ID: 8921359084 Enrollment ID: I20200806000371 |
| Provider Name | Christelle Thi Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922534684 PECOS PAC ID: 1850716846 Enrollment ID: I20200807001877 |
| Provider Name | Jennifer F Harbour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902449663 PECOS PAC ID: 1355761271 Enrollment ID: I20201015000179 |
| Provider Name | Teige Jeanette Ballweber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881204329 PECOS PAC ID: 0941610885 Enrollment ID: I20201105000326 |
| Provider Name | Tamara King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033622287 PECOS PAC ID: 0547527855 Enrollment ID: I20201218001184 |
| Provider Name | Raixa Rivas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134578008 PECOS PAC ID: 8820403801 Enrollment ID: I20210225001359 |
| Provider Name | Diane E Lalley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922429794 PECOS PAC ID: 5294046561 Enrollment ID: I20210309001239 |
| Provider Name | Bijal Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265626949 PECOS PAC ID: 8729351176 Enrollment ID: I20210511002782 |
| Provider Name | Heather D Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871132670 PECOS PAC ID: 7012338940 Enrollment ID: I20210519001429 |
| Provider Name | Nehabahen Chauhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063062545 PECOS PAC ID: 1052714466 Enrollment ID: I20210722002931 |
| Provider Name | Dora E Izaguirre Anariba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013364215 PECOS PAC ID: 8820494834 Enrollment ID: I20210830003551 |
| Provider Name | Emilio Sanchez-medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285308957 PECOS PAC ID: 8325444250 Enrollment ID: I20210901001496 |
| Provider Name | Deborah Diaz Telesford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861001919 PECOS PAC ID: 9739586819 Enrollment ID: I20210916003257 |
| Provider Name | Immanuel Amissah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114066115 PECOS PAC ID: 6002960317 Enrollment ID: I20211021003177 |
| Provider Name | Olivia Pardi Rahman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720756406 PECOS PAC ID: 8628468071 Enrollment ID: I20211130000172 |
| Provider Name | Jacqueline Elizabeth Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619562147 PECOS PAC ID: 1355731985 Enrollment ID: I20211214000616 |
| Provider Name | Heidi Papesh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467989343 PECOS PAC ID: 2264785807 Enrollment ID: I20220118002409 |
| Provider Name | Laali A Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396974119 PECOS PAC ID: 8820233349 Enrollment ID: I20220201002813 |
| Provider Name | Jonathan Woolverton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588259196 PECOS PAC ID: 3779976626 Enrollment ID: I20220217000756 |
| Provider Name | Kenia Gondek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912596602 PECOS PAC ID: 8123412707 Enrollment ID: I20220224001064 |
| Provider Name | Nadia Curren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891443149 PECOS PAC ID: 2860887130 Enrollment ID: I20220323002082 |
| Provider Name | Leandro Alexis Bosques-sanchez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346866407 PECOS PAC ID: 7416342597 Enrollment ID: I20220328002538 |
| Provider Name | Barbara Santana Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538783816 PECOS PAC ID: 4385039460 Enrollment ID: I20220329000089 |
| Provider Name | Diane Camille Truley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437756566 PECOS PAC ID: 3375920721 Enrollment ID: I20220524002432 |
| Provider Name | Ana Maria Guerra Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023619913 PECOS PAC ID: 6608254123 Enrollment ID: I20220610002494 |
| Provider Name | Steven N Rives |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982944666 PECOS PAC ID: 3476825456 Enrollment ID: I20220713002416 |
| Provider Name | Maria Pseftelis Ciraldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003545237 PECOS PAC ID: 0446631972 Enrollment ID: I20220714004179 |
| Provider Name | Eslam Mohamed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881220846 PECOS PAC ID: 0840671848 Enrollment ID: I20220722000381 |
| Provider Name | Louella Pritchette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104161017 PECOS PAC ID: 7012216484 Enrollment ID: I20220812000494 |
| Provider Name | Maryam Micheline Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265097042 PECOS PAC ID: 8426432154 Enrollment ID: I20220830002991 |
| Provider Name | Linsey Atchison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326605437 PECOS PAC ID: 9234562935 Enrollment ID: I20220901001410 |
| Provider Name | Demaris Soto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093155384 PECOS PAC ID: 5395989214 Enrollment ID: I20220919001762 |
| Provider Name | Mouline Guerrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518441864 PECOS PAC ID: 9436570249 Enrollment ID: I20220921001499 |
| Provider Name | Laura Summer Afghani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508503681 PECOS PAC ID: 7810373875 Enrollment ID: I20220929000950 |
| Provider Name | Stephannie Rey-cubero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285201822 PECOS PAC ID: 6103202601 Enrollment ID: I20221006003169 |
| Provider Name | Nicole Brittany Hamlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043930571 PECOS PAC ID: 1759757099 Enrollment ID: I20221012000477 |
| Provider Name | Althea A Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033563283 PECOS PAC ID: 8729992078 Enrollment ID: I20221208000402 |
| Provider Name | Flortile Jean-baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528707783 PECOS PAC ID: 3678942448 Enrollment ID: I20221219000027 |
| Provider Name | Stephanie Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801524384 PECOS PAC ID: 9335519354 Enrollment ID: I20230106001952 |
| Provider Name | Tania Mildrely Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518674753 PECOS PAC ID: 0042681793 Enrollment ID: I20230117002677 |
| Provider Name | Kimberly Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982270674 PECOS PAC ID: 3375940596 Enrollment ID: I20230119002987 |
| Provider Name | Bonita Rita Moynihan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922774066 PECOS PAC ID: 3678944667 Enrollment ID: I20230131000814 |
| Provider Name | Sahyly Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851850663 PECOS PAC ID: 5991132375 Enrollment ID: I20230220002368 |
| Provider Name | Tricia Slone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033816962 PECOS PAC ID: 0941674055 Enrollment ID: I20230313000830 |
| Provider Name | Ana Zoila Torres Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689382863 PECOS PAC ID: 7113392382 Enrollment ID: I20230331002706 |
| Provider Name | Jennifer Lynn Beitelshees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184316341 PECOS PAC ID: 8224496716 Enrollment ID: I20230614004165 |
| Provider Name | John Kapaniris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467080697 PECOS PAC ID: 6709246945 Enrollment ID: I20230719001281 |
| Provider Name | Karine Desouza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689293250 PECOS PAC ID: 9830550383 Enrollment ID: I20230731002083 |
| Provider Name | Devin Paige Petrone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043773443 PECOS PAC ID: 5496082141 Enrollment ID: I20230731003210 |
| Provider Name | Matthew David Nichols |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588292692 PECOS PAC ID: 1951766104 Enrollment ID: I20230818002613 |
| Provider Name | Pamela Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871511923 PECOS PAC ID: 5597864678 Enrollment ID: I20230914004272 |
| Provider Name | Dina Sidig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083234736 PECOS PAC ID: 1153744917 Enrollment ID: I20230919003988 |
| Provider Name | Angeline David |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255837498 PECOS PAC ID: 7012264211 Enrollment ID: I20230930000536 |
| Provider Name | Melanie Ice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417987579 PECOS PAC ID: 3678618931 Enrollment ID: I20231006002109 |
Path Medical- Port St. Lucie Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 549 Nw Lake Whitney Pl Ste 101, Port St Lucie, FL 34986 Phone: 772-732-7874 Fax: 772-300-9093 | |
Larry Quirit, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1810 Se Port St Lucie Blvd, Port St Lucie, FL 34952 Phone: 772-398-0043 Fax: 772-398-4914 | |
Independent Medical Group, Llc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7436 S Federal Hwy, Port St Lucie, FL 34952 Phone: 800-773-7066 | |
Live Young Chiropractic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 Phone: 772-212-1111 Fax: 772-212-0201 | |
The Shores Treatment And Recovery Service, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8493 S Us Highway 1, Suite 14, Port St Lucie, FL 34952 Phone: 772-800-3990 | |
Quality Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4182 Sw Baird St, Port St Lucie, FL 34953 Phone: 561-714-6059 |