| West Coast Family Medical Care | |
|
3165 N Mcmullen Booth Rd Suite H Clearwater FL 33761-2032 | |
| (727) 787-3911 | |
| (727) 786-2272 |
| Full Name | West Coast Family Medical Care |
|---|---|
| Speciality | Family Medicine |
| Location | 3165 N Mcmullen Booth Rd, Clearwater, Florida |
| Authorized Official Name and Position | David L Hicks (PHYSICIAN/CEO) |
| Authorized Official Contact | 7277873911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Coast Family Medical Care 3165 N Mcmullen Booth Rd Suite H Clearwater FL 33761-2032 Ph: (727) 787-3911 | West Coast Family Medical Care 3165 N Mcmullen Booth Rd Suite H Clearwater FL 33761-2032 Ph: (727) 787-3911 |
| NPI Number | 1285631416 |
|---|---|
| Provider Enumeration Date | 07/01/2005 |
| Last Update Date | 10/13/2016 |
| Medicare PECOS PAC ID | 7911961784 |
|---|---|
| Medicare Enrollment ID | O20041112000430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285631416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS4796 (Florida) | Primary |
| Provider Name | David L Hicks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093904815 PECOS PAC ID: 4789586793 Enrollment ID: I20041116000428 |
| Provider Name | Laronda L Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154850683 PECOS PAC ID: 9335402106 Enrollment ID: I20180409000099 |
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