| Clewiston Center | |
|
315 S W C Owen Ave Clewiston FL 33440-3637 | |
| (863) 983-7813 | |
| (863) 983-9604 |
| Full Name | Clewiston Center |
|---|---|
| Speciality | Family Medicine |
| Location | 315 S W C Owen Ave, Clewiston, Florida |
| Authorized Official Name and Position | Michael F Gervasi (PRESIDENT & CEO) |
| Authorized Official Contact | 5618449443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clewiston Center 5827 Corporate Way West Palm Beach FL 33407-2000 Ph: (561) 844-9443 | Clewiston Center 315 S W C Owen Ave Clewiston FL 33440-3637 Ph: (863) 983-7813 |
| NPI Number | 1124078571 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 06/17/2016 |
| Medicare PECOS PAC ID | 9931017126 |
|---|---|
| Medicare Enrollment ID | O20100908001102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124078571 | NPI | - | NPPES |
| 029574402 | Medicaid | FL | |
| 060151900 | Medicaid | FL |
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