Charles Mckinley Zollicoffer, MD | |
1871 Se Tiffany Ave, Suite 200, Port St Lucie, FL 34952-7585 | |
(772) 337-4000 | |
(772) 335-4054 |
Full Name | Charles Mckinley Zollicoffer |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 1871 Se Tiffany Ave, Port St Lucie, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750486460 | NPI | - | NPPES |
278332100 | Medicaid | FL | |
ME97653 | Other | FL | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 231571 (New York) | Secondary |
207V00000X | Obstetrics & Gynecology | ME 97653 (Florida) | Primary |
Entity Name | Florida Community Health Centers Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851518211 PECOS PAC ID: 9931017126 Enrollment ID: O20040515000037 |
Entity Name | Ob Hospitalist Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710647334 PECOS PAC ID: 5193866838 Enrollment ID: O20100104000363 |
Mailing Address | Practice Location Address |
---|---|
Charles Mckinley Zollicoffer, MD 5827 Corporate Way, West Palm Beach, FL 33407-2000 Ph: (561) 844-9443 | Charles Mckinley Zollicoffer, MD 1871 Se Tiffany Ave, Suite 200, Port St Lucie, FL 34952-7585 Ph: (772) 337-4000 |
Gonzalo A Oria, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1696 Se Hillmoor Dr, Suite A, Port St Lucie, FL 34952 Phone: 772-337-4600 Fax: 772-337-7600 | |
Judith Watson Bradfield, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 8024 Links Way, Port St Lucie, FL 34986 Phone: 772-631-8508 | |
Dr. Kathleen Marie Berkowitz, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 Phone: 772-345-5280 Fax: 772-345-5274 | |
Allison Blomer, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1801 Se Hillmoor Dr, Suite C-109, Port St Lucie, FL 34952 Phone: 772-777-3344 Fax: 772-905-4429 | |
George Tuttle Iii, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 8235 S Us Highway 1, Port St Lucie, FL 34952 Phone: 561-601-7343 | |
Lorene Delia Ligouri, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1871 Se Tiffany Ave, Suite 200, Port St Lucie, FL 34952 Phone: 772-337-4000 Fax: 772-335-4054 |