Dr David P Divita, MD | |
1120 10th St E, Palmetto, FL 34221-4134 | |
(941) 847-7903 | |
(941) 847-7919 |
Full Name | Dr David P Divita |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1120 10th St E, Palmetto, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205821303 | NPI | - | NPPES |
267953100 | Medicaid | FL | |
080194322 | Other | FL | RAIL ROAD MEDICARE |
57812 | Other | FL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | ME86246 (Florida) | Primary |
Entity Name | Optumcare Florida, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053384214 PECOS PAC ID: 3072403476 Enrollment ID: O20040318001123 |
Mailing Address | Practice Location Address |
---|---|
Dr David P Divita, MD 5130 Sunforest Dr Ste 300, Tampa, FL 33634-6327 Ph: (727) 824-0780 | Dr David P Divita, MD 1120 10th St E, Palmetto, FL 34221-4134 Ph: (941) 847-7903 |
Mihaela Beloiu, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 506 4th Ave W, Palmetto, FL 34221 Phone: 941-933-8108 Fax: 941-933-8109 | |
Dr. Thomas A Keith, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 606 4th Ave W, Palmetto, FL 34221 Phone: 941-722-7785 Fax: 941-729-5267 | |
Dr. Angel Enrique Llanio, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 606 4th Ave W, Palmetto, FL 34221 Phone: 941-722-7785 Fax: 941-729-5267 | |
Dr. Kimberley Kleckner, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 14470 Harlee Rd, Palmetto, FL 34221 Phone: 941-747-3011 | |
Dr. James A Briles, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 606 4th Ave W, Palmetto, FL 34221 Phone: 941-722-7785 Fax: 941-729-5267 | |
Dr. Suzanne Sandra Johnson, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1120 10th St E, Palmetto, FL 34221 Phone: 941-847-7903 Fax: 941-847-7919 |