Katie Longo Cantrell, MD | |
520 A1a N Ste 101, Ponte Vedra Beach, FL 32082-2260 | |
(904) 273-6900 | |
(904) 390-7479 |
Full Name | Katie Longo Cantrell |
---|---|
Gender | Female |
Speciality | Family Practice |
Experience | 9 Years |
Location | 520 A1a N Ste 101, Ponte Vedra Beach, Florida |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538541768 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 125-066188 (Illinois) | Secondary |
207Q00000X | Family Medicine | ME136447 (Florida) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Baptist Health Medical Center - Jacksonville | Jacksonville, FL | Hospital |
Baptist Medical Center Beaches | Jacksonville beach, FL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Baptist Primary Care Inc | 0648177733 | 405 |
Entity Name | Baptist Primary Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508817529 PECOS PAC ID: 0648177733 Enrollment ID: O20031217000248 |
Entity Name | St Vincent's Ambulatory Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417987124 PECOS PAC ID: 2860411188 Enrollment ID: O20051116000430 |
Mailing Address | Practice Location Address |
---|---|
Katie Longo Cantrell, MD Po Box 746638, Atlanta, GA 30374-6638 Ph: (904) 202-1032 | Katie Longo Cantrell, MD 520 A1a N Ste 101, Ponte Vedra Beach, FL 32082-2260 Ph: (904) 273-6900 |
Dr. Jeremy Shawn Mirabile, M.D. ABPM-ADM, FASAM Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1030 A1a N, Ponte Vedra Beach, FL 32082 Phone: 904-551-1394 Fax: 888-770-4284 | |
Eric J Norenberg, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 228 Ponte Vedra Park Dr Ste 500, Ponte Vedra Beach, FL 32082 Phone: 904-273-1180 Fax: 904-273-6116 | |
Jacob Marvin Wolf, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 520 A1a N Ste 101, Ponte Vedra Beach, FL 32082 Phone: 904-273-6900 Fax: 904-273-9022 | |
Dr. Thomas Allen Tomlin, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 830 A1a N Ste 13-137, Ponte Vedra Beach, FL 32082 Phone: 904-608-1420 | |
Mrs. Jessica Marie Clark, APRN Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 41 Willow Falls Trl, Ponte Vedra Beach, FL 32081 Phone: 352-817-1452 | |
Dr. Elicia D Roos, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 520 A1a N Ste 101, Ponte Vedra Beach, FL 32082 Phone: 904-273-6900 Fax: 904-273-9022 |