Dr Rathna Bushan, MD | |
1454 Madison Ave W, Immokalee, FL 34142-2200 | |
(239) 965-8300 | |
(239) 658-3175 |
Full Name | Dr Rathna Bushan |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1454 Madison Ave W, Immokalee, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780723577 | NPI | - | NPPES |
ME55449 | Other | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME55449 (Florida) | Primary |
Entity Name | Hope Hospice And Community Services, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114225745 PECOS PAC ID: 0941105308 Enrollment ID: O20031201000035 |
Mailing Address | Practice Location Address |
---|---|
Dr Rathna Bushan, MD 11341 Longwater Chase Court, Fort Myers, FL 33908 Ph: () - | Dr Rathna Bushan, MD 1454 Madison Ave W, Immokalee, FL 34142-2200 Ph: (239) 965-8300 |
Alexandra Bianca Sarac, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1441 Heritage Blvd, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 237-658-3175 | |
Dr. Adela M De Vera, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1441 Heritage Blvd, Immokalee, FL 34142 Phone: 239-658-3000 | |
Flora Consul Sakornsin, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 | |
Jerry Williamson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3196 Fax: 239-658-3175 | |
Dawn M Bertram-stewart, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 | |
Dr. Luis Eduardo Aviles-lopez, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3011 Fax: 239-658-3070 |