Dr Reda Awad, MD | |
12136 Cobble Stone Dr, Hudson, FL 34667-2432 | |
(727) 863-5474 | |
Not Available |
Full Name | Dr Reda Awad |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 12136 Cobble Stone Dr, Hudson, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568768166 | NPI | - | NPPES |
ME110635 | Other | FL | LICENSE |
010501900 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME110635 (Florida) | Primary |
Entity Name | Premier Community Healthcare Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841263399 PECOS PAC ID: 3476450818 Enrollment ID: O20031215000701 |
Mailing Address | Practice Location Address |
---|---|
Dr Reda Awad, MD 4028 Ligustrum Dr, Palm Harbor, FL 34685-3631 Ph: (718) 213-5453 | Dr Reda Awad, MD 12136 Cobble Stone Dr, Hudson, FL 34667-2432 Ph: (727) 863-5474 |
Phimagham Sriramulu Premkanth, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12136 Cobblestone Dr, Hudson, FL 34667 Phone: 727-863-5474 | |
Monica Tunde Porcelli, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12136 Cobblestone Dr, Hudson, FL 34667 Phone: 727-863-5474 Fax: 727-868-0312 | |
Dr. Jeanette Maryam Ramos-bermudez, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12136 Cobble Stone Dr, Hudson, FL 34667 Phone: 727-863-5474 |