Hiro M Rahbar, MD | |
400 Colonnade Dr, Ponte Vedra, FL 32081-6235 | |
(904) 824-1020 | |
(904) 824-5333 |
Full Name | Hiro M Rahbar |
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Gender | Female |
Speciality | Family Medicine |
Location | 400 Colonnade Dr, Ponte Vedra, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093151540 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301103701 (Michigan) | Secondary |
207Q00000X | Family Medicine | ME132952 (Florida) | Primary |
Entity Name | Great Lakes Urgent Care, Pc Of Eastside |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477978930 PECOS PAC ID: 7810120235 Enrollment ID: O20140508001412 |
Entity Name | Great Lakes Medical Group Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053787853 PECOS PAC ID: 1557679073 Enrollment ID: O20151002001904 |
Mailing Address | Practice Location Address |
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Hiro M Rahbar, MD Po Box 45443, Salt Lake City, UT 84145-0443 Ph: (904) 202-1032 | Hiro M Rahbar, MD 400 Colonnade Dr, Ponte Vedra, FL 32081-6235 Ph: (904) 824-1020 |
Nasrin Datar Raina, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 151 Pine Lake Dr Ste B, Ponte Vedra, FL 32081 Phone: 904-543-3677 | |
Richard W. Townsend, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 351 Town Plaza Ave Ste 105a, Ponte Vedra, FL 32081 Phone: 904-819-3233 Fax: 904-456-0819 | |
Dr. Lara Diane Church, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 141 Hilden Rd Ste 201, Credentialing Department, Ponte Vedra, FL 32081 Phone: 904-825-1941 Fax: 904-829-2850 | |
Elizabeth Anne Nelson Andersen, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 141 Hilden Rd Ste 201, Ponte Vedra, FL 32081 Phone: 904-825-1941 Fax: 904-390-7460 | |
Donald W Tice, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 141 Hilden Rd Ste 201, Ponte Vedra, FL 32081 Phone: 904-825-1941 Fax: 904-390-7460 | |
Sarah Crane Adams, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 400 Colonnade Dr Ste 160, Ponte Vedra, FL 32081 Phone: 904-824-1020 Fax: 904-390-7503 |