Kevin J Desantis, MD | |
1912 Kings Hwy Unit 700, Port Charlotte, FL 33980-4305 | |
(941) 255-0032 | |
(941) 391-5213 |
Full Name | Kevin J Desantis |
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Gender | Male |
Speciality | General Practice |
Location | 1912 Kings Hwy Unit 700, Port Charlotte, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255353595 | NPI | - | NPPES |
064805100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | ME58093 (Florida) | Secondary |
208D00000X | General Practice | ME58093 (Florida) | Primary |
Entity Name | St. Joseph Emergency Medical Physicians Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053358903 PECOS PAC ID: 5092718387 Enrollment ID: O20060818000119 |
Entity Name | Millennium Physician Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811122880 PECOS PAC ID: 9830244433 Enrollment ID: O20090903000338 |
Mailing Address | Practice Location Address |
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Kevin J Desantis, MD 2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342 Ph: (877) 856-3774 | Kevin J Desantis, MD 1912 Kings Hwy Unit 700, Port Charlotte, FL 33980-4305 Ph: (941) 255-0032 |
Dr. Martin Francisco Aguero, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 18700 Veterans Blvd Unit 9, Port Charlotte, FL 33954 Phone: 941-263-1776 | |
Dr. Pamela Papola, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 22655 Bayshore Rd Ste 110, Port Charlotte, FL 33980 Phone: 941-235-4900 Fax: 941-235-4901 | |
Dr. Sonia M Ibarra Arias, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 3005 Caring Way Ste 3, Port Charlotte, FL 33952 Phone: 941-273-3102 |