Patrice R Frederick, MD | |
1290 Waterman Way Ste 1290, Tavares, FL 32778-5229 | |
(352) 742-0054 | |
Not Available |
Full Name | Patrice R Frederick |
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Gender | Female |
Speciality | Surgery |
Location | 1290 Waterman Way Ste 1290, Tavares, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225288921 | NPI | - | NPPES |
036117915 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 036117915 (Illinois) | Secondary |
208600000X | Surgery | ME155086 (Florida) | Primary |
Entity Name | The Board Of Trustees Of The University Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
Entity Name | Little Company Of Mary Affiliated Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033162086 PECOS PAC ID: 5193629202 Enrollment ID: O20040127000775 |
Entity Name | Mount Sinai Community Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376715896 PECOS PAC ID: 5991600405 Enrollment ID: O20040202001032 |
Mailing Address | Practice Location Address |
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Patrice R Frederick, MD 1290 Waterman Way Ste 1290, Tavares, FL 32778-5229 Ph: (352) 742-0054 | Patrice R Frederick, MD 1290 Waterman Way Ste 1290, Tavares, FL 32778-5229 Ph: (352) 742-0054 |
Mauricio Perez Martinez, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 3330 Waterman Way, Tavares, FL 32778 Phone: 352-385-3022 Fax: 352-385-3023 | |
Dan Nicolas Tran, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1290 Waterman Way Ste 1290, Tavares, FL 32778 Phone: 352-742-0054 Fax: 352-742-2103 | |
Dr. Sotero Peralta, M.D Surgery Medicare: Accepting Medicare Assignments Practice Location: 3310 Waterman Way, Tavares, FL 32778 Phone: 352-385-3022 Fax: 352-385-3023 | |
Dr. Christopher John Keeler, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1290 Waterman Way, Tavares, FL 32778 Phone: 352-742-0054 Fax: 352-742-4814 | |
Dr. Jason Smith, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1290 Waterman Way, Tavares, FL 32778 Phone: 352-742-0054 Fax: 352-742-4814 | |
Borys A Mascarenhas, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1879 Nightingale Ln, Ste B4, Tavares, FL 32778 Phone: 352-742-2286 Fax: 352-742-2289 |