Serge Mistivar, DO | |
1454 Madison Ave W, Immokalee, FL 34142-2200 | |
(239) 658-3064 | |
(239) 658-3175 |
Full Name | Serge Mistivar |
---|---|
Gender | Male |
Speciality | Family Medicine |
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 |
---|---|---|---|
1609080126 | NPI | - | NPPES |
064865 | Other | GA | PHYSICIAN LICENSE |
DO.1242 | Other | AL | ALABAMA |
OS 9898 | Other | FL | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 064865 (Georgia) | Primary |
Entity Name | Collier Health Services, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609827211 PECOS PAC ID: 4183521925 Enrollment ID: O20040210000106 |
Mailing Address | Practice Location Address |
---|---|
Serge Mistivar, DO 1454 Madison Ave W, Immokalee, FL 34142-2200 Ph: (239) 658-3064 | Serge Mistivar, DO 1454 Madison Ave W, Immokalee, FL 34142-2200 Ph: (239) 658-3064 |
Dr. Jaimenee Khemraj, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 | |
Mr. Reinier F Ramirez, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3064 Fax: 239-658-3175 | |
Alexeiv Perez, M.D Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3064 Fax: 239-658-3175 | |
Joseph James Guernsey, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 | |
Claudia Teresa Lenis, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-658-3175 | |
Marlene Gonzalez, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 |