Shelley Smith Tickett, | |
901 E Bloomingdale Ave Ste 501, Brandon, FL 33511-8118 | |
(813) 699-3995 | |
Not Available |
Full Name | Shelley Smith Tickett |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 901 E Bloomingdale Ave Ste 501, Brandon, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023064292 | NPI | - | NPPES |
269812900 | Medicaid | FL | |
44141 | Other | FL | BCBS OF FLORIDA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME90313 (Florida) | Primary |
Entity Name | Emergency Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285686675 PECOS PAC ID: 7911811435 Enrollment ID: O20040407000673 |
Mailing Address | Practice Location Address |
---|---|
Shelley Smith Tickett, 14902 Heronglen Dr, Lithia, FL 33547-5887 Ph: (813) 317-1591 | Shelley Smith Tickett, 901 E Bloomingdale Ave Ste 501, Brandon, FL 33511-8118 Ph: (813) 699-3995 |
Dr. Monica Shah, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 811 S Parsons Ave, Brandon, FL 33511 Phone: 813-685-4553 Fax: 813-681-1191 | |
Noelle Vallimont, PA-C Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 681 W Lumsden Rd, Brandon, FL 33511 Phone: 813-655-7726 | |
Robert Neil Pelaez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 901 E Bloomingdale Ave Ste 501, Brandon, FL 33511 Phone: 813-699-3995 | |
Anna Maria Myers, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 811 S Parsons Ave, Brandon, FL 33511 Phone: 813-685-4553 Fax: 813-681-1191 | |
Dr. Alicia Medrano Ong, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1037 Professional Park Dr, Brandon, FL 33511 Phone: 813-684-5659 Fax: 813-685-2640 | |
Shivinder Narwal, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 205 S Moon Ave Ste 103, Brandon, FL 33511 Phone: 813-324-2613 Fax: 813-324-2614 |