| Ashley Rideout Llc | |
|
1022 Main St Ste B Dunedin FL 34698-5237 | |
| (727) 379-2273 | |
| Not Available |
| Full Name | Ashley Rideout Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1022 Main St Ste B, Dunedin, Florida |
| Authorized Official Name and Position | Ashley Rideout (OWNER) |
| Authorized Official Contact | 7277761719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Rideout Llc 235 San Salvador Dr Dunedin FL 34698-4232 Ph: (727) 776-1719 | Ashley Rideout Llc 1022 Main St Ste B Dunedin FL 34698-5237 Ph: (727) 379-2273 |
| NPI Number | 1669981486 |
|---|---|
| Provider Enumeration Date | 09/25/2017 |
| Last Update Date | 09/15/2022 |
| Certification Date | 09/15/2022 |
| Medicare PECOS PAC ID | 6608252457 |
|---|---|
| Medicare Enrollment ID | O20220930001231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669981486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW6253 (Florida) | Primary |
| Provider Name | Ashley Rideout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821294026 PECOS PAC ID: 0042588311 Enrollment ID: I20170612000327 |
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