| Jose A Gaudier Md Pa | |
|
1805 Se 16th Ave Suite 1202 Ocala FL 34471-4670 | |
| (352) 732-8630 | |
| (352) 867-7895 |
| Full Name | Jose A Gaudier Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1805 Se 16th Ave, Ocala, Florida |
| Authorized Official Name and Position | Maria E Alen (PRINCIPAL OFFICER) |
| Authorized Official Contact | 3527328630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose A Gaudier Md Pa Po Box 5277 Ocala FL 34478-5277 Ph: (352) 732-7095 | Jose A Gaudier Md Pa 1805 Se 16th Ave Suite 1202 Ocala FL 34471-4670 Ph: (352) 732-8630 |
| NPI Number | 1043390651 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 03/09/2012 |
| Medicare PECOS PAC ID | 6204931744 |
|---|---|
| Medicare Enrollment ID | O20070412000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043390651 | NPI | - | NPPES |
| 12485 | Other | FL | BLUE CROSS |
| 7218232004 | Other | FL | CIGNA |
| 055513400 | Medicaid | FL | |
| 214728 | Other | FL | AVMED |
| 22593 | Other | FL | WELLCARE |
| DF6521 | Other | FL | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME0060291 (Florida) | Primary |
| Provider Name | Jose A Gaudier |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760578165 PECOS PAC ID: 5092733998 Enrollment ID: I20070306000692 |
| Provider Name | Lacy L Jernigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306998174 PECOS PAC ID: 5092908848 Enrollment ID: I20101025000871 |
| Provider Name | Chelsea M Cervellera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114379815 PECOS PAC ID: 9830486372 Enrollment ID: I20160927000803 |
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