| Telespecialists North Carolina Neurology Services Pllc | |
|
11215 Metro Pkwy Ste 1 Fort Myers FL 33966-1206 | |
| (239) 208-2212 | |
| Not Available |
| Full Name | Telespecialists North Carolina Neurology Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11215 Metro Pkwy Ste 1, Fort Myers, Florida |
| Authorized Official Name and Position | Mohammed Zaman (OWNER) |
| Authorized Official Contact | 2392082212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telespecialists North Carolina Neurology Services Pllc 11215 Metro Pkwy Ste 1 Fort Myers FL 33966-1206 Ph: () - | Telespecialists North Carolina Neurology Services Pllc 11215 Metro Pkwy Ste 1 Fort Myers FL 33966-1206 Ph: (239) 208-2212 |
| NPI Number | 1245926138 |
|---|---|
| Provider Enumeration Date | 04/13/2023 |
| Last Update Date | 04/13/2023 |
| Certification Date | 04/13/2023 |
| Medicare PECOS PAC ID | 7719348978 |
|---|---|
| Medicare Enrollment ID | O20230803002841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245926138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Chut Sombutmai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649320987 PECOS PAC ID: 4284807413 Enrollment ID: I20111102000829 |
| Provider Name | Harsha Ghatge Nagaraja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568606259 PECOS PAC ID: 5496983009 Enrollment ID: I20141015002294 |
| Provider Name | Theresa B. Sevilis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407111461 PECOS PAC ID: 6608191911 Enrollment ID: I20160907001849 |
| Provider Name | Cintasha Redmond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639437452 PECOS PAC ID: 8628344728 Enrollment ID: I20171017002483 |
| Provider Name | Erica Wilt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003253857 PECOS PAC ID: 5294084265 Enrollment ID: I20180823003560 |
| Provider Name | Ava Giugliano |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1851826309 PECOS PAC ID: 1557631793 Enrollment ID: I20220613000179 |
| Provider Name | Mallory Noelle Luckey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770932170 PECOS PAC ID: 4183902356 Enrollment ID: I20230907003641 |
| Provider Name | Abhi H Kapuria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730542812 PECOS PAC ID: 8820493935 Enrollment ID: I20230915002356 |
| Provider Name | Jessica P Floyd |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386888113 PECOS PAC ID: 3779729868 Enrollment ID: I20231214001223 |
| Provider Name | Steven J Gangloff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952756058 PECOS PAC ID: 4587951637 Enrollment ID: I20240221001066 |
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