| Trauma Treatment Of Pasco Pllc | |
|
38052 Meridian Ave Dade City FL 33525-3811 | |
| (352) 518-5232 | |
| Not Available |
| Full Name | Trauma Treatment Of Pasco Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 38052 Meridian Ave, Dade City, Florida |
| Authorized Official Name and Position | Emily Gilbert (OWNER) |
| Authorized Official Contact | 3525185232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma Treatment Of Pasco Pllc Po Box 2398 Dade City FL 33526-2398 Ph: () - | Trauma Treatment Of Pasco Pllc 38052 Meridian Ave Dade City FL 33525-3811 Ph: (352) 518-5232 |
| NPI Number | 1669013611 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 12/04/2021 |
| Certification Date | 12/04/2021 |
| Medicare PECOS PAC ID | 3870986102 |
|---|---|
| Medicare Enrollment ID | O20220209002906 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669013611 | NPI | - | NPPES |
| 1740601202 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Emily Gilbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740601202 PECOS PAC ID: 6507259835 Enrollment ID: I20220209002928 |
| Provider Name | Dora Graciela Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104419951 PECOS PAC ID: 1052707536 Enrollment ID: I20220410000058 |
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