| Aegis Medical Group Llc | |
|
410 Fern Dr Leesburg FL 34748-7008 | |
| (352) 218-8200 | |
| (352) 435-0690 |
| Full Name | Aegis Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 410 Fern Dr, Leesburg, Florida |
| Authorized Official Name and Position | Shahbaz A Cheema (PRESIDENT) |
| Authorized Official Contact | 3527353755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aegis Medical Group Llc 410 Fern Dr Leesburg FL 34748-7008 Ph: (352) 218-8200 | Aegis Medical Group Llc 410 Fern Dr Leesburg FL 34748-7008 Ph: (352) 218-8200 |
| NPI Number | 1356769384 |
|---|---|
| Provider Enumeration Date | 04/07/2014 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 8022324862 |
|---|---|
| Medicare Enrollment ID | O20150825003518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356769384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Donald T Eagle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326086760 PECOS PAC ID: 3173564895 Enrollment ID: I20050512000618 |
| Provider Name | Frank B Pellegrino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730172479 PECOS PAC ID: 9739189325 Enrollment ID: I20070104000360 |
| Provider Name | Mayra N Munoz Delgado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275677130 PECOS PAC ID: 7618954975 Enrollment ID: I20071208000144 |
| Provider Name | Joseph L Carrasco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174610067 PECOS PAC ID: 8224112719 Enrollment ID: I20080222000297 |
| Provider Name | Mary Ann Tesalona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396744967 PECOS PAC ID: 5395822803 Enrollment ID: I20080408000826 |
| Provider Name | Dan A Boggus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669419248 PECOS PAC ID: 2062303316 Enrollment ID: I20100215000529 |
| Provider Name | Robert D Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841293198 PECOS PAC ID: 3577698075 Enrollment ID: I20100621000350 |
| Provider Name | Cathy Janeane Eagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366729402 PECOS PAC ID: 4082880976 Enrollment ID: I20111227000044 |
| Provider Name | Vimayla Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598994055 PECOS PAC ID: 5193957025 Enrollment ID: I20140408001754 |
| Provider Name | Robert Hung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447480975 PECOS PAC ID: 2264695204 Enrollment ID: I20150224000754 |
| Provider Name | Luis J Barba |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992178750 PECOS PAC ID: 1052603974 Enrollment ID: I20160713000186 |
| Provider Name | Brian Charles Kinsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770035081 PECOS PAC ID: 3072892785 Enrollment ID: I20161121002641 |
| Provider Name | Michelle L Sidor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821549437 PECOS PAC ID: 1951682988 Enrollment ID: I20170105000006 |
| Provider Name | Yadira Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881875029 PECOS PAC ID: 7911083522 Enrollment ID: I20170125002698 |
| Provider Name | Kun Ming Chang |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912171380 PECOS PAC ID: 7517021801 Enrollment ID: I20170831002119 |
| Provider Name | Jose Leonardo Estrella |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1891926911 PECOS PAC ID: 9638361421 Enrollment ID: I20180103002902 |
| Provider Name | Yalieski Garcia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427536259 PECOS PAC ID: 2769726801 Enrollment ID: I20181130001272 |
| Provider Name | Enrique Jose De La Cruz Hernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689920548 PECOS PAC ID: 8628402443 Enrollment ID: I20200102000650 |
| Provider Name | Amy Louise Sierra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578189981 PECOS PAC ID: 3173947264 Enrollment ID: I20200722001836 |
| Provider Name | John A Mccleerey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972641652 PECOS PAC ID: 1658458419 Enrollment ID: I20201016000035 |
| Provider Name | Nicole Cardiello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346845039 PECOS PAC ID: 3971917550 Enrollment ID: I20210121001751 |
| Provider Name | David Levitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679680383 PECOS PAC ID: 1759321706 Enrollment ID: I20210407002804 |
| Provider Name | Usman Khalid Bajwa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356839419 PECOS PAC ID: 2769881333 Enrollment ID: I20210602000464 |
| Provider Name | Elder A Arroyo Nieto |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134898448 PECOS PAC ID: 1557756822 Enrollment ID: I20220323001831 |
| Provider Name | Tina D. Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588308860 PECOS PAC ID: 2668854894 Enrollment ID: I20220803003370 |
| Provider Name | Jo'el Bartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861034506 PECOS PAC ID: 0749664704 Enrollment ID: I20220825001787 |
| Provider Name | Sergio Mercado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730123902 PECOS PAC ID: 5294636577 Enrollment ID: I20240304000095 |
| Provider Name | Reynaldo Javier Martinez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881333888 PECOS PAC ID: 9234571548 Enrollment ID: I20240531000506 |
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