| Alpha Omega Medical Group, Llc | |
|
36503 Us Highway 19 N Palm Harbor FL 34684 | |
| (201) 925-1105 | |
| Not Available |
| Full Name | Alpha Omega Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 36503 Us Highway 19 N, Palm Harbor, Florida |
| Authorized Official Name and Position | Raymon Hanna (PODIATRIST/FOOT AND ANKLE SURGEON) |
| Authorized Official Contact | 2019251105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Omega Medical Group, Llc 5750 Rusack Dr Melbourne FL 32940-8016 Ph: () - | Alpha Omega Medical Group, Llc 36503 Us Highway 19 N Palm Harbor FL 34684 Ph: (201) 925-1105 |
| NPI Number | 1386136315 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 06/25/2018 |
| Medicare PECOS PAC ID | 9830433440 |
|---|---|
| Medicare Enrollment ID | O20181210001312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386136315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME131622 (Florida) | Primary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | PO3900 (Florida) | Secondary |
| Provider Name | Raymon Hanna |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1518371616 PECOS PAC ID: 8224305628 Enrollment ID: I20170606000277 |
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