| Ancuram Llc | |
|
10700 Stringfellow Rd Ste 50 Bokeelia FL 33922-3232 | |
| (833) 742-6276 | |
| (833) 895-9833 |
| Full Name | Ancuram Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10700 Stringfellow Rd Ste 50, Bokeelia, Florida |
| Authorized Official Name and Position | Daniel Lee Wilburn Hanley (MEMBER) |
| Authorized Official Contact | 8337426276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ancuram Llc 2838 Sw 30th St Cape Coral FL 33914-2000 Ph: (833) 742-6276 | Ancuram Llc 10700 Stringfellow Rd Ste 50 Bokeelia FL 33922-3232 Ph: (833) 742-6276 |
| NPI Number | 1043775232 |
|---|---|
| Provider Enumeration Date | 02/01/2019 |
| Last Update Date | 04/22/2020 |
| Medicare PECOS PAC ID | 6002238755 |
|---|---|
| Medicare Enrollment ID | O20200625000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043775232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Daniel Hanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407268600 PECOS PAC ID: 1254639602 Enrollment ID: I20190920002219 |
| Provider Name | Alisha Marie Hatch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235992330 PECOS PAC ID: 3678017878 Enrollment ID: I20240628001664 |