| Anglin Medical Pa | |
|
13045 Summerfield Square Dr Riverview FL 33578-7402 | |
| (813) 672-1385 | |
| (813) 672-8904 |
| Full Name | Anglin Medical Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 13045 Summerfield Square Dr, Riverview, Florida |
| Authorized Official Name and Position | Mickel Wray Anglin (PRESIDENT) |
| Authorized Official Contact | 8136721385 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anglin Medical Pa 13045 Summerfield Square Dr Riverview FL 33578-7402 Ph: (813) 672-1385 | Anglin Medical Pa 13045 Summerfield Square Dr Riverview FL 33578-7402 Ph: (813) 672-1385 |
| NPI Number | 1134336209 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 01/23/2019 |
| Medicare PECOS PAC ID | 3678653334 |
|---|---|
| Medicare Enrollment ID | O20080108000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134336209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | ME91647 (Florida) | Primary |
| Provider Name | Mickel W Anglin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013980267 PECOS PAC ID: 9931154192 Enrollment ID: I20050321000684 |
| Provider Name | Kristi L Cabiao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598034209 PECOS PAC ID: 1951548619 Enrollment ID: I20171102001997 |
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