| Llc | |
|
6811 Porto Fino Cir Fort Myers FL 33912-4354 | |
| (239) 208-6648 | |
| (239) 931-0221 |
| Full Name | Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6811 Porto Fino Cir, Fort Myers, Florida |
| Authorized Official Name and Position | Sumeet Shetty (CEO) |
| Authorized Official Contact | 2392086648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Llc 6811 Porto Fino Cir Fort Myers FL 33912-4354 Ph: (239) 208-6648 | Llc 6811 Porto Fino Cir Fort Myers FL 33912-4354 Ph: (239) 208-6648 |
| NPI Number | 1700463643 |
|---|---|
| Provider Enumeration Date | 03/26/2021 |
| Last Update Date | 08/10/2023 |
| Medicare PECOS PAC ID | 9537568266 |
|---|---|
| Medicare Enrollment ID | O20210528000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700463643 | NPI | - | NPPES |
| ME91067 | Other | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shailaja Hegde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841281722 PECOS PAC ID: 3779548532 Enrollment ID: I20041122000548 |
| Provider Name | Rahul K Challapalli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205815818 PECOS PAC ID: 4789721564 Enrollment ID: I20091027000848 |
| Provider Name | Joel C Pelissier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730454323 PECOS PAC ID: 5092961946 Enrollment ID: I20120808000365 |
| Provider Name | Daniel Stanciu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144644642 PECOS PAC ID: 6507166782 Enrollment ID: I20151119000534 |
| Provider Name | Fredrick Cadet |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093106239 PECOS PAC ID: 0840595781 Enrollment ID: I20160301001997 |
| Provider Name | Rosemita Telisca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225765589 PECOS PAC ID: 4587047824 Enrollment ID: I20220818001747 |
| Provider Name | Montana L Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063133544 PECOS PAC ID: 7315316916 Enrollment ID: I20221202001538 |
| Provider Name | Erin R Moffat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396293486 PECOS PAC ID: 1456631332 Enrollment ID: I20230405001108 |
| Provider Name | Daineris Crespo Velazco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487330429 PECOS PAC ID: 1951758598 Enrollment ID: I20231103001868 |
Tele-id Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14192 Metropolis Ave, Fort Myers, FL 33912 Phone: 239-245-8223 Fax: 239-244-9481 | |
Vg Primary Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5285 Summerlin Rd Ste 101, Fort Myers, FL 33919 Phone: 978-495-0389 | |
Millennium Physician Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13813 Metro Pkwy, Fort Myers, FL 33912 Phone: 855-674-4624 | |
Lch- Peds Page Field Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4751 S Cleveland Ave, Fort Myers, FL 33907 Phone: 239-343-9888 Fax: 239-343-9968 | |
Lch-internal Medicine Matthew Drive Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1569 Matthew Dr, Fort Myers, FL 33907 Phone: 239-343-8220 Fax: 239-468-7909 | |
G & C Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4048 Evans Ave, Suite 208, Fort Myers, FL 33901 Phone: 786-991-4400 | |
Millennium Physician Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9671 Gladiolus Dr Ste 109, Fort Myers, FL 33908 Phone: 239-362-1450 Fax: 239-985-9629 |