| Barry C Pevner Md Pa | |
|
601 N Flamingo Rd Suite 303 Pembroke Pines FL 33028-1010 | |
| (954) 557-5407 | |
| (954) 436-8024 |
| Full Name | Barry C Pevner Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 601 N Flamingo Rd, Pembroke Pines, Florida |
| Authorized Official Name and Position | Barry C Pevner (PRESIDENT) |
| Authorized Official Contact | 9543471360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barry C Pevner Md Pa 601 N Flamingo Rd Suite 303 Pembroke Pines FL 33028-1010 Ph: (954) 347-1360 | Barry C Pevner Md Pa 601 N Flamingo Rd Suite 303 Pembroke Pines FL 33028-1010 Ph: (954) 557-5407 |
| NPI Number | 1598875486 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 03/23/2021 |
| Medicare PECOS PAC ID | 6608044565 |
|---|---|
| Medicare Enrollment ID | O20110719000834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598875486 | NPI | - | NPPES |
| 063488300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME50444 (Florida) | Primary |
| Provider Name | Barry C Pevner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184700940 PECOS PAC ID: 6507034469 Enrollment ID: I20110722000206 |
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