| Bloomingdale Medical Associates | |
|
13403 Boyette Rd Riverview FL 33569-8742 | |
| (813) 654-1775 | |
| (813) 651-9082 |
| Full Name | Bloomingdale Medical Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 13403 Boyette Rd, Riverview, Florida |
| Authorized Official Name and Position | Jeffrey David Wartman (PRESIDENT) |
| Authorized Official Contact | 8136541775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomingdale Medical Associates 13403 Boyette Rd Riverview FL 33569-8742 Ph: (813) 654-1775 | Bloomingdale Medical Associates 13403 Boyette Rd Riverview FL 33569-8742 Ph: (813) 654-1775 |
| NPI Number | 1972502557 |
|---|---|
| Provider Enumeration Date | 07/18/2005 |
| Last Update Date | 12/12/2007 |
| Medicare PECOS PAC ID | 0547150617 |
|---|---|
| Medicare Enrollment ID | O20040319001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972502557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 127604 (Florida) | Primary |
| Provider Name | Deborah Ann Waurishuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821097791 PECOS PAC ID: 1254361827 Enrollment ID: I20050815000399 |
| Provider Name | Debra Hastings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366441230 PECOS PAC ID: 0941225122 Enrollment ID: I20051006000604 |
| Provider Name | Jaima Peyton Woodiwiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902822323 PECOS PAC ID: 7911036512 Enrollment ID: I20100519000781 |
| Provider Name | Jeffrey David Wartman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295730414 PECOS PAC ID: 7517857683 Enrollment ID: I20100817001432 |
| Provider Name | Margaret Ann Colleran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457356677 PECOS PAC ID: 9537293261 Enrollment ID: I20101124000711 |
| Provider Name | Craig Randall Martin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144509860 PECOS PAC ID: 0547213456 Enrollment ID: I20110901000591 |
| Provider Name | Ren Bernardo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639304389 PECOS PAC ID: 3971774415 Enrollment ID: I20120731000339 |
| Provider Name | Shawna King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952740599 PECOS PAC ID: 3375834567 Enrollment ID: I20160617001590 |
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