| Bluerock Medical Llc | |
|
810 N Ridgewood Dr Sebring FL 33870-7217 | |
| (863) 873-0072 | |
| Not Available |
| Full Name | Bluerock Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 810 N Ridgewood Dr, Sebring, Florida |
| Authorized Official Name and Position | Jennie Leclair Spencer (OWNER) |
| Authorized Official Contact | 8638730072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluerock Medical Llc 505 Summit Dr Sebring FL 33870-2341 Ph: (863) 873-0072 | Bluerock Medical Llc 810 N Ridgewood Dr Sebring FL 33870-7217 Ph: (863) 873-0072 |
| NPI Number | 1386408706 |
|---|---|
| Provider Enumeration Date | 02/07/2024 |
| Last Update Date | 03/04/2024 |
| Medicare PECOS PAC ID | 3072959345 |
|---|---|
| Medicare Enrollment ID | O20240308000971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386408706 | NPI | - | NPPES |
| 1164189015 | Other | FL | NPI |
| Provider Name | Jennie Leclair Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164189015 PECOS PAC ID: 2264825355 Enrollment ID: I20220214001681 |
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