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10150 Highland Manor Dr Ste 205 Tampa FL 33610-9727 | |
| (813) 259-1013 | |
| (813) 254-0396 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 10150 Highland Manor Dr Ste 205, Tampa, Florida |
| Authorized Official Name and Position | Diana Bernard (OFFICE MANAGER) |
| Authorized Official Contact | 8132591013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
10150 Highland Manor Dr Ste 205 Tampa FL 33610-9727 Ph: (813) 259-1013 | 10150 Highland Manor Dr Ste 205 Tampa FL 33610-9727 Ph: (813) 259-1013 |
| NPI Number | 1346212370 |
|---|---|
| Provider Enumeration Date | 02/03/2006 |
| Last Update Date | 02/07/2024 |
| Medicare PECOS PAC ID | 9739086257 |
|---|---|
| Medicare Enrollment ID | O20031215000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346212370 | NPI | - | NPPES |
| 015006200 | Medicaid | FL | |
| 34388 | Other | FL | BC/BS |
| CK5239 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jamie Dilorenzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053437855 PECOS PAC ID: 4880597640 Enrollment ID: I20040129000274 |
| Provider Name | Rachel Ann Cascio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508820515 PECOS PAC ID: 4284790957 Enrollment ID: I20090304000392 |
| Provider Name | Laura Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245461466 PECOS PAC ID: 7113064775 Enrollment ID: I20091030000208 |
| Provider Name | Christine Lee Hightower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932496841 PECOS PAC ID: 5496924094 Enrollment ID: I20110817000247 |
| Provider Name | Lotricia Guerrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801143433 PECOS PAC ID: 1254571540 Enrollment ID: I20130710000297 |
| Provider Name | Teresa L Passalacqua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679915854 PECOS PAC ID: 1254575426 Enrollment ID: I20130910000825 |
| Provider Name | Meagan Ann Ducharme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881068310 PECOS PAC ID: 8921302183 Enrollment ID: I20160323001349 |
| Provider Name | Kandi Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881133940 PECOS PAC ID: 5496023558 Enrollment ID: I20170613001914 |
| Provider Name | Ramon Osorio Figueroa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376735654 PECOS PAC ID: 0042490815 Enrollment ID: I20170707002219 |
| Provider Name | Jason C Evers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235506387 PECOS PAC ID: 4587913751 Enrollment ID: I20180821002793 |
| Provider Name | Sydney Kozlowski Belanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386135945 PECOS PAC ID: 9335491539 Enrollment ID: I20181017000951 |
| Provider Name | Sebastian Hayatyfar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255891313 PECOS PAC ID: 7416282280 Enrollment ID: I20190716002683 |
| Provider Name | Kristen Coles Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396239224 PECOS PAC ID: 8022354935 Enrollment ID: I20210707001849 |
| Provider Name | Preston J Hatlestad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851567192 PECOS PAC ID: 3072668748 Enrollment ID: I20220317001515 |
| Provider Name | Stacie Urbanick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174295000 PECOS PAC ID: 0143611475 Enrollment ID: I20220824003814 |
| Provider Name | Nicole Denise Kitrick Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205557147 PECOS PAC ID: 4082081187 Enrollment ID: I20221102001816 |
| Provider Name | Elsa Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992319529 PECOS PAC ID: 5698183184 Enrollment ID: I20230822002446 |
| Provider Name | Amber Nicoal Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316417892 PECOS PAC ID: 1355764754 Enrollment ID: I20230920003968 |
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