| Boca Grande Health Clinic | |
|
320 Park Avenue Boca Grande FL 33921 | |
| (941) 964-2276 | |
| (941) 964-0158 |
| Full Name | Boca Grande Health Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 320 Park Avenue, Boca Grande, Florida |
| Authorized Official Name and Position | Jonna Foos (OPERATIONS COORDINATOR) |
| Authorized Official Contact | 9419642276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boca Grande Health Clinic Po Box 517 Boca Grande FL 33921 Ph: (941) 964-2276 | Boca Grande Health Clinic 320 Park Avenue Boca Grande FL 33921 Ph: (941) 964-2276 |
| NPI Number | 1972683910 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 06/30/2021 |
| Medicare PECOS PAC ID | 7810069879 |
|---|---|
| Medicare Enrollment ID | O20080708000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972683910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Raymond A James |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285793232 PECOS PAC ID: 4981867306 Enrollment ID: I20120601000469 |
| Provider Name | Emily Adams Haly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831277250 PECOS PAC ID: 8820162951 Enrollment ID: I20180219000356 |
| Provider Name | Bret D Kueber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922078062 PECOS PAC ID: 6901792175 Enrollment ID: I20220319000060 |