| Cdr Health Care Inc | |
|
313 Norton Dr Ste 102 Tallahassee FL 32308-5965 | |
| (850) 738-7977 | |
| Not Available |
| Full Name | Cdr Health Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 313 Norton Dr Ste 102, Tallahassee, Florida |
| Authorized Official Name and Position | Tina Vidal-duart (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7862358534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdr Health Care Inc 11740 Sw 80th St Ste 102 Miami FL 33183-4822 Ph: (786) 235-8534 | Cdr Health Care Inc 313 Norton Dr Ste 102 Tallahassee FL 32308-5965 Ph: (850) 738-7977 |
| NPI Number | 1497352587 |
|---|---|
| Provider Enumeration Date | 10/02/2020 |
| Last Update Date | 04/04/2024 |
| Medicare PECOS PAC ID | 8325437924 |
|---|---|
| Medicare Enrollment ID | O20211122000655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497352587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio Gandia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992896898 PECOS PAC ID: 2961466255 Enrollment ID: I20041116001069 |
| Provider Name | Hugh E Vanlandingham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326056706 PECOS PAC ID: 1355477498 Enrollment ID: I20100329000620 |
| Provider Name | Vanessa Gammill Lickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609343698 PECOS PAC ID: 0941534382 Enrollment ID: I20190619000393 |
| Provider Name | Narendra Kini |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386671303 PECOS PAC ID: 3274500350 Enrollment ID: I20220110000315 |
| Provider Name | Marilyn Narvaez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083388334 PECOS PAC ID: 1850778424 Enrollment ID: I20220519002856 |
| Provider Name | Anthony Delgado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295360063 PECOS PAC ID: 1355722927 Enrollment ID: I20220714001380 |
| Provider Name | Renee Marie Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548517956 PECOS PAC ID: 5799003687 Enrollment ID: I20220804003500 |
| Provider Name | Micah Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235599671 PECOS PAC ID: 6608238522 Enrollment ID: I20230809002619 |
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