| Central Florida Inpatient Medicine Llc | |
|
525 Technology Park Ste 109 Lake Mary FL 32746-7107 | |
| (407) 647-2346 | |
| (407) 647-5431 |
| Full Name | Central Florida Inpatient Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 525 Technology Park Ste 109, Lake Mary, Florida |
| Authorized Official Name and Position | Shannon Abbott (CEO) |
| Authorized Official Contact | 4076472346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Florida Inpatient Medicine Llc Po Box 102224 Atlanta GA 30368-7746 Ph: (407) 647-2346 | Central Florida Inpatient Medicine Llc 525 Technology Park Ste 109 Lake Mary FL 32746-7107 Ph: (407) 647-2346 |
| NPI Number | 1649228859 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 07/18/2024 |
| Medicare PECOS PAC ID | 7911805254 |
|---|---|
| Medicare Enrollment ID | O20031223000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649228859 | NPI | - | NPPES |
| 117229400 | Medicaid | FL | |
| 56966 | Other | FL | FHHS |
| 8900052 | Other | FL | UHC |
| 2289953 | Other | FL | CIGNA |
| DA4377 | Other | FL | RR MEDICARE |
| 38407 | Other | FL | BCBS |
| 2571358 | Other | FL | AETNA HMO |
| 7014260 | Other | FL | AETNA PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME80505 (Florida) | Primary |
| Provider Name | Amarin Alexander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215926373 PECOS PAC ID: 0446151633 Enrollment ID: I20040120000503 |
| Provider Name | Kimberly S Westbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649253139 PECOS PAC ID: 3072406792 Enrollment ID: I20040205001189 |
| Provider Name | James L. Willis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154322915 PECOS PAC ID: 5597658914 Enrollment ID: I20040207000228 |
| Provider Name | Ian Richard Day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316944317 PECOS PAC ID: 3870480452 Enrollment ID: I20040228000346 |
| Provider Name | Brian S Masters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932172731 PECOS PAC ID: 5597753640 Enrollment ID: I20040505001459 |
| Provider Name | Syed Hasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790895035 PECOS PAC ID: 1153234208 Enrollment ID: I20040524000744 |
| Provider Name | Jackeline D Briceno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619043684 PECOS PAC ID: 7517948557 Enrollment ID: I20040526000839 |
| Provider Name | Patrick John Berger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629173273 PECOS PAC ID: 9436133147 Enrollment ID: I20040617001408 |
| Provider Name | Tammy L Tadom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982627352 PECOS PAC ID: 5890771208 Enrollment ID: I20040626000247 |
| Provider Name | Viola Jacob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972597193 PECOS PAC ID: 7012987571 Enrollment ID: I20040730000560 |
| Provider Name | Anand R Mahadevan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245238245 PECOS PAC ID: 7113914953 Enrollment ID: I20040810000929 |
| Provider Name | Sanjay A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003866823 PECOS PAC ID: 8123092004 Enrollment ID: I20040825001000 |
| Provider Name | Patricio Giovanni Bruno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336120690 PECOS PAC ID: 2062487184 Enrollment ID: I20040831001412 |
| Provider Name | Vipul Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992754329 PECOS PAC ID: 1254307226 Enrollment ID: I20040913001400 |
| Provider Name | Baldev S Lalli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881655439 PECOS PAC ID: 7113996505 Enrollment ID: I20041001000589 |
| Provider Name | Steven V Turpin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427090109 PECOS PAC ID: 7810956919 Enrollment ID: I20041005000759 |
| Provider Name | Shelly A Scott-castell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427214881 PECOS PAC ID: 5294794913 Enrollment ID: I20041007000638 |
| Provider Name | Shaik Ejazuddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073501185 PECOS PAC ID: 0749243426 Enrollment ID: I20041104000827 |
| Provider Name | Cindy K Lockwood Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851385165 PECOS PAC ID: 2264497312 Enrollment ID: I20041130000871 |
| Provider Name | Antonio R Velardi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558435107 PECOS PAC ID: 7810946183 Enrollment ID: I20050114000156 |
| Provider Name | Ravishankar L Rao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164414249 PECOS PAC ID: 4082515085 Enrollment ID: I20050317000547 |
| Provider Name | Michael R Gebauer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306930540 PECOS PAC ID: 9133166564 Enrollment ID: I20050419000967 |
| Provider Name | Namita Arya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538278643 PECOS PAC ID: 3870534431 Enrollment ID: I20050513000601 |
| Provider Name | Kanika Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679790976 PECOS PAC ID: 9830132901 Enrollment ID: I20050609000298 |
| Provider Name | Priti Manek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972551166 PECOS PAC ID: 0042284895 Enrollment ID: I20050805000184 |
| Provider Name | Sharon S Scofield Marques |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952394835 PECOS PAC ID: 1153354667 Enrollment ID: I20050915000286 |
| Provider Name | Camilo A Rincon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033206453 PECOS PAC ID: 4880628239 Enrollment ID: I20050924000105 |
| Provider Name | Chaker M Dahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003803412 PECOS PAC ID: 0840190823 Enrollment ID: I20051028000083 |
| Provider Name | Rikkele Saefkow |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265513113 PECOS PAC ID: 2961420096 Enrollment ID: I20051108000261 |
| Provider Name | Arthur Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093717613 PECOS PAC ID: 6103851621 Enrollment ID: I20060120000602 |
| Provider Name | Alexander Fishberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225038391 PECOS PAC ID: 1456328715 Enrollment ID: I20060419000504 |
| Provider Name | Jose Alfonso Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306882196 PECOS PAC ID: 4385657030 Enrollment ID: I20060724000268 |
| Provider Name | Alexandra Alexis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386601839 PECOS PAC ID: 1254344526 Enrollment ID: I20060803000426 |
| Provider Name | Sangeetha Polasa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336107622 PECOS PAC ID: 1052316353 Enrollment ID: I20060920000137 |
| Provider Name | Mohammad Ibrahim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992725048 PECOS PAC ID: 2264432467 Enrollment ID: I20070112000172 |
| Provider Name | Baney P Nandlall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760441117 PECOS PAC ID: 8628050747 Enrollment ID: I20070201000098 |
| Provider Name | Evelyn Rentas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952483356 PECOS PAC ID: 1658478359 Enrollment ID: I20070514000647 |
| Provider Name | Poonam Warman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871508549 PECOS PAC ID: 7315030616 Enrollment ID: I20070831000448 |
| Provider Name | Junias Desamour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609890045 PECOS PAC ID: 5294821583 Enrollment ID: I20071018000034 |
| Provider Name | David R Simmons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790787901 PECOS PAC ID: 7810087699 Enrollment ID: I20071217000543 |
| Provider Name | Alejandro Victoria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043200934 PECOS PAC ID: 2062502560 Enrollment ID: I20071220000601 |
| Provider Name | Cristina C Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356525703 PECOS PAC ID: 5193803690 Enrollment ID: I20080424000253 |
| Provider Name | Albert A Kaplan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558371203 PECOS PAC ID: 8426128802 Enrollment ID: I20080529000015 |
| Provider Name | Adnan A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164498051 PECOS PAC ID: 9638111404 Enrollment ID: I20080530000024 |
| Provider Name | Larry A Suecof |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1033104062 PECOS PAC ID: 3375503527 Enrollment ID: I20080707000489 |
| Provider Name | Buchi V Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699783522 PECOS PAC ID: 1951476753 Enrollment ID: I20080813000435 |
| Provider Name | Ismael A Acevedo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205967585 PECOS PAC ID: 2769559053 Enrollment ID: I20080929000574 |
| Provider Name | Ivan Bolivar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619985645 PECOS PAC ID: 0749340859 Enrollment ID: I20081119000601 |
| Provider Name | Dennis Ray Stevenson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942298179 PECOS PAC ID: 3274690862 Enrollment ID: I20090326000166 |
| Provider Name | Angel M Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902969603 PECOS PAC ID: 4284781196 Enrollment ID: I20090413000031 |
| Provider Name | Mark Britton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497795959 PECOS PAC ID: 3072525385 Enrollment ID: I20090428000256 |
| Provider Name | Mark A Bobek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962489195 PECOS PAC ID: 8426041138 Enrollment ID: I20090527000540 |
| Provider Name | Keith B Murray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972744860 PECOS PAC ID: 1759430499 Enrollment ID: I20090528000554 |
| Provider Name | Carlos M Mercado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033139100 PECOS PAC ID: 3274683248 Enrollment ID: I20090612000255 |
| Provider Name | Lumen B Nordblom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851593974 PECOS PAC ID: 0143371815 Enrollment ID: I20090619000582 |
| Provider Name | Merlyn S Salmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912130246 PECOS PAC ID: 3870631534 Enrollment ID: I20091117000691 |
| Provider Name | Eduardo C Pigtain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144469107 PECOS PAC ID: 3274672951 Enrollment ID: I20091209000724 |
| Provider Name | Susan P Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881887925 PECOS PAC ID: 5395886931 Enrollment ID: I20100105000460 |
| Provider Name | Lukasz K Janeczek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023217502 PECOS PAC ID: 9830233931 Enrollment ID: I20100212000243 |
| Provider Name | Shriram S Marathe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134179922 PECOS PAC ID: 4183535487 Enrollment ID: I20100224000223 |
| Provider Name | Ravindra Tak |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124017827 PECOS PAC ID: 6507992427 Enrollment ID: I20100330001246 |
| Provider Name | Salma Hitawala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659379352 PECOS PAC ID: 1658407184 Enrollment ID: I20100409000075 |
| Provider Name | Kristina L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750415584 PECOS PAC ID: 7214065580 Enrollment ID: I20100506000428 |
| Provider Name | Rajeev Tangri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861468886 PECOS PAC ID: 8527199900 Enrollment ID: I20100629000320 |
| Provider Name | Victor Mikhael |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154397032 PECOS PAC ID: 4688705064 Enrollment ID: I20100629000360 |
| Provider Name | James F Crum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437122090 PECOS PAC ID: 1153453089 Enrollment ID: I20100713000275 |
| Provider Name | Osvaldo Velez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831165711 PECOS PAC ID: 7618072414 Enrollment ID: I20100713000464 |
| Provider Name | Usman Tanveer Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457520561 PECOS PAC ID: 1951426782 Enrollment ID: I20100916000313 |
| Provider Name | Miguel M Alba Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770777294 PECOS PAC ID: 6103942693 Enrollment ID: I20100921001264 |
| Provider Name | Bhavana Madyahnapu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134351067 PECOS PAC ID: 0840482998 Enrollment ID: I20101007000289 |
| Provider Name | Kristi S Killingworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023282225 PECOS PAC ID: 9830382076 Enrollment ID: I20101020001418 |
| Provider Name | Erik Fernandez Perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467788182 PECOS PAC ID: 7416149968 Enrollment ID: I20101021001347 |
| Provider Name | Bella H Dattani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972754687 PECOS PAC ID: 8820282338 Enrollment ID: I20101028001060 |
| Provider Name | David F Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871578617 PECOS PAC ID: 4880886613 Enrollment ID: I20101221000403 |
| Provider Name | Feras Toumeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174774046 PECOS PAC ID: 8921297227 Enrollment ID: I20110118000423 |
| Provider Name | Kendra Lee Blythe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124322359 PECOS PAC ID: 5092996017 Enrollment ID: I20110224000302 |
| Provider Name | Jason Littleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831392737 PECOS PAC ID: 2961690433 Enrollment ID: I20110419000397 |
| Provider Name | Allison L Tucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306177498 PECOS PAC ID: 1658557988 Enrollment ID: I20110520000240 |
| Provider Name | Dawn A Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295030799 PECOS PAC ID: 0042498222 Enrollment ID: I20110617000623 |
| Provider Name | Mara De La Vega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750335147 PECOS PAC ID: 1951589084 Enrollment ID: I20110621000037 |
| Provider Name | Alfonso Gonzalez-rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629091384 PECOS PAC ID: 1557453131 Enrollment ID: I20111031000337 |
| Provider Name | Sridevi Manginani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609156975 PECOS PAC ID: 0648444646 Enrollment ID: I20111130000587 |
| Provider Name | John Venzor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033342274 PECOS PAC ID: 4486818267 Enrollment ID: I20120606000621 |
| Provider Name | Shahid Samy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285610188 PECOS PAC ID: 3971590209 Enrollment ID: I20120627000393 |
| Provider Name | Asim Rahman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366749731 PECOS PAC ID: 8426228669 Enrollment ID: I20120703000054 |
| Provider Name | Jason Edward Szymala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851330807 PECOS PAC ID: 1557368818 Enrollment ID: I20120719000114 |
| Provider Name | Isaac Joseph Paff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710110788 PECOS PAC ID: 9931365426 Enrollment ID: I20120727000550 |
| Provider Name | Caroline Smith |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588958326 PECOS PAC ID: 2365698685 Enrollment ID: I20120801000837 |
| Provider Name | Elina Bobkova |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700110376 PECOS PAC ID: 8628224631 Enrollment ID: I20120807000724 |
| Provider Name | Graciela Ismelda Maalouf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992968028 PECOS PAC ID: 8224284112 Enrollment ID: I20120808000763 |
| Provider Name | Sadia Ijlaluddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912177023 PECOS PAC ID: 2668628322 Enrollment ID: I20120813000242 |
| Provider Name | Azmeena Laila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811290182 PECOS PAC ID: 3678720513 Enrollment ID: I20120828000272 |
| Provider Name | Fabian Rodas Ochoa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972734234 PECOS PAC ID: 9133376809 Enrollment ID: I20120831000287 |
| Provider Name | Jose F Bichara-sudah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336302421 PECOS PAC ID: 1355590753 Enrollment ID: I20120928000269 |
| Provider Name | Sheryl Ann Altamirano Dimayuga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457581001 PECOS PAC ID: 7113177288 Enrollment ID: I20121025000619 |
| Provider Name | Gretchen Martinez-alayon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942465661 PECOS PAC ID: 6103077276 Enrollment ID: I20121119000538 |
| Provider Name | Diane Schoeni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821274192 PECOS PAC ID: 3375795321 Enrollment ID: I20121220000315 |
| Provider Name | Zunaira Islam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548598055 PECOS PAC ID: 2062665268 Enrollment ID: I20130122000455 |
| Provider Name | Elena Malyutina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114246667 PECOS PAC ID: 8426295353 Enrollment ID: I20130513000210 |
| Provider Name | Sangita Mohan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104832062 PECOS PAC ID: 0840438560 Enrollment ID: I20130607000232 |
| Provider Name | Mohammad Fahad Bin Asad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982910527 PECOS PAC ID: 6204078488 Enrollment ID: I20130819000334 |
| Provider Name | Imad M Tahbub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639482391 PECOS PAC ID: 0648412791 Enrollment ID: I20130820000440 |
| Provider Name | Ayham Mouawad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417261611 PECOS PAC ID: 6103069166 Enrollment ID: I20130823000912 |
| Provider Name | Sarah A Vauiso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245513043 PECOS PAC ID: 4789819103 Enrollment ID: I20131021000345 |
| Provider Name | Mariela Salinas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225272461 PECOS PAC ID: 3173770989 Enrollment ID: I20131104000693 |
| Provider Name | Tung Ho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861705477 PECOS PAC ID: 5294961488 Enrollment ID: I20131118000664 |
| Provider Name | Mildride P Monize |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194165142 PECOS PAC ID: 6800022559 Enrollment ID: I20131202001058 |
| Provider Name | Dimtri Fares |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538474994 PECOS PAC ID: 7416183173 Enrollment ID: I20131202001440 |
| Provider Name | Jade E Bagley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578998183 PECOS PAC ID: 6204064280 Enrollment ID: I20140121001023 |
| Provider Name | Enrique J Lozano Ayala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134413289 PECOS PAC ID: 5991921801 Enrollment ID: I20140730001672 |
| Provider Name | Nelsy E Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720490329 PECOS PAC ID: 0648497461 Enrollment ID: I20140818002334 |
| Provider Name | Arash G Pasha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780828095 PECOS PAC ID: 2365698008 Enrollment ID: I20140823000036 |
| Provider Name | Mayra Abreu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346471133 PECOS PAC ID: 6901024140 Enrollment ID: I20140829000111 |
| Provider Name | Belmar A Irizarry Garces |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750679379 PECOS PAC ID: 7416177423 Enrollment ID: I20140925000621 |
| Provider Name | Aisha Afzal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538474440 PECOS PAC ID: 7214170950 Enrollment ID: I20141007000796 |
| Provider Name | Andre S Marques |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144515917 PECOS PAC ID: 6305168022 Enrollment ID: I20141209001158 |
| Provider Name | Cindy Henry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548410475 PECOS PAC ID: 6204004310 Enrollment ID: I20150220001786 |
| Provider Name | Tracy J Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477943447 PECOS PAC ID: 3577880194 Enrollment ID: I20150319001287 |
| Provider Name | Juanetta A Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760875488 PECOS PAC ID: 3476574443 Enrollment ID: I20150505000614 |
| Provider Name | Bolajoko R Adeniyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104112036 PECOS PAC ID: 2466771589 Enrollment ID: I20150512000207 |
| Provider Name | Jan M De Camps Antonio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609010669 PECOS PAC ID: 8123293933 Enrollment ID: I20150720001216 |
| Provider Name | Rory C Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043522915 PECOS PAC ID: 9638307564 Enrollment ID: I20150728003524 |
| Provider Name | Milin Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720421126 PECOS PAC ID: 8729393343 Enrollment ID: I20150811005815 |
| Provider Name | Preethi Gondi Kamma Venkatesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619222411 PECOS PAC ID: 4486961034 Enrollment ID: I20150915002766 |
| Provider Name | Saul F Estrada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982909271 PECOS PAC ID: 1759698921 Enrollment ID: I20150921001693 |
| Provider Name | Joel Ramos-tirado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487963450 PECOS PAC ID: 3577872118 Enrollment ID: I20151021001246 |
| Provider Name | Narsimha R Rangaraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861402638 PECOS PAC ID: 7719162981 Enrollment ID: I20151022002649 |
| Provider Name | Musaddeque Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093738742 PECOS PAC ID: 5092799130 Enrollment ID: I20151105002211 |
| Provider Name | Karin Sieger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790083970 PECOS PAC ID: 2062713001 Enrollment ID: I20151217000492 |
| Provider Name | Kanagalingam Gopalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114235991 PECOS PAC ID: 0244533602 Enrollment ID: I20160120000220 |
| Provider Name | Christy L Manganello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871734749 PECOS PAC ID: 7517132905 Enrollment ID: I20160127002169 |
| Provider Name | Thomas Y Shen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275999369 PECOS PAC ID: 2860799152 Enrollment ID: I20160331001987 |
| Provider Name | Amina Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689090276 PECOS PAC ID: 1557650603 Enrollment ID: I20160513000381 |
| Provider Name | Nastasia Magda Douyon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235424151 PECOS PAC ID: 6800117755 Enrollment ID: I20160525002825 |
| Provider Name | Shoaib Arif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801035985 PECOS PAC ID: 6709910466 Enrollment ID: I20160728000911 |
| Provider Name | Richard Luke Elloway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003226556 PECOS PAC ID: 6204120306 Enrollment ID: I20160812000734 |
| Provider Name | Robert F Lapuma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386986453 PECOS PAC ID: 4880981356 Enrollment ID: I20160927001809 |
| Provider Name | Sascha P Beaumont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689120867 PECOS PAC ID: 1951698398 Enrollment ID: I20160928001381 |
| Provider Name | Sarah Fatima Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225379407 PECOS PAC ID: 4587892336 Enrollment ID: I20161028001778 |
| Provider Name | Keiler Moreno Rivero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659780625 PECOS PAC ID: 7911285325 Enrollment ID: I20161104001172 |
| Provider Name | Dawn Charmaine Mccalla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568719425 PECOS PAC ID: 7618256991 Enrollment ID: I20161108002462 |
| Provider Name | Sumita Aggarwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225224405 PECOS PAC ID: 3375724230 Enrollment ID: I20161110000971 |
| Provider Name | Mohammed A Rizvi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992148050 PECOS PAC ID: 1052555257 Enrollment ID: I20161110001794 |
| Provider Name | Angela A Asemota |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609211010 PECOS PAC ID: 5698917268 Enrollment ID: I20161111000005 |
| Provider Name | David Ali Khosrowzadeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821438094 PECOS PAC ID: 9032406251 Enrollment ID: I20161111001401 |
| Provider Name | Kimiben V Gandhi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639512130 PECOS PAC ID: 5294014379 Enrollment ID: I20161112000088 |
| Provider Name | Jomeo George Padavil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033475181 PECOS PAC ID: 8628385275 Enrollment ID: I20161112000203 |
| Provider Name | Lourdes Martinez Brenes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396186961 PECOS PAC ID: 2264712702 Enrollment ID: I20161129002143 |
| Provider Name | Myrna E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124476221 PECOS PAC ID: 7214217678 Enrollment ID: I20161201001231 |
| Provider Name | Jonathan Paul Clarke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942641121 PECOS PAC ID: 7315228517 Enrollment ID: I20161230001010 |
| Provider Name | Angel M Quesada Pintor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184658759 PECOS PAC ID: 2961665120 Enrollment ID: I20170109001856 |
| Provider Name | Mark L Beauchamp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811911373 PECOS PAC ID: 9234147489 Enrollment ID: I20170123000151 |
| Provider Name | Faisal Mohammad Fakih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114292653 PECOS PAC ID: 4385883883 Enrollment ID: I20170215001368 |
| Provider Name | Naightasha A Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144766684 PECOS PAC ID: 1052694049 Enrollment ID: I20170217001125 |
| Provider Name | Landis Arroyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366806564 PECOS PAC ID: 6002190030 Enrollment ID: I20170310001264 |
| Provider Name | Akilah D Tunsill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164974507 PECOS PAC ID: 7214206614 Enrollment ID: I20170628000949 |
| Provider Name | Abbas A Rizvi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437404274 PECOS PAC ID: 9234351347 Enrollment ID: I20170718002696 |
| Provider Name | Skeeter A Thompson Nembhard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861859183 PECOS PAC ID: 9335436971 Enrollment ID: I20170719001746 |
| Provider Name | Alfredo Lisboa Salcedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861923021 PECOS PAC ID: 2860763620 Enrollment ID: I20170812000208 |
| Provider Name | Ahmad F Almustafa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740693688 PECOS PAC ID: 4880975762 Enrollment ID: I20170926002688 |
| Provider Name | Sujatha Vuyyuru |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1467483875 PECOS PAC ID: 1759332299 Enrollment ID: I20171027002035 |
| Provider Name | Samuel Borrelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861805905 PECOS PAC ID: 5395001127 Enrollment ID: I20171113000529 |
| Provider Name | Robert Weir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154618916 PECOS PAC ID: 7719209063 Enrollment ID: I20180122000436 |
| Provider Name | Miguel J Boque-santiago |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891801247 PECOS PAC ID: 9739180142 Enrollment ID: I20180124003304 |
| Provider Name | Courtney A Lemming Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932574787 PECOS PAC ID: 3375804065 Enrollment ID: I20180220002036 |
| Provider Name | Angel M Gonzalez Cardona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336428739 PECOS PAC ID: 2769743228 Enrollment ID: I20180223001504 |
| Provider Name | Stacie L Lilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295243590 PECOS PAC ID: 9133480007 Enrollment ID: I20180312000216 |
| Provider Name | Zamara V Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912424441 PECOS PAC ID: 0446513121 Enrollment ID: I20180410002873 |
| Provider Name | Cassandra L O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821597717 PECOS PAC ID: 6507129038 Enrollment ID: I20180417000111 |
| Provider Name | Kayla M Stiegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215430681 PECOS PAC ID: 4183989601 Enrollment ID: I20180604000008 |
| Provider Name | Ronja Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558386920 PECOS PAC ID: 6608766308 Enrollment ID: I20180606000948 |
| Provider Name | Saman Jalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154675635 PECOS PAC ID: 6709181548 Enrollment ID: I20180619001445 |
| Provider Name | Amanda L Hartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184058182 PECOS PAC ID: 9234354317 Enrollment ID: I20180625001744 |
| Provider Name | Sheryl L O'connell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639685944 PECOS PAC ID: 8123374014 Enrollment ID: I20180706002152 |
| Provider Name | Satyendra Pratap Singh Raghaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669818308 PECOS PAC ID: 2860788155 Enrollment ID: I20180731003079 |
| Provider Name | Lindsay Samples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992241384 PECOS PAC ID: 8426306523 Enrollment ID: I20180807000546 |
| Provider Name | Tonya Michell Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235639543 PECOS PAC ID: 7810245933 Enrollment ID: I20180807001404 |
| Provider Name | Elzbieta S Kubek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164938072 PECOS PAC ID: 1254680168 Enrollment ID: I20180824001852 |
| Provider Name | Srinivas Raju Dantuluri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881089472 PECOS PAC ID: 2668789900 Enrollment ID: I20180831001152 |
| Provider Name | Adrain Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477906782 PECOS PAC ID: 2668751066 Enrollment ID: I20180914002344 |
| Provider Name | Tamara Alicea Nieves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821589896 PECOS PAC ID: 7315281367 Enrollment ID: I20181203002538 |
| Provider Name | Alexander Samara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376922740 PECOS PAC ID: 3375845357 Enrollment ID: I20181205002431 |
| Provider Name | Kristin Marie Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992284103 PECOS PAC ID: 8921342668 Enrollment ID: I20181206000626 |
| Provider Name | Hilton A Alemar Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659765352 PECOS PAC ID: 3870839327 Enrollment ID: I20190104000988 |
| Provider Name | Abbas H Peera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518353226 PECOS PAC ID: 9830436815 Enrollment ID: I20190129002469 |
| Provider Name | Agustin Vega Santiago |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124322193 PECOS PAC ID: 1759668528 Enrollment ID: I20190201002413 |
| Provider Name | Gabriel A Lopez-vega |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689089567 PECOS PAC ID: 5193063550 Enrollment ID: I20190208002439 |
| Provider Name | Nasser Nasralla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417444019 PECOS PAC ID: 0840538138 Enrollment ID: I20190212001351 |
| Provider Name | Heather Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093288045 PECOS PAC ID: 0042558108 Enrollment ID: I20190214002479 |
| Provider Name | Ericka Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598084428 PECOS PAC ID: 0749529311 Enrollment ID: I20190226000445 |
| Provider Name | Patricia E Flores Dominguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497130108 PECOS PAC ID: 7517207517 Enrollment ID: I20190328000891 |
| Provider Name | Deanna Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609353937 PECOS PAC ID: 3971844671 Enrollment ID: I20190405002176 |
| Provider Name | Chantal P Baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851867766 PECOS PAC ID: 7911231246 Enrollment ID: I20190620001163 |
| Provider Name | Sharlyn J Pamatian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073170247 PECOS PAC ID: 8224362488 Enrollment ID: I20190624000114 |
| Provider Name | Marisol Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679138226 PECOS PAC ID: 3971837592 Enrollment ID: I20190701001856 |
| Provider Name | Fatima Koumtani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588127922 PECOS PAC ID: 7810221397 Enrollment ID: I20190703001442 |
| Provider Name | Joseph Michael Rizzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942658083 PECOS PAC ID: 8325374499 Enrollment ID: I20190726001477 |
| Provider Name | Francisco Baltodano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972161701 PECOS PAC ID: 6608104989 Enrollment ID: I20190823002752 |
| Provider Name | Dayana Jennifer Sawh |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952755936 PECOS PAC ID: 4880922822 Enrollment ID: I20190828003356 |
| Provider Name | Hector David Gallego |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568720779 PECOS PAC ID: 1759601842 Enrollment ID: I20190903002498 |
| Provider Name | Daniel James Breznau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962883652 PECOS PAC ID: 0345515987 Enrollment ID: I20190924000138 |
| Provider Name | Christos C Christolias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750728051 PECOS PAC ID: 0446526057 Enrollment ID: I20191028001226 |
| Provider Name | Erika Cortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396392304 PECOS PAC ID: 6305178005 Enrollment ID: I20191030000962 |
| Provider Name | Yulisa Astudillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871003574 PECOS PAC ID: 9537409958 Enrollment ID: I20191105001408 |
| Provider Name | Ina A Chery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942869094 PECOS PAC ID: 3577997212 Enrollment ID: I20200106000737 |
| Provider Name | Maria T Milan Melo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962846808 PECOS PAC ID: 1052603651 Enrollment ID: I20200131001488 |
| Provider Name | Garrett A Dobson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861843468 PECOS PAC ID: 3476980822 Enrollment ID: I20200224002153 |
| Provider Name | Tiffany Dawn Westbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033741970 PECOS PAC ID: 2961830849 Enrollment ID: I20200309001376 |
| Provider Name | Melissa A Bouvier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265916654 PECOS PAC ID: 7214365089 Enrollment ID: I20200311000034 |
| Provider Name | Carolina Alzate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528699212 PECOS PAC ID: 1456780519 Enrollment ID: I20200411000424 |
| Provider Name | Olga Lorena Seoanes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952872061 PECOS PAC ID: 3870922933 Enrollment ID: I20200412000003 |
| Provider Name | Ashely A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831669126 PECOS PAC ID: 9032530100 Enrollment ID: I20200527001605 |
| Provider Name | Pranav Ravi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881076040 PECOS PAC ID: 0446597694 Enrollment ID: I20200611002165 |
| Provider Name | Kelly J Mackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386287217 PECOS PAC ID: 0244652865 Enrollment ID: I20200626000789 |
| Provider Name | Pragnesh Rajnikant Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780786236 PECOS PAC ID: 4486653599 Enrollment ID: I20200702000882 |
| Provider Name | I-chi Liang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588104806 PECOS PAC ID: 3476824798 Enrollment ID: I20200715001075 |
| Provider Name | Mary Cisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215422068 PECOS PAC ID: 9335566918 Enrollment ID: I20200827001251 |
| Provider Name | Matias Rojas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902054414 PECOS PAC ID: 7719304062 Enrollment ID: I20200901001109 |
| Provider Name | Joshua A Powell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598045205 PECOS PAC ID: 0446403331 Enrollment ID: I20200916001995 |
| Provider Name | David Sukhai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770012502 PECOS PAC ID: 3072932052 Enrollment ID: I20200924000293 |
| Provider Name | Ellena Lois Boddie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689673790 PECOS PAC ID: 0840399515 Enrollment ID: I20201105001302 |
| Provider Name | Almatmed H Abdelsalam |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396157657 PECOS PAC ID: 9830462936 Enrollment ID: I20201215000790 |
| Provider Name | Urmilla Medrano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407402480 PECOS PAC ID: 8527471945 Enrollment ID: I20210104001189 |
| Provider Name | Endri Ceka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386177517 PECOS PAC ID: 1951644186 Enrollment ID: I20210122001847 |
| Provider Name | Catrina M Hajal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962008532 PECOS PAC ID: 1658786637 Enrollment ID: I20210225001336 |
| Provider Name | Amir I Kaldas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316914526 PECOS PAC ID: 4284607862 Enrollment ID: I20210316001487 |
| Provider Name | Matthew C Booker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306402391 PECOS PAC ID: 2668880709 Enrollment ID: I20210409000895 |
| Provider Name | Sheila Soares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629666458 PECOS PAC ID: 8426466863 Enrollment ID: I20210422003137 |
| Provider Name | Melissa Castro Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598344988 PECOS PAC ID: 5799193199 Enrollment ID: I20210423002193 |
| Provider Name | Enzo Andre Nicosia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972008852 PECOS PAC ID: 5890104525 Enrollment ID: I20210511000652 |
| Provider Name | Maryam Y Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972022648 PECOS PAC ID: 8820499387 Enrollment ID: I20210622002795 |
| Provider Name | Abhishek Khatri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366974503 PECOS PAC ID: 0042582165 Enrollment ID: I20210624001659 |
| Provider Name | Amit A Rama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386023356 PECOS PAC ID: 9436451606 Enrollment ID: I20210630001724 |
| Provider Name | Mohamed Gharib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720575137 PECOS PAC ID: 7012319387 Enrollment ID: I20210708002389 |
| Provider Name | Brandi Lee Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164092755 PECOS PAC ID: 7517369762 Enrollment ID: I20210709001361 |
| Provider Name | Prabhdeep Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285131045 PECOS PAC ID: 6305193962 Enrollment ID: I20210713002770 |
| Provider Name | John Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548765464 PECOS PAC ID: 7618224163 Enrollment ID: I20210714000366 |
| Provider Name | Jumana Al-deek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710477047 PECOS PAC ID: 3577997139 Enrollment ID: I20210817004199 |
| Provider Name | Biju Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609443951 PECOS PAC ID: 7517362296 Enrollment ID: I20210818001363 |
| Provider Name | Selsabeel Elyaman |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1871026377 PECOS PAC ID: 5698194223 Enrollment ID: I20210818002296 |
| Provider Name | Idean Sotoudeh Deilamy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982108676 PECOS PAC ID: 4789933888 Enrollment ID: I20210903000115 |
| Provider Name | Shelby S Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518633940 PECOS PAC ID: 3072911130 Enrollment ID: I20211005001204 |
| Provider Name | Sally Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629742424 PECOS PAC ID: 1557769577 Enrollment ID: I20211006000198 |
| Provider Name | Anquanette Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881360493 PECOS PAC ID: 6507256070 Enrollment ID: I20211124001764 |
| Provider Name | Srinivasa R Mandadapu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326060435 PECOS PAC ID: 7810982667 Enrollment ID: I20211130000252 |
| Provider Name | Tanya R Jilkevorkian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003564014 PECOS PAC ID: 2062892201 Enrollment ID: I20220706002928 |
| Provider Name | Sahana Aravind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730749052 PECOS PAC ID: 8224365945 Enrollment ID: I20220706003646 |
| Provider Name | Candice Omega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639815376 PECOS PAC ID: 5092196576 Enrollment ID: I20220714001765 |
| Provider Name | Eslam Mohamed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881220846 PECOS PAC ID: 0840671848 Enrollment ID: I20220722000381 |
| Provider Name | Liliana Colon Santos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437539541 PECOS PAC ID: 5597034280 Enrollment ID: I20220810002223 |
| Provider Name | Yanett Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487386132 PECOS PAC ID: 3476936519 Enrollment ID: I20220822003527 |
| Provider Name | Mohamad Sharbatji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982076816 PECOS PAC ID: 0840555678 Enrollment ID: I20220823001741 |
| Provider Name | Daniel Urdaneta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649587908 PECOS PAC ID: 6507148525 Enrollment ID: I20220824000538 |
| Provider Name | Janaki Saoji Juma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588126437 PECOS PAC ID: 7416332861 Enrollment ID: I20220921000826 |
| Provider Name | Samantha M Crews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609538768 PECOS PAC ID: 1456729565 Enrollment ID: I20221122000148 |
| Provider Name | Ariane Neyou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386854073 PECOS PAC ID: 8820140783 Enrollment ID: I20230130000654 |
| Provider Name | Shiv Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205395084 PECOS PAC ID: 6800261504 Enrollment ID: I20230411002784 |
| Provider Name | Fredely Petiote |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639599194 PECOS PAC ID: 4981905692 Enrollment ID: I20230413000461 |
| Provider Name | Ronald Benard Saborio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114556800 PECOS PAC ID: 8123447356 Enrollment ID: I20230524003569 |
| Provider Name | Cordelia Okwuosah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578867966 PECOS PAC ID: 8820261381 Enrollment ID: I20230629002991 |
| Provider Name | Gineen A Cudjoe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992180483 PECOS PAC ID: 3072862416 Enrollment ID: I20230719004405 |
| Provider Name | Peter Lipsy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124386669 PECOS PAC ID: 3173838919 Enrollment ID: I20230801004519 |
| Provider Name | Vincent A Disilvestro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740228436 PECOS PAC ID: 0648173666 Enrollment ID: I20230816000060 |
| Provider Name | Mohammad F Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447711767 PECOS PAC ID: 8325379886 Enrollment ID: I20230824000437 |
| Provider Name | Elizabeth Agunloye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154107571 PECOS PAC ID: 9335593979 Enrollment ID: I20230929002259 |
| Provider Name | Sydney Mcbean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699559849 PECOS PAC ID: 9739534140 Enrollment ID: I20231004002542 |
| Provider Name | Lisette Conde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225736671 PECOS PAC ID: 1153776430 Enrollment ID: I20231005002050 |
| Provider Name | Victoria E Surujlall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710645999 PECOS PAC ID: 7618329921 Enrollment ID: I20240122003765 |
| Provider Name | Roney Oommen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487353413 PECOS PAC ID: 2567808835 Enrollment ID: I20240308001178 |
| Provider Name | Lackson Msoba Kaunda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215716915 PECOS PAC ID: 5698112266 Enrollment ID: I20240319003115 |
| Provider Name | Dieula John |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861954265 PECOS PAC ID: 3870930811 Enrollment ID: I20240326001676 |
| Provider Name | Karan Alag |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245560093 PECOS PAC ID: 2062609951 Enrollment ID: I20240418002633 |
| Provider Name | Kate Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689444697 PECOS PAC ID: 5799127619 Enrollment ID: I20240523002472 |
| Provider Name | Jonathan Alejandro Vargas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366020133 PECOS PAC ID: 5890237325 Enrollment ID: I20240611004281 |
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