| Citrus Gastroenterology Pa | |
|
3653 E Forest Dr Inverness FL 34453-0787 | |
| (352) 344-8080 | |
| (352) 344-0631 |
| Full Name | Citrus Gastroenterology Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3653 E Forest Dr, Inverness, Florida |
| Authorized Official Name and Position | Johannes Martensson (PRESIDENT) |
| Authorized Official Contact | 3523448080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citrus Gastroenterology Pa 3653 E Forest Dr Inverness FL 34453-0787 Ph: (352) 344-8080 | Citrus Gastroenterology Pa 3653 E Forest Dr Inverness FL 34453-0787 Ph: (352) 344-8080 |
| NPI Number | 1407853195 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 06/21/2011 |
| Medicare PECOS PAC ID | 4284654187 |
|---|---|
| Medicare Enrollment ID | O20051206000651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407853195 | NPI | - | NPPES |
| 173547 | Other | PA | BS OF PENNSYLVANIA |
| 21861 | Other | FL | BCBS OF FLORIDA |
| 263450300 | Medicaid | FL | |
| 2900981 | Other | FL | UNITED HEALTH CARE |
| CN7015 | Other | GA | RAILROAD MEDICARE PIN |
| 84959 | Other | FL | UMWA |
| 213279 | Other | FL | HEALTHEASE |
| 4002702 | Other | TN | BCBS OF TENNESSEE |
| 160659200 | Other | FL | DEPT OF LABOR |
| 2400710 | Other | NY | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 80110022812 (Florida) | Primary |
| Provider Name | Patricia L Duffy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629067525 PECOS PAC ID: 6305746546 Enrollment ID: I20040113000057 |
| Provider Name | Ludwig Bavetta |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104826999 PECOS PAC ID: 9931198785 Enrollment ID: I20040507000975 |
| Provider Name | Mario Blanco |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891754917 PECOS PAC ID: 1658359856 Enrollment ID: I20040713001080 |
| Provider Name | Brenton G Fulks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134181175 PECOS PAC ID: 2264405240 Enrollment ID: I20040817001329 |
| Provider Name | Yi Hwa Sung Outerbridge |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770562829 PECOS PAC ID: 1951377092 Enrollment ID: I20040909000398 |
| Provider Name | Scott L Tanner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841264124 PECOS PAC ID: 5799752713 Enrollment ID: I20040910000384 |
| Provider Name | Aparna V Chunduri |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528031200 PECOS PAC ID: 9234181868 Enrollment ID: I20050211000431 |
| Provider Name | Dereck L Pettiford |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972677367 PECOS PAC ID: 9739120700 Enrollment ID: I20050519000731 |
| Provider Name | James K Allen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073592812 PECOS PAC ID: 6305855768 Enrollment ID: I20060418000162 |
| Provider Name | Barbara A Mcdermott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538139217 PECOS PAC ID: 0840393237 Enrollment ID: I20070905000500 |
| Provider Name | Johannes K Martensson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417954298 PECOS PAC ID: 5597656967 Enrollment ID: I20100415000980 |
| Provider Name | Leonard Calodney |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174538896 PECOS PAC ID: 3476443961 Enrollment ID: I20101227000755 |
| Provider Name | David G Riehn |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023118981 PECOS PAC ID: 8921096967 Enrollment ID: I20110406000786 |
| Provider Name | Ryte Baksiene |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588998306 PECOS PAC ID: 7618134487 Enrollment ID: I20120206000796 |
| Provider Name | Cynthia Sue Hopper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750629804 PECOS PAC ID: 0345495909 Enrollment ID: I20130305000215 |
| Provider Name | Elaine M Whyte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558329565 PECOS PAC ID: 9830168269 Enrollment ID: I20150105000664 |
| Provider Name | Nicole M Dibella |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083005532 PECOS PAC ID: 6406175173 Enrollment ID: I20150430000832 |
| Provider Name | Lauralee A Woods-brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467822957 PECOS PAC ID: 0345540308 Enrollment ID: I20151123001577 |
| Provider Name | Daniel L Huther |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194149765 PECOS PAC ID: 3173756194 Enrollment ID: I20170424001044 |
Quick Care Med, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1907 Highway 44 W, Inverness, FL 34453 Phone: 844-797-8425 | |
Citrus Gastroenterology Mgt Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3653 E Forest Dr, Inverness, FL 34453 Phone: 352-344-8080 Fax: 352-344-0631 | |
Ace Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 W Highland Blvd, Inverness, FL 34452 Phone: 904-475-2039 Fax: 904-330-0668 | |
Barbel Inpatient Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 W Highland Blvd, Inverness, FL 34452 Phone: 469-401-2386 | |
Arnelle V Eslava-fernandez Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 S Apoka Avenue, Inverness, FL 34452 Phone: 352-341-1159 Fax: 352-341-2718 | |
Citrus Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 216 S Seminole Ave, Inverness, FL 34452 Phone: 352-560-0333 Fax: 352-560-0337 | |
Pedim Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3580 E Gulf To Lake Hwy, Inverness, FL 34453 Phone: 352-527-6888 |