Community Family Health Care | |
11392 Ne Highway 316 Fort Mccoy FL 32134-0000 | |
(352) 236-0440 | |
(352) 236-0717 |
Full Name | Community Family Health Care |
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Speciality | Clinic/Center |
Location | 11392 Ne Highway 316, Fort Mccoy, Florida |
Authorized Official Name and Position | Sondra Smith (PRESIDENT/OWNER) |
Authorized Official Contact | 7864098387 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Family Health Care 11392 Ne Highway 316 Fort Mccoy FL 32134-8114 Ph: (352) 236-0440 | Community Family Health Care 11392 Ne Highway 316 Fort Mccoy FL 32134-0000 Ph: (352) 236-0440 |
NPI Number | 1144666439 |
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Provider Enumeration Date | 05/14/2013 |
Last Update Date | 02/04/2020 |
Medicare PECOS PAC ID | 6204060312 |
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Medicare Enrollment ID | O20131003000170 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144666439 | NPI | - | NPPES |
683830 | Other | FL | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Pamela Lynn Breen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467515486 PECOS PAC ID: 0042117764 Enrollment ID: I20031218000888 |
Provider Name | Sondra Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164759957 PECOS PAC ID: 2163558347 Enrollment ID: I20100326000417 |
Provider Name | Tracy L Riddle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083890271 PECOS PAC ID: 3476850876 Enrollment ID: I20160330001674 |
Thomas Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15035 Ne Hwy 315, Fort Mccoy, FL 32134 Phone: 352-236-2525 Fax: 352-236-8610 |