| Corporation | |
|
1050 Se Monterey Rd Stuart FL 34994 | |
| (772) 419-0560 | |
| (772) 403-2379 |
| Full Name | Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1050 Se Monterey Rd, Stuart, Florida |
| Authorized Official Name and Position | Michele F Libman (PRES/OWNER) |
| Authorized Official Contact | 7724192560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 1050 Se Monterey Road Stuart FL 34994 Ph: (772) 419-0560 | Corporation 1050 Se Monterey Rd Stuart FL 34994 Ph: (772) 419-0560 |
| NPI Number | 1407080773 |
|---|---|
| Provider Enumeration Date | 05/14/2009 |
| Last Update Date | 05/14/2009 |
| Medicare PECOS PAC ID | 1951583806 |
|---|---|
| Medicare Enrollment ID | O20110314000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407080773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME0081297 (Florida) | Primary |
| Provider Name | Donna M Dyer Dubois |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275602377 PECOS PAC ID: 4082605670 Enrollment ID: I20040524000383 |
| Provider Name | Roger J Nicosia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548213697 PECOS PAC ID: 4082508684 Enrollment ID: I20050413000335 |
| Provider Name | Michele F Libman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619946597 PECOS PAC ID: 2668412024 Enrollment ID: I20050505000513 |
| Provider Name | Kathleen Ann Sharkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679760086 PECOS PAC ID: 5890865547 Enrollment ID: I20080606000227 |
| Provider Name | Sarah E Mayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477796589 PECOS PAC ID: 1850440900 Enrollment ID: I20090519000585 |
| Provider Name | Paul A Lowery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447272240 PECOS PAC ID: 6204963978 Enrollment ID: I20100429000054 |
| Provider Name | Jacqueline S Mclaughlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700037348 PECOS PAC ID: 6507038189 Enrollment ID: I20111003000543 |
| Provider Name | Toni A Sawczak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154349546 PECOS PAC ID: 5991988446 Enrollment ID: I20111129000148 |
| Provider Name | Kelly L Carbonaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588936025 PECOS PAC ID: 3375706567 Enrollment ID: I20120525000608 |
| Provider Name | Jacilyn L Mikels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487917753 PECOS PAC ID: 5597914424 Enrollment ID: I20121009000284 |
| Provider Name | Megan Kamerer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487896791 PECOS PAC ID: 1355591090 Enrollment ID: I20141210000945 |
| Provider Name | Samantha Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700277217 PECOS PAC ID: 1850694290 Enrollment ID: I20160119002514 |
| Provider Name | Paul Kushner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477611002 PECOS PAC ID: 3779487020 Enrollment ID: I20160510000408 |
| Provider Name | Erin Shaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053772095 PECOS PAC ID: 3072803139 Enrollment ID: I20160601001277 |
| Provider Name | Kristin Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902246416 PECOS PAC ID: 3476841644 Enrollment ID: I20161004002570 |
| Provider Name | Marvalee T Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972040616 PECOS PAC ID: 2365725926 Enrollment ID: I20170207000511 |
| Provider Name | Tony Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861854671 PECOS PAC ID: 7618242397 Enrollment ID: I20171005001419 |
| Provider Name | Catherine A Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154844108 PECOS PAC ID: 5698034742 Enrollment ID: I20180117001481 |
| Provider Name | Dianna G Dashner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235388448 PECOS PAC ID: 5193087682 Enrollment ID: I20180321001005 |
| Provider Name | Rachel L Tougher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285141846 PECOS PAC ID: 0749539476 Enrollment ID: I20180814001267 |
| Provider Name | Sarah M Robitaille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265935399 PECOS PAC ID: 0648522789 Enrollment ID: I20181017003000 |
| Provider Name | Leslie Giordano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285125567 PECOS PAC ID: 8527312487 Enrollment ID: I20181112001321 |
| Provider Name | Rachel Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801354071 PECOS PAC ID: 0749521912 Enrollment ID: I20190416003002 |
| Provider Name | Lauren Weissing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356993190 PECOS PAC ID: 8123357134 Enrollment ID: I20190916003294 |
| Provider Name | Kelly C Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184270209 PECOS PAC ID: 9335576255 Enrollment ID: I20200305000234 |
| Provider Name | Kristen Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437824281 PECOS PAC ID: 1254737158 Enrollment ID: I20210901000171 |
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