David A Long Md, Pa | |
1615 Pasadena Ave S 250 South Pasadena FL 33707-4516 | |
(727) 381-7727 | |
(727) 381-8229 |
Full Name | David A Long Md, Pa |
---|---|
Speciality | Internal Medicine |
Location | 1615 Pasadena Ave S, South Pasadena, Florida |
Authorized Official Name and Position | David A Long (PRESIDENT) |
Authorized Official Contact | 7273817727 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
David A Long Md, Pa 1615 Pasadena Ave S 250 South Pasadena FL 33707-4516 Ph: (727) 381-7727 | David A Long Md, Pa 1615 Pasadena Ave S 250 South Pasadena FL 33707-4516 Ph: (727) 381-7727 |
NPI Number | 1386962439 |
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Provider Enumeration Date | 05/13/2010 |
Last Update Date | 06/15/2011 |
Medicare PECOS PAC ID | 2860677135 |
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Medicare Enrollment ID | O20110502000237 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386962439 | NPI | - | NPPES |
044825700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME44760 (Florida) | Primary |
Provider Name | David A Long |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871603613 PECOS PAC ID: 8921123498 Enrollment ID: I20101004001202 |
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