| Dean Medical Inc | |
|
1500 Lakeland Hills Blvd Ste 4 Lakeland FL 33805-3257 | |
| (863) 937-7157 | |
| (863) 333-0260 |
| Full Name | Dean Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 Lakeland Hills Blvd Ste 4, Lakeland, Florida |
| Authorized Official Name and Position | Byron Renard Dean (PHYSICIAN) |
| Authorized Official Contact | 8639377157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dean Medical Inc 3616 Harden Blvd # 311 Lakeland FL 33803-5938 Ph: (863) 937-7157 | Dean Medical Inc 1500 Lakeland Hills Blvd Ste 4 Lakeland FL 33805-3257 Ph: (863) 937-7157 |
| NPI Number | 1619274388 |
|---|---|
| Provider Enumeration Date | 02/16/2011 |
| Last Update Date | 11/05/2023 |
| Medicare PECOS PAC ID | 7810174711 |
|---|---|
| Medicare Enrollment ID | O20110601000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619274388 | NPI | - | NPPES |
| 245345600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS9203 (Florida) | Primary |
| Provider Name | Byron R Dean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104851559 PECOS PAC ID: 1658396494 Enrollment ID: I20051011000176 |
| Provider Name | Nathalie Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083885453 PECOS PAC ID: 4880761832 Enrollment ID: I20080917000656 |
| Provider Name | Tiara Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851863872 PECOS PAC ID: 2365789930 Enrollment ID: I20190122000990 |
| Provider Name | Sophia Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700509221 PECOS PAC ID: 1759747033 Enrollment ID: I20230510003338 |
| Provider Name | Fadette Lumorin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710672654 PECOS PAC ID: 0143677070 Enrollment ID: I20231114001518 |
| Provider Name | Sharika Jefferson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063293793 PECOS PAC ID: 6800242447 Enrollment ID: I20240116003721 |
| Provider Name | Christopher A Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174392732 PECOS PAC ID: 6800237934 Enrollment ID: I20240507003372 |
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