| Diabetes And Endocrine Associates Of The Treasure Coast Llc | |
|
2835 20th Street Building C Vero Beach FL 32960 | |
| (772) 299-3003 | |
| (772) 299-3005 |
| Full Name | Diabetes And Endocrine Associates Of The Treasure Coast Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2835 20th Street, Vero Beach, Florida |
| Authorized Official Name and Position | Denise R Tonner (MANAGING MEMBER) |
| Authorized Official Contact | 7722993003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Endocrine Associates Of The Treasure Coast Llc 2835 20th Street Building C Vero Beach FL 32960 Ph: (772) 299-3003 | Diabetes And Endocrine Associates Of The Treasure Coast Llc 2835 20th Street Building C Vero Beach FL 32960 Ph: (772) 299-3003 |
| NPI Number | 1952484412 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 10/18/2007 |
| Medicare PECOS PAC ID | 3779573357 |
|---|---|
| Medicare Enrollment ID | O20071023000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952484412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Paul Abram Graham |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1881777332 PECOS PAC ID: 3779565312 Enrollment ID: I20040607000359 |
| Provider Name | Lauren D Garris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144951070 PECOS PAC ID: 6901289065 Enrollment ID: I20220823000770 |
| Provider Name | Tori G Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821713629 PECOS PAC ID: 8123494648 Enrollment ID: I20221024002715 |
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