| Dover Shores Family Practice | |
|
4711 Curry Ford Rd Ste B Orlando FL 32812-2704 | |
| (407) 275-9014 | |
| (407) 277-9249 |
| Full Name | Dover Shores Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 4711 Curry Ford Rd Ste B, Orlando, Florida |
| Authorized Official Name and Position | Debbie B Kivett (MANAGER) |
| Authorized Official Contact | 4072759014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dover Shores Family Practice 4711 Curry Ford Rd Ste B Orlando FL 32812-2704 Ph: (407) 275-9014 | Dover Shores Family Practice 4711 Curry Ford Rd Ste B Orlando FL 32812-2704 Ph: (407) 275-9014 |
| NPI Number | 1417683707 |
|---|---|
| Provider Enumeration Date | 07/28/2022 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 7517336431 |
|---|---|
| Medicare Enrollment ID | O20221214003092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417683707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gerald J Kivett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205810421 PECOS PAC ID: 8921902719 Enrollment ID: I20040108000637 |
| Provider Name | Kathleen Christian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447695093 PECOS PAC ID: 5395986384 Enrollment ID: I20211004003044 |
| Provider Name | Kristy Vandergriff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699298372 PECOS PAC ID: 9537432133 Enrollment ID: I20211229000683 |
| Provider Name | Michael Leon Sevick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851940613 PECOS PAC ID: 1355737594 Enrollment ID: I20220415000173 |
| Provider Name | Phillip Ulyanovskiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821471665 PECOS PAC ID: 8325395403 Enrollment ID: I20240313001180 |
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