| Dynamic Primary Healthcare Clinic | |
|
163 Sw Stonegate Ter Ste 109 Lake City FL 32024-3459 | |
| (330) 323-8976 | |
| Not Available |
| Full Name | Dynamic Primary Healthcare Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 163 Sw Stonegate Ter Ste 109, Lake City, Florida |
| Authorized Official Name and Position | John Distefano (BUSINESS MANAGER) |
| Authorized Official Contact | 3523173214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Primary Healthcare Clinic 924 Se Lantana Loop Lake City FL 32025-6848 Ph: (330) 323-8976 | Dynamic Primary Healthcare Clinic 163 Sw Stonegate Ter Ste 109 Lake City FL 32024-3459 Ph: (330) 323-8976 |
| NPI Number | 1710633144 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 03/18/2024 |
| Medicare PECOS PAC ID | 6608255716 |
|---|---|
| Medicare Enrollment ID | O20220621001695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710633144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Ernest De Leon, Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4225 Nw American Ln, Lake City, FL 32055 Phone: 386-758-6141 | |
Richard Weizenecker, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1297 Sw State Road 47, Lake City, FL 32025 Phone: 386-752-4711 Fax: 386-752-5075 | |
Palms Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 173 Nw Albritton Ln, Lake City, FL 32055 Phone: 386-755-4020 Fax: 386-752-9143 | |
Artemis Billing Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 284 Sw Loren Ct, Lake City, FL 32024 Phone: 772-404-8426 Fax: 772-209-7667 | |
Internal Medicine Of Lake City , Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 334 Sw Commerce Dr, Suite 2, Lake City, FL 32025 Phone: 386-755-1703 Fax: 386-755-1744 | |
Randolph Medical Practices Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1847 Sw Barnett Way, Lake City, FL 32025 Phone: 386-755-1440 Fax: 386-758-5628 | |
Raimah Primary Care Center Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1283 Sw State Road 47, 103, Lake City, FL 32025 Phone: 386-754-0339 Fax: 386-754-0393 |