East Coast Medical Center Pa | |
7664 S Us Highway 1 Port St Lucie FL 34952-2320 | |
(772) 879-0699 | |
(772) 879-6650 |
Full Name | East Coast Medical Center Pa |
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Speciality | Internal Medicine |
Location | 7664 S Us Highway 1, Port St Lucie, Florida |
Authorized Official Name and Position | Juan M Escobar (OWNER) |
Authorized Official Contact | 7728790699 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East Coast Medical Center Pa 7664 S Us Highway 1 Port St Lucie FL 34952-2320 Ph: (772) 879-0699 | East Coast Medical Center Pa 7664 S Us Highway 1 Port St Lucie FL 34952-2320 Ph: (772) 879-0699 |
NPI Number | 1609104215 |
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Provider Enumeration Date | 11/20/2009 |
Last Update Date | 11/20/2009 |
Medicare PECOS PAC ID | 8628226297 |
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Medicare Enrollment ID | O20120924000857 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609104215 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Juan M Escobar |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1194771386 PECOS PAC ID: 7113920828 Enrollment ID: I20060818000476 |
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