| Eastlake Medical Center Pa | |
|
2595 Tampa Rd Ste K Palm Harbor FL 34684-3152 | |
| (727) 789-6551 | |
| Not Available |
| Full Name | Eastlake Medical Center Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2595 Tampa Rd, Palm Harbor, Florida |
| Authorized Official Name and Position | Vijay Taunk (PRESIDENT) |
| Authorized Official Contact | 7277896551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Medical Center Pa 2595 Tampa Rd Ste K Palm Harbor FL 34684 Ph: (727) 789-6551 | Eastlake Medical Center Pa 2595 Tampa Rd Ste K Palm Harbor FL 34684-3152 Ph: (727) 789-6551 |
| NPI Number | 1376735316 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 12/03/2012 |
| Medicare PECOS PAC ID | 3870786940 |
|---|---|
| Medicare Enrollment ID | O20101021000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376735316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0064536 (Florida) | Primary |
| Provider Name | Vijay L Taunk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417958497 PECOS PAC ID: 4082807151 Enrollment ID: I20101021000293 |
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