| Ehealth Provisions, Llc | |
|
1435 S Osprey Ave Ste 200 Sarasota FL 34239-2905 | |
| (941) 404-5453 | |
| Not Available |
| Full Name | Ehealth Provisions, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1435 S Osprey Ave Ste 200, Sarasota, Florida |
| Authorized Official Name and Position | Kim Lilly Thomson (AUTHORIZED REP /NURSE PRACTITIONER) |
| Authorized Official Contact | 9412980045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ehealth Provisions, Llc 1435 S Osprey Ave Ste 200 Sarasota FL 34239-2905 Ph: (941) 298-0045 | Ehealth Provisions, Llc 1435 S Osprey Ave Ste 200 Sarasota FL 34239-2905 Ph: (941) 404-5453 |
| NPI Number | 1821797622 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 10/14/2024 |
| Medicare PECOS PAC ID | 8527425693 |
|---|---|
| Medicare Enrollment ID | O20230605002069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821797622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Primary |
| Provider Name | Kim Lilly-bernau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952836298 PECOS PAC ID: 9436426442 Enrollment ID: I20230605002239 |
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