| Elite Clinical Services | |
|
3601 Nw Federal Hwy Jensen Beach FL 34957-3676 | |
| (772) 218-0977 | |
| Not Available |
| Full Name | Elite Clinical Services |
|---|---|
| Speciality | Family Medicine |
| Location | 3601 Nw Federal Hwy, Jensen Beach, Florida |
| Authorized Official Name and Position | Jason Watt (PARTNER) |
| Authorized Official Contact | 7722180977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Clinical Services 3601 Nw Federal Hwy Jensen Beach FL 34957-3676 Ph: (772) 218-0977 | Elite Clinical Services 3601 Nw Federal Hwy Jensen Beach FL 34957-3676 Ph: (772) 218-0977 |
| NPI Number | 1154895878 |
|---|---|
| Provider Enumeration Date | 01/16/2019 |
| Last Update Date | 01/16/2019 |
| Medicare PECOS PAC ID | 8729329495 |
|---|---|
| Medicare Enrollment ID | O20190405000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154895878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Ann J Dietrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922156470 PECOS PAC ID: 7416081351 Enrollment ID: I20100814000128 |
| Provider Name | Karen L Vassell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679728091 PECOS PAC ID: 9537284278 Enrollment ID: I20100917000406 |
| Provider Name | Jason A Watt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487821641 PECOS PAC ID: 0345416731 Enrollment ID: I20120106000310 |
| Provider Name | Hardik M Soni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639428394 PECOS PAC ID: 9830311398 Enrollment ID: I20141118000429 |
| Provider Name | Sabrina M Seus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033452578 PECOS PAC ID: 7113214388 Enrollment ID: I20161003001530 |
| Provider Name | Racquel A Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366977944 PECOS PAC ID: 3870867815 Enrollment ID: I20170914002776 |
| Provider Name | Martine C Apollon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063961605 PECOS PAC ID: 7113282146 Enrollment ID: I20180522002989 |
| Provider Name | Tanya N Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538755681 PECOS PAC ID: 0840688446 Enrollment ID: I20211102000041 |
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