| Emerald Coast Glambulance Llc | |
|
2318 Cypress Cv Wesley Chapel FL 33544-6786 | |
| (813) 367-1474 | |
| Not Available |
| Full Name | Emerald Coast Glambulance Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2318 Cypress Cv, Wesley Chapel, Florida |
| Authorized Official Name and Position | Monique Wyche (CEO/OWNER) |
| Authorized Official Contact | 8133871474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Glambulance Llc 2318 Cypress Cv Wesley Chapel FL 33544-6786 Ph: (813) 367-1474 | Emerald Coast Glambulance Llc 2318 Cypress Cv Wesley Chapel FL 33544-6786 Ph: (813) 367-1474 |
| NPI Number | 1477267474 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 01/13/2023 |
| Medicare PECOS PAC ID | 6507222809 |
|---|---|
| Medicare Enrollment ID | O20230511000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477267474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Monique R Wyche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447881404 PECOS PAC ID: 2567899198 Enrollment ID: I20200220002279 |
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