| Executive Healthcare, Inc. | |
|
1700 Se Hillmoor Dr Port St Lucie FL 34952-7539 | |
| (772) 335-5679 | |
| Not Available |
| Full Name | Executive Healthcare, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1700 Se Hillmoor Dr, Port St Lucie, Florida |
| Authorized Official Name and Position | Albert Zamek (MEMBER) |
| Authorized Official Contact | 5617589222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Healthcare, Inc. Po Box 2335 Jupiter FL 33468-2335 Ph: (772) 335-5679 | Executive Healthcare, Inc. 1700 Se Hillmoor Dr Port St Lucie FL 34952-7539 Ph: (772) 335-5679 |
| NPI Number | 1952611352 |
|---|---|
| Provider Enumeration Date | 10/19/2010 |
| Last Update Date | 07/05/2011 |
| Medicare PECOS PAC ID | 3072782960 |
|---|---|
| Medicare Enrollment ID | O20110810000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952611352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME62525 (Florida) | Primary |
| Provider Name | Albert Zamek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043437106 PECOS PAC ID: 8921076522 Enrollment ID: I20040921001280 |
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