| Family Medical Group Pa | |
|
113 Health Way Lake Placid FL 33852-8123 | |
| (863) 465-7010 | |
| Not Available |
| Full Name | Family Medical Group Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 113 Health Way, Lake Placid, Florida |
| Authorized Official Name and Position | Joanne E Stayton (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8634657010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Group Pa 113 Health Way Lake Placid FL 33852-8123 Ph: (863) 465-7010 | Family Medical Group Pa 113 Health Way Lake Placid FL 33852-8123 Ph: (863) 465-7010 |
| NPI Number | 1215099007 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 05/24/2021 |
| Medicare PECOS PAC ID | 9133172240 |
|---|---|
| Medicare Enrollment ID | O20050301000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215099007 | NPI | - | NPPES |
| 660046800 | Medicaid | FL | |
| 660129400 | Medicaid | FL | |
| 45269 | Other | FL | BCBSFL |
| 660219300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel E Montero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376591842 PECOS PAC ID: 5698720134 Enrollment ID: I20100810000103 |
| Provider Name | Wilfred Corredera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891743365 PECOS PAC ID: 3870548316 Enrollment ID: I20101103001069 |
| Provider Name | Richard A Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154387967 PECOS PAC ID: 9638122740 Enrollment ID: I20110513000197 |
| Provider Name | Cheryl Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174571525 PECOS PAC ID: 6507992930 Enrollment ID: I20110928000557 |
| Provider Name | Bentia E Leavelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669727970 PECOS PAC ID: 3870744485 Enrollment ID: I20121107000742 |
| Provider Name | Darian Hilton Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487128393 PECOS PAC ID: 8527399831 Enrollment ID: I20191016003327 |
| Provider Name | Heidi Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932748183 PECOS PAC ID: 5991026262 Enrollment ID: I20210106001125 |
| Provider Name | Kimberly Queen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467760231 PECOS PAC ID: 2365628930 Enrollment ID: I20221012002368 |
| Provider Name | Nicole Rae Lorden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134982978 PECOS PAC ID: 0446691885 Enrollment ID: I20240515004160 |
Adventist Health System Sunbelt Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Us 27 S, Lake Placid, FL 33852 Phone: 863-465-6200 | |
A B Roa Medical Center Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Us Highway 27 S, Lake Placid, FL 33852 Phone: 863-465-6200 Fax: 863-465-9217 | |
Neil Shechtman Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 W Interlake Blvd, Lake Placid, FL 33852 Phone: 863-465-7650 Fax: 863-465-7636 | |
Mina B Bhatt Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 103 Tomoka Blvd S, Lake Placid, FL 33852 Phone: 863-699-1181 | |
Highlands Medical Group-lake Placid Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 W Interlake Blvd, Lake Placid, FL 33852 Phone: 963-465-1725 Fax: 863-465-2595 | |
Main Avenue Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13 N Main Ave, Lake Placid, FL 33852 Phone: 863-659-1079 Fax: 863-659-1317 |