| First Harbour Medical Centers, Llc | |
|
712 53rd Ave E Bradenton FL 34203-5827 | |
| (941) 755-2456 | |
| Not Available |
| Full Name | First Harbour Medical Centers, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 712 53rd Ave E, Bradenton, Florida |
| Authorized Official Name and Position | Gabriela Watters (DIRECTOR OF COMPLIANCE) |
| Authorized Official Contact | 9412434660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Harbour Medical Centers, Llc 7320 Delainey Ct Lakewood Ranch FL 34240-8445 Ph: (941) 373-6323 | First Harbour Medical Centers, Llc 712 53rd Ave E Bradenton FL 34203-5827 Ph: (941) 755-2456 |
| NPI Number | 1831543982 |
|---|---|
| Provider Enumeration Date | 04/14/2016 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 2062704679 |
|---|---|
| Medicare Enrollment ID | O20160629002947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831543982 | NPI | - | NPPES |
| Provider Name | James J Hanusa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417923855 PECOS PAC ID: 0547272700 Enrollment ID: I20060707000166 |
| Provider Name | Kenneth A Neifeld |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669400586 PECOS PAC ID: 7517017437 Enrollment ID: I20090615000176 |
| Provider Name | Craig Anthony Trigueiro |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1306806187 PECOS PAC ID: 8628061074 Enrollment ID: I20100916000648 |
| Provider Name | Regina Lydon Soderberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508151838 PECOS PAC ID: 1557539509 Enrollment ID: I20110719000641 |
| Provider Name | Erin Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043329956 PECOS PAC ID: 3476578394 Enrollment ID: I20151103000213 |
| Provider Name | Susan Elizabeth Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114693686 PECOS PAC ID: 8527464874 Enrollment ID: I20210910002964 |
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