Fl Medical Center Of New Port Richey Pa | |
4648 Grand Blvd New Port Richey FL 34652-5113 | |
(727) 842-7397 | |
(727) 842-7790 |
Full Name | Fl Medical Center Of New Port Richey Pa |
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Speciality | Internal Medicine |
Location | 4648 Grand Blvd, New Port Richey, Florida |
Authorized Official Name and Position | Nancy R. Wert (OFFICE MANAGER) |
Authorized Official Contact | 7278427397 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fl Medical Center Of New Port Richey Pa 4648 Grand Blvd New Port Richey FL 34652-5113 Ph: (727) 842-7397 | Fl Medical Center Of New Port Richey Pa 4648 Grand Blvd New Port Richey FL 34652-5113 Ph: (727) 842-7397 |
NPI Number | 1043536022 |
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Provider Enumeration Date | 04/15/2010 |
Last Update Date | 02/25/2013 |
Medicare PECOS PAC ID | 6901099423 |
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Medicare Enrollment ID | O20101015001294 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043536022 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME0050514 (Florida) | Primary |
Provider Name | Douglas Allen Wert |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528018017 PECOS PAC ID: 4082807508 Enrollment ID: I20101111001513 |
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