| Florida Medical Practice Plan Inc | |
|
2911 Roberts Ave Tallahassee FL 32310-5007 | |
| (850) 644-1543 | |
| (855) 230-7421 |
| Full Name | Florida Medical Practice Plan Inc |
|---|---|
| Speciality | General Practice |
| Location | 2911 Roberts Ave, Tallahassee, Florida |
| Authorized Official Name and Position | John P Fogarty (PRESIDENT) |
| Authorized Official Contact | 8506445024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Medical Practice Plan Inc 2911 Roberts Ave Tallahassee FL 32310-5007 Ph: (850) 644-1542 | Florida Medical Practice Plan Inc 2911 Roberts Ave Tallahassee FL 32310-5007 Ph: (850) 644-1543 |
| NPI Number | 1326386293 |
|---|---|
| Provider Enumeration Date | 01/28/2013 |
| Last Update Date | 03/31/2021 |
| Medicare PECOS PAC ID | 3971608993 |
|---|---|
| Medicare Enrollment ID | O20070420000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326386293 | NPI | - | NPPES |
| 18113359504 | Other | SC | NPI |
| 276305209 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Florida) | Primary |
| Provider Name | Suzanne L Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073658852 PECOS PAC ID: 5092704825 Enrollment ID: I20040507000842 |
| Provider Name | Robert J Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790748598 PECOS PAC ID: 5092782821 Enrollment ID: I20040913000337 |
| Provider Name | Nighat S Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083766687 PECOS PAC ID: 7012924442 Enrollment ID: I20060309000611 |
| Provider Name | Brian Sontag |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497709539 PECOS PAC ID: 8123020658 Enrollment ID: I20070212000592 |
| Provider Name | Todd D Stalnaker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275571135 PECOS PAC ID: 7911009741 Enrollment ID: I20070226000663 |
| Provider Name | Tracey E Hellgren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184664724 PECOS PAC ID: 1850473331 Enrollment ID: I20080419000060 |
| Provider Name | Joseph E Peterson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770769820 PECOS PAC ID: 8426137209 Enrollment ID: I20080505000694 |
| Provider Name | Christienne P Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679775738 PECOS PAC ID: 8325118250 Enrollment ID: I20080604000621 |
| Provider Name | Joedrecka Brown Speights |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336199132 PECOS PAC ID: 9133287022 Enrollment ID: I20081021000893 |
| Provider Name | George R Whiddon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982660791 PECOS PAC ID: 3173655289 Enrollment ID: I20100723000904 |
| Provider Name | Kerwyn L Flowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518114685 PECOS PAC ID: 6608900709 Enrollment ID: I20100811000444 |
| Provider Name | Cyneetha Ann Strong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083661870 PECOS PAC ID: 8527183581 Enrollment ID: I20100914000636 |
| Provider Name | Stephen M Quintero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861610834 PECOS PAC ID: 4587849716 Enrollment ID: I20110503000256 |
| Provider Name | Frank A Kozel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013979160 PECOS PAC ID: 6901839851 Enrollment ID: I20110913000917 |
| Provider Name | John E Agens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144287087 PECOS PAC ID: 2668631763 Enrollment ID: I20120308000814 |
| Provider Name | Lisa Granville |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306957964 PECOS PAC ID: 9234375049 Enrollment ID: I20130424000460 |
| Provider Name | Kenneth Md Brummel-smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609868900 PECOS PAC ID: 9830335645 Enrollment ID: I20130424000500 |
| Provider Name | Niharika Naresh Suchak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932155975 PECOS PAC ID: 1456387448 Enrollment ID: I20130923000225 |
| Provider Name | Laurel A Pfeil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902825649 PECOS PAC ID: 0345227351 Enrollment ID: I20151208002110 |
| Provider Name | Paul R Katz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417976242 PECOS PAC ID: 6305147703 Enrollment ID: I20151208002914 |
| Provider Name | Mridul Mazumder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407902364 PECOS PAC ID: 2668579525 Enrollment ID: I20161025002941 |
| Provider Name | Stefanie Nolder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942454707 PECOS PAC ID: 2163791211 Enrollment ID: I20170705000359 |
| Provider Name | Debra Wagner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013989623 PECOS PAC ID: 4183669294 Enrollment ID: I20170823000165 |
| Provider Name | Brittany Tenorio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639691728 PECOS PAC ID: 8325312374 Enrollment ID: I20170914003186 |
| Provider Name | Shermeeka M Hogans-mathews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578943239 PECOS PAC ID: 7719266535 Enrollment ID: I20180919002769 |
| Provider Name | Mary Norton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811335904 PECOS PAC ID: 1153555834 Enrollment ID: I20180919003870 |
| Provider Name | Charles Robin Fleischer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386006716 PECOS PAC ID: 8921351107 Enrollment ID: I20181106000776 |
| Provider Name | George Staben Rust |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346376308 PECOS PAC ID: 9234326919 Enrollment ID: I20190418001280 |
| Provider Name | Julia Drude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780098095 PECOS PAC ID: 3870835002 Enrollment ID: I20190508001736 |
| Provider Name | Ramiz Kseri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366825622 PECOS PAC ID: 6406145218 Enrollment ID: I20190627000113 |
| Provider Name | Kenneth O'dell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154778975 PECOS PAC ID: 6709113319 Enrollment ID: I20190805003230 |
| Provider Name | Kelsey N Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740849900 PECOS PAC ID: 8224366653 Enrollment ID: I20190823000307 |
| Provider Name | Casey Nicole Rust |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417310632 PECOS PAC ID: 8224310552 Enrollment ID: I20201223000539 |
| Provider Name | Savitri Ramdial |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043658149 PECOS PAC ID: 3577788827 Enrollment ID: I20221012000801 |
| Provider Name | Alexis Bianca Chambers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245991504 PECOS PAC ID: 7911373857 Enrollment ID: I20221018003604 |
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