| Fsu/tmh Internal Medicine Residency Program | |
|
1300 Miccosukee Road Internal Medicine Residency Program Tallahassee FL 32308-5607 | |
| (850) 431-7900 | |
| (850) 431-7990 |
| Full Name | Fsu/tmh Internal Medicine Residency Program |
|---|---|
| Speciality | Internal Medicine |
| Location | 1300 Miccosukee Road, Tallahassee, Florida |
| Authorized Official Name and Position | George M O'bryant (CEO) |
| Authorized Official Contact | 8504315380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fsu/tmh Internal Medicine Residency Program 1607 Saint James Ct Tallahassee FL 32308-5352 Ph: (850) 431-7021 | Fsu/tmh Internal Medicine Residency Program 1300 Miccosukee Road Internal Medicine Residency Program Tallahassee FL 32308-5607 Ph: (850) 431-7900 |
| NPI Number | 1740545128 |
|---|---|
| Provider Enumeration Date | 07/11/2012 |
| Last Update Date | 01/28/2019 |
| Medicare PECOS PAC ID | 6103724778 |
|---|---|
| Medicare Enrollment ID | O20120913000355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740545128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4080 (Florida) | Primary |
| Provider Name | Terence N Reisman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619926227 PECOS PAC ID: 4284618307 Enrollment ID: I20040616000683 |
| Provider Name | Susan Manson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467407635 PECOS PAC ID: 2769465327 Enrollment ID: I20080125000324 |
| Provider Name | Ingrid C Jones-ince |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831410174 PECOS PAC ID: 7315127149 Enrollment ID: I20110210000468 |
| Provider Name | Raymond Shashaty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164470811 PECOS PAC ID: 1759538424 Enrollment ID: I20120831000201 |
| Provider Name | Sudha Ravilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750466546 PECOS PAC ID: 1557544467 Enrollment ID: I20150911000611 |
| Provider Name | Philip Michael Denoux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588008213 PECOS PAC ID: 3375765258 Enrollment ID: I20170228000524 |
| Provider Name | Stephen Sandroni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750382057 PECOS PAC ID: 8426191792 Enrollment ID: I20170616001051 |
| Provider Name | Claudia A. Kroker-bode |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568467009 PECOS PAC ID: 9537115605 Enrollment ID: I20180822003397 |
| Provider Name | Nakeisha R Rodgers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679880843 PECOS PAC ID: 1355563677 Enrollment ID: I20191210002323 |
| Provider Name | Vincent James Riesgo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689170540 PECOS PAC ID: 3870841091 Enrollment ID: I20210525002879 |
| Provider Name | Kristin Cynthia Magrini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902303910 PECOS PAC ID: 2769731132 Enrollment ID: I20210610000787 |
| Provider Name | Sangeeta Nair-collins |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558859728 PECOS PAC ID: 3779831995 Enrollment ID: I20210720000060 |
| Provider Name | Anazilta Edward |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053872929 PECOS PAC ID: 1153658901 Enrollment ID: I20220601002899 |
| Provider Name | Hussam Ammar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780712273 PECOS PAC ID: 6103868138 Enrollment ID: I20230526000582 |
| Provider Name | Nithya M Yadlapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063033751 PECOS PAC ID: 2769892009 Enrollment ID: I20231002001851 |
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