| Gainesville Geriatric Rehabilitation Medicine Llc | |
|
5002 Nw 15th Pl Gainesville FL 32605-4555 | |
| (352) 328-1529 | |
| Not Available |
| Full Name | Gainesville Geriatric Rehabilitation Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5002 Nw 15th Pl, Gainesville, Florida |
| Authorized Official Name and Position | John F Brandt (CEO) |
| Authorized Official Contact | 3525146476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gainesville Geriatric Rehabilitation Medicine Llc 5200 Nw 43rd St Suite 102/387 Gainesville FL 32606-4484 Ph: (352) 328-1529 | Gainesville Geriatric Rehabilitation Medicine Llc 5002 Nw 15th Pl Gainesville FL 32605-4555 Ph: (352) 328-1529 |
| NPI Number | 1750835211 |
|---|---|
| Provider Enumeration Date | 08/12/2016 |
| Last Update Date | 08/12/2016 |
| Medicare PECOS PAC ID | 1254619919 |
|---|---|
| Medicare Enrollment ID | O20161031002251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750835211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | L16000146361 (Florida) | Primary |
| Provider Name | Molly Nicholas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629097555 PECOS PAC ID: 4688675689 Enrollment ID: I20070117000485 |
| Provider Name | Constance A Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225001415 PECOS PAC ID: 1951405034 Enrollment ID: I20070329000283 |
| Provider Name | John F Brandt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689606030 PECOS PAC ID: 7810065950 Enrollment ID: I20081002000571 |
| Provider Name | Kathleen E Flaherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265755565 PECOS PAC ID: 3476677576 Enrollment ID: I20100826000141 |
| Provider Name | Karen Elizabeth Valentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104197441 PECOS PAC ID: 4688838014 Enrollment ID: I20120614000201 |
| Provider Name | Camilla D Pace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740747047 PECOS PAC ID: 1557602984 Enrollment ID: I20190411000735 |
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