| Gaps Health Fl | |
|
611 S 13th St Fort Pierce FL 34950-4054 | |
| (772) 464-5262 | |
| Not Available |
| Full Name | Gaps Health Fl |
|---|---|
| Speciality | General Practice |
| Location | 611 S 13th St, Fort Pierce, Florida |
| Authorized Official Name and Position | Sonali Wilborn (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 2484709509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaps Health Fl Po Box 208003 Dallas TX 75320-8003 Ph: () - | Gaps Health Fl 611 S 13th St Fort Pierce FL 34950-4054 Ph: (772) 464-5262 |
| NPI Number | 1174299655 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 08/17/2021 |
| Medicare PECOS PAC ID | 5193123156 |
|---|---|
| Medicare Enrollment ID | O20211006001977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174299655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Lorraine M Childs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558498139 PECOS PAC ID: 0941191258 Enrollment ID: I20040324000431 |
| Provider Name | John Weaver |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174547467 PECOS PAC ID: 0345292728 Enrollment ID: I20050214000654 |
| Provider Name | Chelsea Pierce |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093166829 PECOS PAC ID: 9032452065 Enrollment ID: I20190515000782 |
| Provider Name | Lorynn Ashley Hunter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982055711 PECOS PAC ID: 4385977800 Enrollment ID: I20190614000639 |
| Provider Name | Andrea Charmaine Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871143081 PECOS PAC ID: 4385042241 Enrollment ID: I20211006002337 |
| Provider Name | Sonali Wilborn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164523247 PECOS PAC ID: 0446317358 Enrollment ID: I20211014003274 |
| Provider Name | Fadi Hawawini |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124236690 PECOS PAC ID: 1254430093 Enrollment ID: I20211222000791 |
| Provider Name | Rosemary Castoreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225135957 PECOS PAC ID: 8921009697 Enrollment ID: I20220506000296 |
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