| Health & Wellcare Services Of Florida, Inc. | |
|
5915 W Gulf To Lake Hwy Crystal River FL 34429-7565 | |
| (352) 794-3872 | |
| (352) 794-3876 |
| Full Name | Health & Wellcare Services Of Florida, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 5915 W Gulf To Lake Hwy, Crystal River, Florida |
| Authorized Official Name and Position | Johnnie R Degraw (PRESIDENT) |
| Authorized Official Contact | 3527943872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health & Wellcare Services Of Florida, Inc. 5915 W Gulf To Lake Hwy Crystal River FL 34429-7565 Ph: (352) 794-3872 | Health & Wellcare Services Of Florida, Inc. 5915 W Gulf To Lake Hwy Crystal River FL 34429-7565 Ph: (352) 794-3872 |
| NPI Number | 1144376658 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 11/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144376658 | NPI | - | NPPES |
| 108911 | Other | FL | OSCAR |
| 002711800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0048978 (Florida) | Primary |
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