| Holy Infant Primary Care And Wellness Center | |
|
2215 Nebraska Ave Ste 3-e Fort Pierce FL 34950-4867 | |
| (786) 368-7626 | |
| Not Available |
| Full Name | Holy Infant Primary Care And Wellness Center |
|---|---|
| Speciality | General Practice |
| Location | 2215 Nebraska Ave Ste 3-e, Fort Pierce, Florida |
| Authorized Official Name and Position | Anna Jose Elissenda Chanoine (PHYSICIAN) |
| Authorized Official Contact | 7863687626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Infant Primary Care And Wellness Center 6440 Nw 170th Ter Hialeah FL 33015-4600 Ph: (786) 368-7626 | Holy Infant Primary Care And Wellness Center 2215 Nebraska Ave Ste 3-e Fort Pierce FL 34950-4867 Ph: (786) 368-7626 |
| NPI Number | 1417633991 |
|---|---|
| Provider Enumeration Date | 06/27/2023 |
| Last Update Date | 06/28/2023 |
| Medicare PECOS PAC ID | 8628412319 |
|---|---|
| Medicare Enrollment ID | O20240221002721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417633991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Anna Jose Elissenda Chanoine |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851789192 PECOS PAC ID: 3870812845 Enrollment ID: I20190108003182 |
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