Ido Care Md Llc | |
255 Se Calmo Cir Port Saint Lucie FL 34984-6626 | |
(787) 546-2795 | |
Not Available |
Full Name | Ido Care Md Llc |
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Speciality | Internal Medicine |
Location | 255 Se Calmo Cir, Port Saint Lucie, Florida |
Authorized Official Name and Position | Stella Medina Lewis (OWNER/PROVIDER) |
Authorized Official Contact | 7875462795 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ido Care Md Llc 255 Se Calmo Cir Port Saint Lucie FL 34984-6626 Ph: () - | Ido Care Md Llc 255 Se Calmo Cir Port Saint Lucie FL 34984-6626 Ph: (787) 546-2795 |
NPI Number | 1184402810 |
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Provider Enumeration Date | 09/14/2023 |
Last Update Date | 10/27/2023 |
Medicare PECOS PAC ID | 8022455518 |
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Medicare Enrollment ID | O20240320000108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184402810 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
Provider Name | Stella Iramil Medina Lewis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740363589 PECOS PAC ID: 5890886071 Enrollment ID: I20180515001037 |
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