| Immokalee Family Doctor's Clinic, Llc | |
|
555 N 15th St Unit A Immokalee FL 34142-2824 | |
| (239) 657-2779 | |
| (239) 657-3335 |
| Full Name | Immokalee Family Doctor's Clinic, Llc |
|---|---|
| Speciality | General Practice |
| Location | 555 N 15th St Unit A, Immokalee, Florida |
| Authorized Official Name and Position | Andrea Keppel (OFFICE MANAGER) |
| Authorized Official Contact | 2396572779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Immokalee Family Doctor's Clinic, Llc 555 N 15th St Unit A Immokalee FL 34142-2824 Ph: (239) 657-2779 | Immokalee Family Doctor's Clinic, Llc 555 N 15th St Unit A Immokalee FL 34142-2824 Ph: (239) 657-2779 |
| NPI Number | 1801157839 |
|---|---|
| Provider Enumeration Date | 06/06/2012 |
| Last Update Date | 04/25/2022 |
| Medicare PECOS PAC ID | 0244650257 |
|---|---|
| Medicare Enrollment ID | O20201013002073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801157839 | NPI | - | NPPES |
| 113836500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME42490 (Florida) | Primary |
| Provider Name | Juan R Puerto |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689682296 PECOS PAC ID: 3779701396 Enrollment ID: I20201013002381 |
Golden Gate Dental Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-658-3175 | |
Healthcare Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-658-3175 | |
Marion E Fether Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3064 Fax: 239-658-3175 | |
Collier Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-932-6935 | |
Healthcare Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-658-3175 | |
Marion E Fether Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-658-3063 | |
Healthcare Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1441 Heritage Blvd, Immokalee, FL 34142 Phone: 239-658-3000 |