| Independent Multispecialty Group Of Florida Llc | |
|
1447 Medical Park Blvd Ste 405 Wellington FL 33414-3183 | |
| (904) 334-0910 | |
| (561) 363-2597 |
| Full Name | Independent Multispecialty Group Of Florida Llc |
|---|---|
| Speciality | Surgery |
| Location | 1447 Medical Park Blvd Ste 405, Wellington, Florida |
| Authorized Official Name and Position | Sriinivas Kaza (OWNER) |
| Authorized Official Contact | 5617678342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Multispecialty Group Of Florida Llc 1447 Medical Park Blvd Ste 405 Wellington FL 33414-3183 Ph: (904) 334-0910 | Independent Multispecialty Group Of Florida Llc 1447 Medical Park Blvd Ste 405 Wellington FL 33414-3183 Ph: (904) 334-0910 |
| NPI Number | 1346745122 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 9638429731 |
|---|---|
| Medicare Enrollment ID | O20180911003654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346745122 | NPI | - | NPPES |
| 100453300 | Medicaid | FL |
| Provider Name | Jaime Toro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770537417 PECOS PAC ID: 9537057021 Enrollment ID: I20040308000025 |
| Provider Name | Kishore K Dass |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1245229533 PECOS PAC ID: 0648260372 Enrollment ID: I20040515000010 |
| Provider Name | Raymond Henderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275648750 PECOS PAC ID: 6800817446 Enrollment ID: I20051212000459 |
| Provider Name | Kunal I Nanavati |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1437265121 PECOS PAC ID: 0446356281 Enrollment ID: I20070510000507 |
| Provider Name | Geoffrey Mccormick Lynn |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1710072673 PECOS PAC ID: 6103902192 Enrollment ID: I20080401000374 |
| Provider Name | Srinivas Kaza |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750311551 PECOS PAC ID: 5597761163 Enrollment ID: I20090210000288 |
| Provider Name | Eugenio Rodriguez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508921172 PECOS PAC ID: 6305029414 Enrollment ID: I20110328000659 |
| Provider Name | Abel E Bello |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891094579 PECOS PAC ID: 8921271420 Enrollment ID: I20151028001842 |
| Provider Name | Alvaro E Castillo |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1891939385 PECOS PAC ID: 1456574516 Enrollment ID: I20160823000624 |
| Provider Name | Mark J Meyer |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1124263603 PECOS PAC ID: 8426343849 Enrollment ID: I20160824002586 |
| Provider Name | Seyed-mojtaba Gashti |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1649271925 PECOS PAC ID: 6103812201 Enrollment ID: I20170127001416 |
| Provider Name | Chetan J Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992071047 PECOS PAC ID: 4688944978 Enrollment ID: I20181108001945 |
| Provider Name | Emilio Enrique Lopez |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1881919124 PECOS PAC ID: 2567776248 Enrollment ID: I20181231000372 |
| Provider Name | Erika Sirois- Moreno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578114658 PECOS PAC ID: 7113350968 Enrollment ID: I20191209001633 |
| Provider Name | Luis Arangua |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1033329677 PECOS PAC ID: 3870677255 Enrollment ID: I20200922000467 |
| Provider Name | Kareem Riad Mostafa Eid |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649590118 PECOS PAC ID: 7911276993 Enrollment ID: I20201119000254 |
| Provider Name | Marcus Eby |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1669899845 PECOS PAC ID: 7416284187 Enrollment ID: I20210401000734 |
| Provider Name | Brian Dessify |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780063974 PECOS PAC ID: 2769776178 Enrollment ID: I20210408000839 |
| Provider Name | Shaan E Alam |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811379761 PECOS PAC ID: 7517348659 Enrollment ID: I20220720001452 |
| Provider Name | Alberto Zarak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659650034 PECOS PAC ID: 3173893377 Enrollment ID: I20221031000941 |
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