Internal Medicine Md Llc | |
14153 Yosemite Dr Ste 104 Hudson FL 34667-8065 | |
(727) 267-6490 | |
Not Available |
Full Name | Internal Medicine Md Llc |
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Speciality | Internal Medicine |
Location | 14153 Yosemite Dr Ste 104, Hudson, Florida |
Authorized Official Name and Position | John Hanna (MANAGER) |
Authorized Official Contact | 7272676490 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Internal Medicine Md Llc 10642 Firebrick Ct Trinity FL 34655-5030 Ph: (727) 267-6490 | Internal Medicine Md Llc 14153 Yosemite Dr Ste 104 Hudson FL 34667-8065 Ph: (727) 267-6490 |
NPI Number | 1982332011 |
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Provider Enumeration Date | 08/08/2022 |
Last Update Date | 09/14/2022 |
Medicare PECOS PAC ID | 4688059934 |
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Medicare Enrollment ID | O20220922001587 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982332011 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | John Hanna |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1548765464 PECOS PAC ID: 7618224163 Enrollment ID: I20210714000366 |
Provider Name | Miranda D Mcwhirter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124896766 PECOS PAC ID: 7315489317 Enrollment ID: I20240605003442 |
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