| |
1620 Southern Blvd West Palm Beach FL 33406-3242 | |
(561) 800-4111 | |
(716) 631-9525 |
Full Name | |
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Speciality | Neurological Surgery |
Location | 1620 Southern Blvd, West Palm Beach, Florida |
Authorized Official Name and Position | Michael K Landi (PRESIDENT/COO) |
Authorized Official Contact | 7166313555 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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400 International Drive Williamsville NY 14221-5771 Ph: (716) 631-3555 | 1620 Southern Blvd West Palm Beach FL 33406-3242 Ph: (561) 800-4111 |
NPI Number | 1134728561 |
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Provider Enumeration Date | 10/17/2020 |
Last Update Date | 02/02/2023 |
Medicare PECOS PAC ID | 5698162642 |
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Medicare Enrollment ID | O20220421002817 |
Identifier | Type | State | Issuer |
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1134728561 | NPI | - | NPPES |
Provider Name | Brett Adam Osborn |
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Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1932104049 PECOS PAC ID: 2163314915 Enrollment ID: I20040326000319 |
Provider Name | Michael K Landi |
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Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1437116308 PECOS PAC ID: 8820082845 Enrollment ID: I20200514000202 |
Provider Name | Carlos A Dorta |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063807170 PECOS PAC ID: 7618225483 Enrollment ID: I20200811003202 |
Provider Name | Chananya Goldman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1508285941 PECOS PAC ID: 8123447166 Enrollment ID: I20200924002407 |
Provider Name | Vijay Narasimhan Srinivasan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1851753909 PECOS PAC ID: 6002205598 Enrollment ID: I20211123001834 |
Provider Name | Evelio Manteira Barban |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720631542 PECOS PAC ID: 9537544838 Enrollment ID: I20220922003793 |
Provider Name | Ashley Nicole Wells |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033972286 PECOS PAC ID: 2365888658 Enrollment ID: I20240308001802 |
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