| Jimmy Liu, M.d., P.a. | |
|
24301 Walden Center Dr Ste 300 Bonita Springs FL 34134-4965 | |
| (239) 345-8001 | |
| Not Available |
| Full Name | Jimmy Liu, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 24301 Walden Center Dr Ste 300, Bonita Springs, Florida |
| Authorized Official Name and Position | Jimmy Cheng-yi Liu (OWNER, MD) |
| Authorized Official Contact | 7247599819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jimmy Liu, M.d., P.a. 21301 S Tamiami Trl Suite 320 Pmb 222 Estero FL 33928-2942 Ph: (239) 345-8001 | Jimmy Liu, M.d., P.a. 24301 Walden Center Dr Ste 300 Bonita Springs FL 34134-4965 Ph: (239) 345-8001 |
| NPI Number | 1194184861 |
|---|---|
| Provider Enumeration Date | 02/23/2016 |
| Last Update Date | 12/29/2020 |
| Medicare PECOS PAC ID | 5799012910 |
|---|---|
| Medicare Enrollment ID | O20190812001227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194184861 | NPI | - | NPPES |
| 102334300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Teri L Nies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639291578 PECOS PAC ID: 1658338389 Enrollment ID: I20041214001245 |
| Provider Name | Debra M Dooley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437389848 PECOS PAC ID: 0840482741 Enrollment ID: I20101011000806 |
| Provider Name | Nicole Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104179449 PECOS PAC ID: 3870744410 Enrollment ID: I20121108000186 |
| Provider Name | Jimmy C Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699092627 PECOS PAC ID: 5799925350 Enrollment ID: I20130703000188 |
| Provider Name | Charmy Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114214715 PECOS PAC ID: 8426279787 Enrollment ID: I20141030000531 |
| Provider Name | Rocio Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699201194 PECOS PAC ID: 4587933916 Enrollment ID: I20170628001941 |
| Provider Name | Jacquiline N Greenwald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083008494 PECOS PAC ID: 1153632807 Enrollment ID: I20180816000477 |
| Provider Name | Jessica Arielle Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316420573 PECOS PAC ID: 4880933225 Enrollment ID: I20190304000289 |
| Provider Name | Jaclyn Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033760731 PECOS PAC ID: 5597199893 Enrollment ID: I20191219000918 |
| Provider Name | Martin Vandongen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659969863 PECOS PAC ID: 2163835992 Enrollment ID: I20210115000121 |
| Provider Name | Jenna Marie Heller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457935231 PECOS PAC ID: 9335541671 Enrollment ID: I20210709000715 |
| Provider Name | Adrian Martinez Rubio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366154270 PECOS PAC ID: 6305218009 Enrollment ID: I20230307001975 |
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