| Lakewood Ccl, Llc | |
|
5571 E Sr 44 Ste 501 Wildwood FL 34785-8282 | |
| (352) 643-9070 | |
| (352) 571-6787 |
| Full Name | Lakewood Ccl, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5571 E Sr 44 Ste 501, Wildwood, Florida |
| Authorized Official Name and Position | Jose A Rivera (ADMINISTRATOR) |
| Authorized Official Contact | 3526439070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Ccl, Llc 5571 E Sr 44 Ste 501 Wildwood FL 34785-8282 Ph: (352) 643-9070 | Lakewood Ccl, Llc 5571 E Sr 44 Ste 501 Wildwood FL 34785-8282 Ph: (352) 643-9070 |
| NPI Number | 1922575802 |
|---|---|
| Provider Enumeration Date | 10/29/2018 |
| Last Update Date | 10/29/2018 |
| Medicare PECOS PAC ID | 3678804747 |
|---|---|
| Medicare Enrollment ID | O20191004000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922575802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Srinivas Attanti |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902889413 PECOS PAC ID: 2769455872 Enrollment ID: I20040817000775 |
| Provider Name | Georg J Couturier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710952486 PECOS PAC ID: 3779481254 Enrollment ID: I20060210000455 |
| Provider Name | Vinod R Miryala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891996880 PECOS PAC ID: 0941397723 Enrollment ID: I20071025000337 |
| Provider Name | Rafik Abadier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649253147 PECOS PAC ID: 3072407725 Enrollment ID: I20071204000113 |
| Provider Name | Hari Cp Kannam |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952542375 PECOS PAC ID: 8628121423 Enrollment ID: I20090727000396 |
| Provider Name | Javier M Gonzalez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689658809 PECOS PAC ID: 3870575335 Enrollment ID: I20100209000431 |
| Provider Name | Hector L Garcia |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114910031 PECOS PAC ID: 6406985654 Enrollment ID: I20100526000327 |
| Provider Name | Nitza I Alvarez Torres |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659491983 PECOS PAC ID: 2860582632 Enrollment ID: I20110527000067 |
| Provider Name | Suman Pasupuleti |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1851503809 PECOS PAC ID: 0345410072 Enrollment ID: I20110907000840 |
| Provider Name | Brian H Saluck |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1295796902 PECOS PAC ID: 1456252816 Enrollment ID: I20120208000874 |
| Provider Name | Abel Rivero |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1659531937 PECOS PAC ID: 9133382997 Enrollment ID: I20120515000624 |
| Provider Name | Nishant Nerella |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467659599 PECOS PAC ID: 4880789973 Enrollment ID: I20120622000154 |
| Provider Name | Bernard Topi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1811175391 PECOS PAC ID: 3870771686 Enrollment ID: I20190819003035 |
Promise Medical Group, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9202 Nw 26th St, Wildwood, FL 34785 Phone: 352-812-0579 Fax: 352-571-4349 | |
Mid Florida Physicians Group Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 S Main St, Wildwood, FL 34785 Phone: 352-643-6699 Fax: 888-675-8377 | |
American Urgent Care And Walk In Clinics Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 Gray Ave, Wildwood, FL 34785 Phone: 359-399-2422 Fax: 352-399-2427 | |
Central Florida Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5559 E Sr 44, Wildwood, FL 34785 Phone: 407-226-2993 Fax: 407-226-2996 | |
Suncoast Primary Care Specialists Wildwood Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5559 E Sr 44 Unit 4, Wildwood, FL 34785 Phone: 352-513-5906 | |
Wildwood Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Webster St, Wildwood, FL 34785 Phone: 352-748-6689 Fax: 352-748-6381 | |
Wildwood Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5814 Seven Mile Dr Ste 105, Wildwood, FL 34785 Phone: 813-269-6426 |