| Lifestream Family Medicine P.a. | |
|
1957 Worth Court Bradenton FL 34211 | |
| (941) 755-0433 | |
| Not Available |
| Full Name | Lifestream Family Medicine P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1957 Worth Court, Bradenton, Florida |
| Authorized Official Name and Position | Saska Fiona Sookra Winslow (CEO/OWNER) |
| Authorized Official Contact | 9417550433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestream Family Medicine P.a. 1957 Worth Court Bradenton FL 34211 Ph: (941) 755-0433 | Lifestream Family Medicine P.a. 1957 Worth Court Bradenton FL 34211 Ph: (941) 755-0433 |
| NPI Number | 1265075261 |
|---|---|
| Provider Enumeration Date | 10/22/2019 |
| Last Update Date | 07/10/2020 |
| Medicare PECOS PAC ID | 2264862721 |
|---|---|
| Medicare Enrollment ID | O20200423002249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265075261 | NPI | - | NPPES |
| ME96301 | Other | FL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Saska F Sookra Winslow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730269556 PECOS PAC ID: 0840398475 Enrollment ID: I20070606000092 |
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