| Pitcher Primary Care And La Wellness | |
|
3156 Calgary St Melbourne FL 32935-4639 | |
| (321) 374-4785 | |
| (321) 732-4942 |
| Full Name | Pitcher Primary Care And La Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 3156 Calgary St, Melbourne, Florida |
| Authorized Official Name and Position | Lisa A Baker (PRESIDENT) |
| Authorized Official Contact | 3213744785 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pitcher Primary Care And La Wellness 2511 N Hiatus Rd # 168 Hollywood FL 33026-1301 Ph: (321) 374-4785 | Pitcher Primary Care And La Wellness 3156 Calgary St Melbourne FL 32935-4639 Ph: (321) 374-4785 |
| NPI Number | 1336718089 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 04/03/2024 |
| Medicare PECOS PAC ID | 2860899515 |
|---|---|
| Medicare Enrollment ID | O20210922001409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336718089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Lisa Ann Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467932525 PECOS PAC ID: 9537594932 Enrollment ID: I20200113001524 |
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