| Medical Center On The Gulf Llc | |
|
30522 Us 19 N Ste 109 Palm Harbor FL 34684-4436 | |
| (727) 738-0220 | |
| (727) 734-7072 |
| Full Name | Medical Center On The Gulf Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 30522 Us 19 N Ste 109, Palm Harbor, Florida |
| Authorized Official Name and Position | Ananda Som (CHAIRMAN) |
| Authorized Official Contact | 7277380220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center On The Gulf Llc Po Box 1921 Dunedin FL 34697-1921 Ph: (727) 738-0220 | Medical Center On The Gulf Llc 30522 Us 19 N Ste 109 Palm Harbor FL 34684-4436 Ph: (727) 738-0220 |
| NPI Number | 1497720700 |
|---|---|
| Provider Enumeration Date | 02/21/2006 |
| Last Update Date | 07/13/2015 |
| Medicare PECOS PAC ID | 3173541695 |
|---|---|
| Medicare Enrollment ID | O20051103000407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497720700 | NPI | - | NPPES |
| 110239219 | Other | RAILROAD MEDICARE | |
| K8814 | Other | GRP # | |
| P2746142 | Other | OXFORD HEALTH INSURANCE | |
| 244046 | Other | AVMED | |
| 254433400 | Medicaid | FL | |
| 410972 | Other | TUFTS HEALTH PLAN | |
| 5306646 | Other | AETNA | |
| 1627837 | Other | FIRST HEALTH | |
| 213422 | Other | AMERIGROUP | |
| 3087332 | Other | CIGNA | |
| 43705 | Other | BLUE CROSS BLUE SHIELD | |
| 0407698 | Other | UNITED HEALTHCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ananda Som |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598739534 PECOS PAC ID: 3072531599 Enrollment ID: I20051103000509 |
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