Mediker | |
145 Central Park West Suite 101 Port Saint Lucie FL 34986 | |
(772) 873-1919 | |
Not Available |
Full Name | Mediker |
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Speciality | Internal Medicine |
Location | 145 Central Park West, Port Saint Lucie, Florida |
Authorized Official Name and Position | Iker Leycegui (DIRECTOR, SOLE OWNER, PHYSICIAN) |
Authorized Official Contact | 7728731919 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mediker Po Box 880472 Port Saint Lucie FL 34988-0472 Ph: () - | Mediker 145 Central Park West Suite 101 Port Saint Lucie FL 34986 Ph: (772) 873-1919 |
NPI Number | 1427380708 |
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Provider Enumeration Date | 02/11/2010 |
Last Update Date | 02/11/2010 |
Medicare PECOS PAC ID | 8729123930 |
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Medicare Enrollment ID | O20100226000322 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427380708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME95881 (Florida) | Primary |
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