| Mid Florida Physicians Group Inc. | |
|
300 S Main St Wildwood FL 34785-4542 | |
| (352) 643-6699 | |
| (888) 675-8377 |
| Full Name | Mid Florida Physicians Group Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 300 S Main St, Wildwood, Florida |
| Authorized Official Name and Position | Jerrold Randall Ecklind (PRESIDENT) |
| Authorized Official Contact | 3862906721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Florida Physicians Group Inc. 300 S Main St Ste 2 Wildwood FL 34785-4542 Ph: (352) 643-6699 | Mid Florida Physicians Group Inc. 300 S Main St Wildwood FL 34785-4542 Ph: (352) 643-6699 |
| NPI Number | 1629565932 |
|---|---|
| Provider Enumeration Date | 04/23/2018 |
| Last Update Date | 06/28/2023 |
| Medicare PECOS PAC ID | 8123377439 |
|---|---|
| Medicare Enrollment ID | O20180820003536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629565932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jerrold R Ecklind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851390322 PECOS PAC ID: 9032289210 Enrollment ID: I20080530000088 |
| Provider Name | Michael William Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467196295 PECOS PAC ID: 1052772258 Enrollment ID: I20230803004478 |
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