| Midway Primary Care Llc | |
|
3255 S Us Highway 1 Fort Pierce FL 34982-6381 | |
| (772) 742-9470 | |
| Not Available |
| Full Name | Midway Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3255 S Us Highway 1, Fort Pierce, Florida |
| Authorized Official Name and Position | Kathryn Hayden (BOARD MEMBER) |
| Authorized Official Contact | 7724649746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Primary Care Llc 356 E Midway Rd Fort Pierce FL 34982-7148 Ph: (772) 464-9746 | Midway Primary Care Llc 3255 S Us Highway 1 Fort Pierce FL 34982-6381 Ph: (772) 742-9470 |
| NPI Number | 1598114779 |
|---|---|
| Provider Enumeration Date | 06/08/2016 |
| Last Update Date | 06/24/2022 |
| Medicare PECOS PAC ID | 8820386766 |
|---|---|
| Medicare Enrollment ID | O20161010001944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598114779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Raja R. Talati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942254412 PECOS PAC ID: 7113820614 Enrollment ID: I20040131000007 |
| Provider Name | Suzan E Zimmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750351151 PECOS PAC ID: 8325002900 Enrollment ID: I20041113000160 |
| Provider Name | Tracy L Britcher-speck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831487073 PECOS PAC ID: 5294995098 Enrollment ID: I20120403000093 |
| Provider Name | Suzanne E Runge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245663038 PECOS PAC ID: 3779717814 Enrollment ID: I20131003000543 |
| Provider Name | Kara N Kempf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649943861 PECOS PAC ID: 7416354964 Enrollment ID: I20210925000060 |
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