| Myriad Healthcare Llc | |
|
5460 63rd St E Unit B Bradenton FL 34203-7808 | |
| (941) 202-2305 | |
| (941) 220-4688 |
| Full Name | Myriad Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5460 63rd St E Unit B, Bradenton, Florida |
| Authorized Official Name and Position | Melissa Allen (NURSE PRACTITIONER) |
| Authorized Official Contact | 9412022305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myriad Healthcare Llc 5460 63rd St E Unit B Bradenton FL 34203-7808 Ph: (217) 202-9606 | Myriad Healthcare Llc 5460 63rd St E Unit B Bradenton FL 34203-7808 Ph: (941) 202-2305 |
| NPI Number | 1639884539 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 06/21/2023 |
| Medicare PECOS PAC ID | 4789057183 |
|---|---|
| Medicare Enrollment ID | O20230306002355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639884539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Melissa Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710433537 PECOS PAC ID: 4183911852 Enrollment ID: I20211106000021 |
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