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8696 Ice Wine St Sarasota FL 34238-2403 | |
| (239) 270-3973 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 8696 Ice Wine St, Sarasota, Florida |
| Authorized Official Name and Position | Natalia Capote (OWNER) |
| Authorized Official Contact | 8559795700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8696 Ice Wine St Sarasota FL 34238-2403 Ph: (239) 270-3973 | 8696 Ice Wine St Sarasota FL 34238-2403 Ph: (239) 270-3973 |
| NPI Number | 1104680248 |
|---|---|
| Provider Enumeration Date | 02/08/2024 |
| Last Update Date | 11/20/2024 |
| Medicare PECOS PAC ID | 9032553508 |
|---|---|
| Medicare Enrollment ID | O20240223000682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104680248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Cory H Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225110679 PECOS PAC ID: 0547262479 Enrollment ID: I20070206000630 |
| Provider Name | Jamin Switzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326393075 PECOS PAC ID: 2567616436 Enrollment ID: I20141006001679 |
| Provider Name | Natalia Capote |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518293661 PECOS PAC ID: 8022267806 Enrollment ID: I20150720001532 |
| Provider Name | Neil E Maldonado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326003732 PECOS PAC ID: 2567491285 Enrollment ID: I20160412001182 |
| Provider Name | Elizabeth Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730568601 PECOS PAC ID: 8325316102 Enrollment ID: I20170620001778 |
| Provider Name | Astride Honore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508572736 PECOS PAC ID: 3779940226 Enrollment ID: I20230529000111 |
| Provider Name | Kandi Zielinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336821693 PECOS PAC ID: 2668823998 Enrollment ID: I20240110004348 |
| Provider Name | Nancy Esmeralda Claros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144083916 PECOS PAC ID: 9739628769 Enrollment ID: I20240822000882 |
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