| Okeechobee Family Practice P A | |
|
1713 Hwy 441 N Suite E Okeechobee FL 34972-1900 | |
| (863) 467-8871 | |
| (863) 467-2825 |
| Full Name | Okeechobee Family Practice P A |
|---|---|
| Speciality | Family Medicine |
| Location | 1713 Hwy 441 N, Okeechobee, Florida |
| Authorized Official Name and Position | Leland M Heller (OWNER) |
| Authorized Official Contact | 8634678771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Okeechobee Family Practice P A 1713 Us Highway 441 N Ste D Okeechobee FL 34972-1900 Ph: (863) 467-8771 | Okeechobee Family Practice P A 1713 Hwy 441 N Suite E Okeechobee FL 34972-1900 Ph: (863) 467-8871 |
| NPI Number | 1972780955 |
|---|---|
| Provider Enumeration Date | 01/22/2008 |
| Last Update Date | 03/02/2022 |
| Medicare PECOS PAC ID | 2365508926 |
|---|---|
| Medicare Enrollment ID | O20090305000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972780955 | NPI | - | NPPES |
| 191542364873 | Other | FL | HUMANA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10D0929800 (Florida) | Primary |
| Provider Name | Sandra Marie Cornine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538813324 PECOS PAC ID: 8325432628 Enrollment ID: I20220302002762 |
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