| Padala Family Practice, Pllc | |
|
2063 N Lecanto Hwy Ste 1 Lecanto FL 34461-9675 | |
| (352) 436-4428 | |
| (352) 228-4903 |
| Full Name | Padala Family Practice, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2063 N Lecanto Hwy Ste 1, Lecanto, Florida |
| Authorized Official Name and Position | Lakshmi Narayana Padala (OWNER) |
| Authorized Official Contact | 3524364428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Padala Family Practice, Pllc 2063 N Lecanto Hwy Ste 1 Lecanto FL 34461-9675 Ph: (352) 436-4428 | Padala Family Practice, Pllc 2063 N Lecanto Hwy Ste 1 Lecanto FL 34461-9675 Ph: (352) 436-4428 |
| NPI Number | 1447505227 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 10/22/2021 |
| Medicare PECOS PAC ID | 2466608500 |
|---|---|
| Medicare Enrollment ID | O20120806000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447505227 | NPI | - | NPPES |
| 14L2T | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lakshmi Narayana Padala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053379735 PECOS PAC ID: 5698787869 Enrollment ID: I20120806000813 |
| Provider Name | Virginia Madla |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1427056092 PECOS PAC ID: 2062597271 Enrollment ID: I20170405001794 |
| Provider Name | Theresa Montgomery Tyrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649753468 PECOS PAC ID: 1557590411 Enrollment ID: I20181114003662 |
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Sun Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2063 N Lecanto Hwy, Lecanto, FL 34461 Phone: 352-436-4428 Fax: 352-228-4903 | |
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