| Paladin Family Practice Pa | |
|
330 S Line Ave Inverness FL 34452-4606 | |
| (352) 726-4499 | |
| (352) 726-2808 |
| Full Name | Paladin Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 330 S Line Ave, Inverness, Florida |
| Authorized Official Name and Position | Brian Slaby (PRESIDENT) |
| Authorized Official Contact | 3527264499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paladin Family Practice Pa 330 S Line Ave Inverness FL 34452-4606 Ph: (352) 726-4499 | Paladin Family Practice Pa 330 S Line Ave Inverness FL 34452-4606 Ph: (352) 726-4499 |
| NPI Number | 1922282953 |
|---|---|
| Provider Enumeration Date | 12/27/2007 |
| Last Update Date | 01/05/2010 |
| Medicare PECOS PAC ID | 1759455074 |
|---|---|
| Medicare Enrollment ID | O20080805000602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922282953 | NPI | - | NPPES |
| 274066400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | ME-0074114 (Florida) | Primary |
| Provider Name | Brian A Slaby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871653600 PECOS PAC ID: 3678587805 Enrollment ID: I20060126000830 |
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