| Paxton Medical Management | |
|
14279 Tamiami Trl North Port FL 34287-2215 | |
| (941) 263-2050 | |
| Not Available |
| Full Name | Paxton Medical Management |
|---|---|
| Speciality | Family Medicine |
| Location | 14279 Tamiami Trl, North Port, Florida |
| Authorized Official Name and Position | John Grove (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 7275817212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paxton Medical Management 8050 Seminole Blvd Seminole FL 33772-4808 Ph: (727) 275-2005 | Paxton Medical Management 14279 Tamiami Trl North Port FL 34287-2215 Ph: (941) 263-2050 |
| NPI Number | 1457950420 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 10/21/2020 |
| Medicare PECOS PAC ID | 7214349737 |
|---|---|
| Medicare Enrollment ID | O20201207002092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457950420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey S Grove |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154313252 PECOS PAC ID: 9931152469 Enrollment ID: I20050225000185 |
| Provider Name | Eugene M Dibetta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467761064 PECOS PAC ID: 0345400198 Enrollment ID: I20120402000285 |
| Provider Name | Erick V Mejia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811421357 PECOS PAC ID: 9739503442 Enrollment ID: I20200728000188 |
| Provider Name | Ashley B Bellant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992444616 PECOS PAC ID: 9133500101 Enrollment ID: I20220721003378 |
| Provider Name | Benjamin D Heflin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669001525 PECOS PAC ID: 3779942966 Enrollment ID: I20230706002108 |
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