| Physical Medicine Associates Of Gainesville Llc | |
|
3703 Sw 13th St Gainesville FL 32608-3507 | |
| (352) 378-7664 | |
| (352) 373-0111 |
| Full Name | Physical Medicine Associates Of Gainesville Llc |
|---|---|
| Speciality | General Practice |
| Location | 3703 Sw 13th St, Gainesville, Florida |
| Authorized Official Name and Position | Matthew J Cline (OWNER) |
| Authorized Official Contact | 3523724110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physical Medicine Associates Of Gainesville Llc 3703 Sw 13th St Gainesville FL 32608-3507 Ph: (352) 378-7664 | Physical Medicine Associates Of Gainesville Llc 3703 Sw 13th St Gainesville FL 32608-3507 Ph: (352) 378-7664 |
| NPI Number | 1912397886 |
|---|---|
| Provider Enumeration Date | 01/30/2015 |
| Last Update Date | 12/21/2015 |
| Medicare PECOS PAC ID | 8224359138 |
|---|---|
| Medicare Enrollment ID | O20150604000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912397886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Thomas B Whalen |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366460990 PECOS PAC ID: 0840274726 Enrollment ID: I20040617000338 |
| Provider Name | Craig Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043253768 PECOS PAC ID: 1355318247 Enrollment ID: I20040910000947 |
| Provider Name | Heather K Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467479063 PECOS PAC ID: 6901860006 Enrollment ID: I20041118000239 |
| Provider Name | Jared H Wannenwetsch |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245686823 PECOS PAC ID: 4284926684 Enrollment ID: I20160705001686 |
| Provider Name | Jeffrey Allyn Ruterbusch |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1821142829 PECOS PAC ID: 7416263215 Enrollment ID: I20160708000680 |
| Provider Name | Pamela Susan Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619415361 PECOS PAC ID: 1355626276 Enrollment ID: I20170315002534 |
| Provider Name | Marisol I Santamarina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962954222 PECOS PAC ID: 7315203619 Enrollment ID: I20171101003199 |
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