| Physicians Care Of Keystone | |
|
6542 Triest Ave Keystone Heights FL 32656-9393 | |
| (352) 473-7288 | |
| (352) 473-9365 |
| Full Name | Physicians Care Of Keystone |
|---|---|
| Speciality | Internal Medicine |
| Location | 6542 Triest Ave, Keystone Heights, Florida |
| Authorized Official Name and Position | George L Restea (PRESIDENT) |
| Authorized Official Contact | 3524737288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Care Of Keystone 6542 Triest Ave Keystone Heights FL 32656-9393 Ph: (352) 473-7288 | Physicians Care Of Keystone 6542 Triest Ave Keystone Heights FL 32656-9393 Ph: (352) 473-7288 |
| NPI Number | 1154512432 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 08/05/2007 |
| Medicare PECOS PAC ID | 8123097680 |
|---|---|
| Medicare Enrollment ID | O20040930000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154512432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0049847 (Florida) | Primary |
| Provider Name | George L Restea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881664951 PECOS PAC ID: 4284603044 Enrollment ID: I20080522000192 |
| Provider Name | Dawn Marie Jaquish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811632607 PECOS PAC ID: 6103201785 Enrollment ID: I20220919000027 |
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