| Physicians Of Mid Florida Llc | |
|
1936 Bruce B Downs Blvd Wesley Chapel FL 33544-9262 | |
| (352) 409-5076 | |
| Not Available |
| Full Name | Physicians Of Mid Florida Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1936 Bruce B Downs Blvd, Wesley Chapel, Florida |
| Authorized Official Name and Position | Ghulam M Anwar (MBR) |
| Authorized Official Contact | 3524095076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Of Mid Florida Llc 1936 Bruce B Downs Blvd Wesley Chapel FL 33544-9262 Ph: (352) 409-5076 | Physicians Of Mid Florida Llc 1936 Bruce B Downs Blvd Wesley Chapel FL 33544-9262 Ph: (352) 409-5076 |
| NPI Number | 1366992463 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/12/2016 |
| Medicare PECOS PAC ID | 7012296502 |
|---|---|
| Medicare Enrollment ID | O20161128002695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366992463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME109130 (Florida) | Primary |
| Provider Name | Ghulam M Anwar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326343534 PECOS PAC ID: 7719162023 Enrollment ID: I20110502000722 |
| Provider Name | Carl Thomas Rountree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699318865 PECOS PAC ID: 7113351875 Enrollment ID: I20200106001055 |
| Provider Name | Shanil Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154974145 PECOS PAC ID: 5890162309 Enrollment ID: I20240229002879 |
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