Pioneer Managed Care Llc | |
1000 Waterman Way Tavares FL 32778-5266 | |
(352) 253-3333 | |
Not Available |
Full Name | Pioneer Managed Care Llc |
---|---|
Speciality | Internal Medicine |
Location | 1000 Waterman Way, Tavares, Florida |
Authorized Official Name and Position | Jigna H Shah (OWNER) |
Authorized Official Contact | 3523083117 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pioneer Managed Care Llc 18848 Us Highway 441 #414 Mount Dora FL 32757-6700 Ph: (352) 308-3117 | Pioneer Managed Care Llc 1000 Waterman Way Tavares FL 32778-5266 Ph: (352) 253-3333 |
NPI Number | 1427309988 |
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Provider Enumeration Date | 09/25/2012 |
Last Update Date | 09/25/2012 |
Medicare PECOS PAC ID | 6709035553 |
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Medicare Enrollment ID | O20121011000257 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427309988 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Jigna H Shah |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033309786 PECOS PAC ID: 1951494087 Enrollment ID: I20070906000315 |
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