| Primary Care Of The Treasure Coast, Inc. | |
|
1265 36th St Vero Beach FL 32960-6574 | |
| (772) 567-6340 | |
| (772) 567-6788 |
| Full Name | Primary Care Of The Treasure Coast, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1265 36th St, Vero Beach, Florida |
| Authorized Official Name and Position | Jack M Luton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7725676340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of The Treasure Coast, Inc. 1265 36th St Vero Beach FL 32960-6574 Ph: (772) 567-6340 | Primary Care Of The Treasure Coast, Inc. 1265 36th St Vero Beach FL 32960-6574 Ph: (772) 567-6340 |
| NPI Number | 1356435176 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 11/10/2009 |
| Medicare PECOS PAC ID | 0749275931 |
|---|---|
| Medicare Enrollment ID | O20040603000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356435176 | NPI | - | NPPES |
| 375002700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Gary R Silverman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003812025 PECOS PAC ID: 0042292070 Enrollment ID: I20040603000833 |
| Provider Name | Laura Lee Hanke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437118080 PECOS PAC ID: 6305816810 Enrollment ID: I20040730000239 |
| Provider Name | Andre G Vendryes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194708669 PECOS PAC ID: 5092760033 Enrollment ID: I20050316000316 |
| Provider Name | Richard T Penly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194782185 PECOS PAC ID: 9133133242 Enrollment ID: I20060127000506 |
| Provider Name | Samuel Watkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588661797 PECOS PAC ID: 1153327093 Enrollment ID: I20061017000005 |
| Provider Name | Lori D Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477783447 PECOS PAC ID: 1153465430 Enrollment ID: I20100224000868 |
| Provider Name | Arthur J Splendoria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346246659 PECOS PAC ID: 1153456942 Enrollment ID: I20100318000478 |
| Provider Name | Erol R Atamer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003812322 PECOS PAC ID: 4183740269 Enrollment ID: I20100927000248 |
| Provider Name | Guy R Ulrich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720084056 PECOS PAC ID: 3678699758 Enrollment ID: I20100927000335 |
| Provider Name | Joshua B Shipley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104822436 PECOS PAC ID: 2264558352 Enrollment ID: I20100927000417 |
| Provider Name | Christina Namvar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942532213 PECOS PAC ID: 2264628429 Enrollment ID: I20101130000650 |
| Provider Name | Collin Kitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275945800 PECOS PAC ID: 3375856685 Enrollment ID: I20180820002710 |
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