| Progressive Care Medical Group Of Fl, Llc | |
|
17201 Collins Ave Apt 2504 Sunny Isles Beach FL 33160-3482 | |
| (516) 855-5255 | |
| Not Available |
| Full Name | Progressive Care Medical Group Of Fl, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17201 Collins Ave Apt 2504, Sunny Isles Beach, Florida |
| Authorized Official Name and Position | Abiola Familusi (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5167298606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Care Medical Group Of Fl, Llc 150 Eileen Way Unit 1 Syosset NY 11791-5313 Ph: (516) 855-5255 | Progressive Care Medical Group Of Fl, Llc 17201 Collins Ave Apt 2504 Sunny Isles Beach FL 33160-3482 Ph: (516) 855-5255 |
| NPI Number | 1578194452 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 9638598576 |
|---|---|
| Medicare Enrollment ID | O20200928000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578194452 | NPI | - | NPPES |
| Provider Name | Leslie A Wattkis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952876070 PECOS PAC ID: 8628313319 Enrollment ID: I20181228000550 |
| Provider Name | Sreyboth Sreng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972068153 PECOS PAC ID: 9436499183 Enrollment ID: I20190318000527 |
| Provider Name | Dominique Lotoya Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932730702 PECOS PAC ID: 7719317411 Enrollment ID: I20200429000691 |
| Provider Name | Abiola Familusi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649351214 PECOS PAC ID: 5890608079 Enrollment ID: I20200928001994 |
| Provider Name | Jacqueline Beatriz Cortizo-hernandez |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1972967701 PECOS PAC ID: 9830488899 Enrollment ID: I20210408000660 |
| Provider Name | Gladys Bagesi Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508472291 PECOS PAC ID: 5890170609 Enrollment ID: I20220915000078 |
| Provider Name | Ziqiang Yu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548419385 PECOS PAC ID: 4981056488 Enrollment ID: I20240120000145 |
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