Pst Florida 2009 Llc | |
3300 Sw 34th Ave Suite 116 Ocala FL 34474-7448 | |
(877) 896-9301 | |
Not Available |
Full Name | Pst Florida 2009 Llc |
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Speciality | Internal Medicine |
Location | 3300 Sw 34th Ave, Ocala, Florida |
Authorized Official Name and Position | Michael Grischkan (CEO) |
Authorized Official Contact | 2168969301 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pst Florida 2009 Llc 3300 Sw 34th Ave Suite 116 Ocala FL 34474-7448 Ph: (877) 896-9301 | Pst Florida 2009 Llc 3300 Sw 34th Ave Suite 116 Ocala FL 34474-7448 Ph: (877) 896-9301 |
NPI Number | 1134423072 |
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Provider Enumeration Date | 01/07/2011 |
Last Update Date | 01/07/2011 |
Medicare PECOS PAC ID | 0345422531 |
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Medicare Enrollment ID | O20110309000467 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134423072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Mary R Riedy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982035598 PECOS PAC ID: 3072731298 Enrollment ID: I20140902000425 |
Provider Name | Linda G Perkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629496278 PECOS PAC ID: 5294049870 Enrollment ID: I20150728004152 |
Provider Name | Casey S Chapman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558973511 PECOS PAC ID: 5991104457 Enrollment ID: I20210603001097 |
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