| R K Vishen Md P A | |
|
108 Kingsley Ave Orange Park FL 32073-5685 | |
| (904) 388-3351 | |
| Not Available |
| Full Name | R K Vishen Md P A |
|---|---|
| Speciality | Internal Medicine |
| Location | 108 Kingsley Ave, Orange Park, Florida |
| Authorized Official Name and Position | R. K. Vishen (PRESIDENT) |
| Authorized Official Contact | 9043883351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R K Vishen Md P A Po Box 2310 Orange Park FL 32067-2310 Ph: (904) 388-3351 | R K Vishen Md P A 108 Kingsley Ave Orange Park FL 32073-5685 Ph: (904) 388-3351 |
| NPI Number | 1912011511 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 12/04/2013 |
| Medicare PECOS PAC ID | 1052409703 |
|---|---|
| Medicare Enrollment ID | O20071114000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912011511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rajesh K Vishen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346240504 PECOS PAC ID: 4688562564 Enrollment ID: I20040402000934 |
| Provider Name | Stephanie S Woodburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952736688 PECOS PAC ID: 2264470848 Enrollment ID: I20050423000008 |
| Provider Name | Tera D Maple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043518756 PECOS PAC ID: 3577731066 Enrollment ID: I20110728000306 |
| Provider Name | Vikram Behera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134337892 PECOS PAC ID: 5799841391 Enrollment ID: I20141210000350 |
| Provider Name | Paris Gilbert Russ Kenzo Aaron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871079111 PECOS PAC ID: 3173955135 Enrollment ID: I20191112002344 |
| Provider Name | Myla Espanol Orejudos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871131839 PECOS PAC ID: 6608240346 Enrollment ID: I20230321001814 |
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