| Roser Park Medical Center | |
|
500 10th Ave S Saint Petersburg FL 33701-5214 | |
| (727) 898-4461 | |
| (727) 502-0841 |
| Full Name | Roser Park Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 500 10th Ave S, Saint Petersburg, Florida |
| Authorized Official Name and Position | Frederic Judes Guerrier (OWNER) |
| Authorized Official Contact | 7278984461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roser Park Medical Center 500 10th Ave S Saint Petersburg FL 33701-5214 Ph: (727) 898-4461 | Roser Park Medical Center 500 10th Ave S Saint Petersburg FL 33701-5214 Ph: (727) 898-4461 |
| NPI Number | 1922031939 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 11/05/2010 |
| Medicare PECOS PAC ID | 9234325820 |
|---|---|
| Medicare Enrollment ID | O20101122000692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922031939 | NPI | - | NPPES |
| 37093700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Frederic Judes Guerrier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174512065 PECOS PAC ID: 0042406639 Enrollment ID: I20101229000127 |
| Provider Name | Shacara D Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194014621 PECOS PAC ID: 6608018981 Enrollment ID: I20131227000093 |
| Provider Name | Daniel A Eckstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366704843 PECOS PAC ID: 1355656851 Enrollment ID: I20150812008571 |
| Provider Name | Monique A Tolston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750395109 PECOS PAC ID: 6204836075 Enrollment ID: I20210804000537 |
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