| Saberi Advanced Wound Care Llc | |
|
5880 49th St N Ste N-201 St Petersburg FL 33709-2150 | |
| (727) 300-0405 | |
| (727) 300-2829 |
| Full Name | Saberi Advanced Wound Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5880 49th St N Ste N-201, St Petersburg, Florida |
| Authorized Official Name and Position | Ali Saberi (OWNER) |
| Authorized Official Contact | 7273000405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saberi Advanced Wound Care Llc 5880 49th St N Ste N-201 St Petersburg FL 33709-2150 Ph: (727) 300-0405 | Saberi Advanced Wound Care Llc 5880 49th St N Ste N-201 St Petersburg FL 33709-2150 Ph: (727) 300-0405 |
| NPI Number | 1578264818 |
|---|---|
| Provider Enumeration Date | 03/14/2023 |
| Last Update Date | 03/14/2023 |
| Medicare PECOS PAC ID | 1052778479 |
|---|---|
| Medicare Enrollment ID | O20230531000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578264818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Virginia R Lemoyne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699905240 PECOS PAC ID: 7618014705 Enrollment ID: I20091021000844 |
| Provider Name | Ali Saberi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649495276 PECOS PAC ID: 6709946486 Enrollment ID: I20110512000442 |
| Provider Name | Yisel Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558956359 PECOS PAC ID: 9739589110 Enrollment ID: I20210608000706 |
| Provider Name | Beth Robin Domino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295204741 PECOS PAC ID: 9931592920 Enrollment ID: I20220216000634 |
| Provider Name | Anne M Jetton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851050371 PECOS PAC ID: 2062803885 Enrollment ID: I20220407001463 |
| Provider Name | Evan Bradlee Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548908874 PECOS PAC ID: 0941684823 Enrollment ID: I20220825003174 |
| Provider Name | Patrick Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366177719 PECOS PAC ID: 8820473747 Enrollment ID: I20220913003405 |
| Provider Name | Christina Asher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902546674 PECOS PAC ID: 3274904404 Enrollment ID: I20230125002204 |
| Provider Name | Amber Gephart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356022941 PECOS PAC ID: 4688023823 Enrollment ID: I20231213000487 |
| Provider Name | Lori Jordan Back |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639934102 PECOS PAC ID: 3072951789 Enrollment ID: I20240401001286 |
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