| Sandbay Family Practice, L.l.c. | |
|
2086 Gulf To Bay Blvd Clearwater FL 33765-3714 | |
| (727) 462-0100 | |
| (727) 462-0177 |
| Full Name | Sandbay Family Practice, L.l.c. |
|---|---|
| Speciality | General Practice |
| Location | 2086 Gulf To Bay Blvd, Clearwater, Florida |
| Authorized Official Name and Position | Anthony Ngo (CEO) |
| Authorized Official Contact | 7274620100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandbay Family Practice, L.l.c. 2086 Gulf To Bay Blvd Clearwater FL 33765-3714 Ph: (727) 462-0100 | Sandbay Family Practice, L.l.c. 2086 Gulf To Bay Blvd Clearwater FL 33765-3714 Ph: (727) 462-0100 |
| NPI Number | 1568774479 |
|---|---|
| Provider Enumeration Date | 07/08/2010 |
| Last Update Date | 03/13/2023 |
| Medicare PECOS PAC ID | 5597958280 |
|---|---|
| Medicare Enrollment ID | O20101026001306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568774479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS 10771 (Florida) | Primary |
| Provider Name | Anthony Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033316815 PECOS PAC ID: 6901099696 Enrollment ID: I20101026001454 |
| Provider Name | Jessica Suzann Kaczar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144931932 PECOS PAC ID: 8921452392 Enrollment ID: I20231004000753 |
| Provider Name | Sydney Bui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447890496 PECOS PAC ID: 0446608517 Enrollment ID: I20231129003821 |
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