| Santos Primary Care Medical Clinics, Pllc | |
|
17820 Se 109th Ave Ste 108 Summerfield FL 34491-8968 | |
| (352) 448-6469 | |
| (352) 504-0901 |
| Full Name | Santos Primary Care Medical Clinics, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 17820 Se 109th Ave Ste 108, Summerfield, Florida |
| Authorized Official Name and Position | Adamastor Santos (PROVIDER) |
| Authorized Official Contact | 3524486469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santos Primary Care Medical Clinics, Pllc 17820 Se 109th Ave Ste 108 Summerfield FL 34491-8968 Ph: (352) 448-6469 | Santos Primary Care Medical Clinics, Pllc 17820 Se 109th Ave Ste 108 Summerfield FL 34491-8968 Ph: (352) 448-6469 |
| NPI Number | 1104311315 |
|---|---|
| Provider Enumeration Date | 06/29/2018 |
| Last Update Date | 04/05/2022 |
| Medicare PECOS PAC ID | 9234478926 |
|---|---|
| Medicare Enrollment ID | O20190225000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104311315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Mark J Sbarro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629028196 PECOS PAC ID: 7517957426 Enrollment ID: I20040513000858 |
| Provider Name | John A Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114160272 PECOS PAC ID: 1951451145 Enrollment ID: I20090610000040 |
| Provider Name | Ashley N Hilger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588021083 PECOS PAC ID: 5890047468 Enrollment ID: I20181009002425 |
| Provider Name | Stephanie Cesarec |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902331192 PECOS PAC ID: 9739431107 Enrollment ID: I20181012000592 |
| Provider Name | Francisca Perdomo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770026924 PECOS PAC ID: 7416209812 Enrollment ID: I20181012001905 |
| Provider Name | Georgia F Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457874711 PECOS PAC ID: 9931451143 Enrollment ID: I20181016001230 |
| Provider Name | Sarah J Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740715911 PECOS PAC ID: 2466704697 Enrollment ID: I20181016002001 |
| Provider Name | Ashley E Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396230504 PECOS PAC ID: 2860746179 Enrollment ID: I20181126000817 |
| Provider Name | Vickie J Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275151227 PECOS PAC ID: 9335563428 Enrollment ID: I20200722001879 |
| Provider Name | Jessica E Read |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023702370 PECOS PAC ID: 7517320773 Enrollment ID: I20230906000758 |
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