| Select Specialty Hospital Gainesville Llc | |
|
1600 Sw Archer Rd Fl 5 Gainesville FL 32610 | |
| (717) 972-1100 | |
| Not Available |
| Full Name | Select Specialty Hospital Gainesville Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 1600 Sw Archer Rd Fl 5, Gainesville, Florida |
| Authorized Official Name and Position | Michael Tarvin (VICE PRESIDENT) |
| Authorized Official Contact | 7179754503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Select Specialty Hospital Gainesville Llc 4714 Gettysburg Rd Legal Department Mechanicsburg PA 17055-4325 Ph: (717) 972-1100 | Select Specialty Hospital Gainesville Llc 1600 Sw Archer Rd Fl 5 Gainesville FL 32610 Ph: (717) 972-1100 |
| NPI Number | 1396055604 |
|---|---|
| Provider Enumeration Date | 10/20/2010 |
| Last Update Date | 06/25/2018 |
| Medicare PECOS PAC ID | 5991895476 |
|---|---|
| Medicare Enrollment ID | O20100308000618 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396055604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Melinda Rullan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1922043256 PECOS PAC ID: 4385635176 Enrollment ID: I20040520000728 |
| Provider Name | Christopher Robert Dorothy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1144282849 PECOS PAC ID: 9335117662 Enrollment ID: I20040923000595 |
| Provider Name | Timothy W Jones |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1265517189 PECOS PAC ID: 5294801866 Enrollment ID: I20080904000646 |
| Provider Name | Steven D Podnos |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821026345 PECOS PAC ID: 0446214944 Enrollment ID: I20100318000796 |
| Provider Name | Sasha Boris Grek |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558438085 PECOS PAC ID: 4183753346 Enrollment ID: I20100526000405 |
| Provider Name | Yasser Hussain |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821321134 PECOS PAC ID: 3870618408 Enrollment ID: I20100920000202 |
| Provider Name | Jeremy M Segal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1023063591 PECOS PAC ID: 8527255512 Enrollment ID: I20101202000870 |
| Provider Name | Samuel A Gurevich |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134109044 PECOS PAC ID: 0547252090 Enrollment ID: I20101220000403 |
| Provider Name | Mohamed Moataz Toban |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235289208 PECOS PAC ID: 9739139478 Enrollment ID: I20110304000327 |
| Provider Name | Naeem Z Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942252317 PECOS PAC ID: 0547263626 Enrollment ID: I20110919000372 |
| Provider Name | Luis E Javier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295842698 PECOS PAC ID: 3173783461 Enrollment ID: I20120323000176 |
| Provider Name | Juan D'brot |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700822442 PECOS PAC ID: 3274720040 Enrollment ID: I20131120001633 |
| Provider Name | Kim Schultheiss |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831227560 PECOS PAC ID: 4082792510 Enrollment ID: I20131216001217 |
| Provider Name | Guesly Jerome Delva |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750562724 PECOS PAC ID: 1557523602 Enrollment ID: I20141118000670 |
| Provider Name | Amitesh Agarwal |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629383674 PECOS PAC ID: 1850685074 Enrollment ID: I20160811000955 |
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