| Shane C Hernesman Md Pa | |
|
505 Delannoy Ave Cocoa FL 32922-7813 | |
| (321) 631-4940 | |
| (321) 631-4941 |
| Full Name | Shane C Hernesman Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 505 Delannoy Ave, Cocoa, Florida |
| Authorized Official Name and Position | Shane C Hernesman (PRESIDENT) |
| Authorized Official Contact | 3216314940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shane C Hernesman Md Pa 505 Delannoy Ave Cocoa FL 32922-7813 Ph: (321) 631-4940 | Shane C Hernesman Md Pa 505 Delannoy Ave Cocoa FL 32922-7813 Ph: (321) 631-4940 |
| NPI Number | 1164545620 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4486751104 |
|---|---|
| Medicare Enrollment ID | O20070515000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164545620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME83457 (Florida) | Primary |
| Provider Name | Shane C Hernesman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952412652 PECOS PAC ID: 0749386811 Enrollment ID: I20070507000212 |
| Provider Name | Cori M Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033464441 PECOS PAC ID: 2466882261 Enrollment ID: I20200418000299 |
Ana Conde Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Clearlake Rd Bldg K, Cocoa, FL 32922 Phone: 321-368-3862 | |
Ricardo Antonio Henriques M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 Delannoy Ave, Cocoa, FL 32922 Phone: 321-631-6995 Fax: 321-633-1004 | |
Brevard Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 Blake Ave, Bldg G, Cocoa, FL 32922 Phone: 321-633-6391 Fax: 321-633-6441 | |
Steward Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1317 W Point Dr, Cocoa, FL 32922 Phone: 615-467-4158 Fax: 615-467-1267 | |
Brevard Health Alliance Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Pineda St, Cocoa, FL 32922 Phone: 321-241-6800 Fax: 321-241-6888 | |
Miracle Pain Relief Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 234 Willard St Ste C, Cocoa, FL 32922 Phone: 321-477-2273 | |
Rameshwar N Mathur Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6250 N Us 1, Cocoa, FL 32927 Phone: 321-631-6402 Fax: 321-633-7041 |