| Shiloh Medical Group | |
|
10549 N Florida Ave Ste J Tampa FL 33612-6707 | |
| (813) 252-0242 | |
| Not Available |
| Full Name | Shiloh Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 10549 N Florida Ave Ste J, Tampa, Florida |
| Authorized Official Name and Position | Stephen O Banjoko (CFO) |
| Authorized Official Contact | 2122570225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shiloh Medical Group Po Box 17175 Tampa FL 33682-7175 Ph: () - | Shiloh Medical Group 10549 N Florida Ave Ste J Tampa FL 33612-6707 Ph: (813) 252-0242 |
| NPI Number | 1477119519 |
|---|---|
| Provider Enumeration Date | 05/14/2019 |
| Last Update Date | 01/05/2022 |
| Medicare PECOS PAC ID | 7315273943 |
|---|---|
| Medicare Enrollment ID | O20190719001544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477119519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Michael Lazarus Lemon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427070960 PECOS PAC ID: 6406836311 Enrollment ID: I20050622000920 |
| Provider Name | Lilia K. Vinarsky |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1518120344 PECOS PAC ID: 4183759863 Enrollment ID: I20100319000452 |
| Provider Name | Gregory F Saric |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952330771 PECOS PAC ID: 6305039934 Enrollment ID: I20101015000088 |
| Provider Name | Pattanam D Srinivasan |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1225084155 PECOS PAC ID: 4183640345 Enrollment ID: I20170405000411 |
| Provider Name | Nelson Colon |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1326234790 PECOS PAC ID: 1355337262 Enrollment ID: I20230608001860 |
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