| St. Francis Primary Care Clinic | |
|
720 N Bay St Suite 8 Eustis FL 32726-2964 | |
| (352) 357-1014 | |
| (352) 357-3130 |
| Full Name | St. Francis Primary Care Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 720 N Bay St, Eustis, Florida |
| Authorized Official Name and Position | Roger Cagandahan Roque (FAMILY PHYSICIAN) |
| Authorized Official Contact | 3523571014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Francis Primary Care Clinic Po Box 1386 Eustis FL 32727-1386 Ph: (352) 357-1014 | St. Francis Primary Care Clinic 720 N Bay St Suite 8 Eustis FL 32726-2964 Ph: (352) 357-1014 |
| NPI Number | 1932215043 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 08/23/2011 |
| Medicare PECOS PAC ID | 9234135187 |
|---|---|
| Medicare Enrollment ID | O20070209000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932215043 | NPI | - | NPPES |
| 31407 | Other | BLUE CROSS BLUE SHIELD | |
| 279151000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0070970 (Florida) | Primary |
| Provider Name | Roger C Roque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437156916 PECOS PAC ID: 4981603560 Enrollment ID: I20070207000629 |
| Provider Name | Jennifer Antoine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346756897 PECOS PAC ID: 2567722614 Enrollment ID: I20180209000711 |
| Provider Name | Angela Michelle King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164187977 PECOS PAC ID: 1456731363 Enrollment ID: I20220709000937 |
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