| Summerfield Medical Clinic Md Pa | |
|
13055 Summerfield Square Dr Riverview FL 33578-7402 | |
| (813) 813-5462 | |
| Not Available |
| Full Name | Summerfield Medical Clinic Md Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 13055 Summerfield Square Dr, Riverview, Florida |
| Authorized Official Name and Position | Andrew Henry (MD) |
| Authorized Official Contact | 8137412473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summerfield Medical Clinic Md Pa 13055 Summerfield Square Dr Riverview FL 33578-7402 Ph: (813) 813-5462 | Summerfield Medical Clinic Md Pa 13055 Summerfield Square Dr Riverview FL 33578-7402 Ph: (813) 813-5462 |
| NPI Number | 1568780492 |
|---|---|
| Provider Enumeration Date | 05/17/2010 |
| Last Update Date | 09/07/2023 |
| Medicare PECOS PAC ID | 8325231194 |
|---|---|
| Medicare Enrollment ID | O20101025001171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568780492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Douglas M Burks |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477613420 PECOS PAC ID: 8426125170 Enrollment ID: I20080922000279 |
| Provider Name | Vijayasekhara Kalakata |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407039860 PECOS PAC ID: 0840337994 Enrollment ID: I20091022000600 |
| Provider Name | Amanuel Ambaye Daniachew |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1396955134 PECOS PAC ID: 6406002062 Enrollment ID: I20230208003032 |
| Provider Name | Stephen Watson |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1265625321 PECOS PAC ID: 2365499050 Enrollment ID: I20230921000383 |
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