| Suncoast Internal Medicine Consultants, P.a. | |
|
13644 Walsingham Road S.r. #688 Largo FL 33774-3532 | |
| (727) 595-2519 | |
| (727) 479-0485 |
| Full Name | Suncoast Internal Medicine Consultants, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 13644 Walsingham Road, Largo, Florida |
| Authorized Official Name and Position | Susan L Zito (GENERAL PRACTITIONER/PARTNER) |
| Authorized Official Contact | 7275952519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suncoast Internal Medicine Consultants, P.a. 13644 Walsingham Road S.r. #688 Largo FL 33774-3532 Ph: (727) 595-2519 | Suncoast Internal Medicine Consultants, P.a. 13644 Walsingham Road S.r. #688 Largo FL 33774-3532 Ph: (727) 595-2519 |
| NPI Number | 1710031984 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 05/30/2012 |
| Medicare PECOS PAC ID | 4981679677 |
|---|---|
| Medicare Enrollment ID | O20040826001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710031984 | NPI | - | NPPES |
| 059638800 | Medicaid | FL | |
| CK1058 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 77021 (Florida) | Primary |
| Provider Name | Jennifer L Kudelko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922097955 PECOS PAC ID: 4688607609 Enrollment ID: I20050912000327 |
| Provider Name | Susan L Zito |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1407992597 PECOS PAC ID: 1153406400 Enrollment ID: I20080311000216 |
| Provider Name | Lisa R Luckey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508008772 PECOS PAC ID: 3870646201 Enrollment ID: I20090803000644 |
| Provider Name | Robert L Digiovanni |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1770572778 PECOS PAC ID: 9739266677 Enrollment ID: I20101004001188 |
| Provider Name | Dane L Maxfield |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992794986 PECOS PAC ID: 7810189248 Enrollment ID: I20101004001305 |
| Provider Name | Randal G Worth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023007028 PECOS PAC ID: 9638279367 Enrollment ID: I20101012000330 |
| Provider Name | Rubaiya Y Mallay |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1023268687 PECOS PAC ID: 7113181371 Enrollment ID: I20120619000659 |
| Provider Name | Peggy A Cordle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578826954 PECOS PAC ID: 3173770310 Enrollment ID: I20120823000513 |
| Provider Name | Leo A Choe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508175530 PECOS PAC ID: 4880833888 Enrollment ID: I20130624000673 |
| Provider Name | Brenton D Mccoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053746479 PECOS PAC ID: 2567776586 Enrollment ID: I20150805006846 |
| Provider Name | Rakhee H Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841625290 PECOS PAC ID: 1153694732 Enrollment ID: I20170901000888 |
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