| To Your Health Of Lake County Inc | |
|
26540 Ace Ave Suite 108c Leesburg FL 34748-8279 | |
| (352) 326-5281 | |
| (352) 323-1761 |
| Full Name | To Your Health Of Lake County Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 26540 Ace Ave, Leesburg, Florida |
| Authorized Official Name and Position | Joseph L Carrasco (OWNER) |
| Authorized Official Contact | 3523265281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| To Your Health Of Lake County Inc 26540 Ace Ave Suite 108c Leesburg FL 34748-8279 Ph: (352) 326-5281 | To Your Health Of Lake County Inc 26540 Ace Ave Suite 108c Leesburg FL 34748-8279 Ph: (352) 326-5281 |
| NPI Number | 1104017946 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 10/11/2011 |
| Medicare PECOS PAC ID | 3678657129 |
|---|---|
| Medicare Enrollment ID | O20080222000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104017946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME70698 (Florida) | Primary |
| Provider Name | Jorge E Ribet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245335215 PECOS PAC ID: 1052339546 Enrollment ID: I20051103000201 |
| Provider Name | Joseph L Carrasco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174610067 PECOS PAC ID: 8224112719 Enrollment ID: I20080222000297 |
| Provider Name | Pablo D Cardona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447523493 PECOS PAC ID: 9133348147 Enrollment ID: I20140923002158 |
| Provider Name | Shannon M Carrasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790142511 PECOS PAC ID: 2860799178 Enrollment ID: I20160401000051 |
| Provider Name | Kailey Ann Wickens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073120093 PECOS PAC ID: 5395156087 Enrollment ID: I20201202000432 |
| Provider Name | Brittani Michelle Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386308146 PECOS PAC ID: 1951793124 Enrollment ID: I20220120000632 |
| Provider Name | Suzanne Mariette Pasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942963335 PECOS PAC ID: 4789076738 Enrollment ID: I20220125000424 |
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