| Verimed Health Group Clearwater, Llc | |
|
2515 Countryside Blvd Ste H Clearwater FL 33763-1603 | |
| (727) 796-8600 | |
| (813) 932-0266 |
| Full Name | Verimed Health Group Clearwater, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2515 Countryside Blvd Ste H, Clearwater, Florida |
| Authorized Official Name and Position | Gina Perez (ADMINISTRATOR) |
| Authorized Official Contact | 7277968600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Verimed Health Group Clearwater, Llc 2515 Countryside Blvd Ste H Clearwater FL 33763-1603 Ph: (727) 796-8600 | Verimed Health Group Clearwater, Llc 2515 Countryside Blvd Ste H Clearwater FL 33763-1603 Ph: (727) 796-8600 |
| NPI Number | 1265988752 |
|---|---|
| Provider Enumeration Date | 08/25/2016 |
| Last Update Date | 09/26/2022 |
| Medicare PECOS PAC ID | 6608151139 |
|---|---|
| Medicare Enrollment ID | O20170324001883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265988752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
| Provider Name | Olivia K Gillespie |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1700166675 PECOS PAC ID: 1456582485 Enrollment ID: I20140314001835 |
| Provider Name | Charlene E Dacosta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306802905 PECOS PAC ID: 6002828076 Enrollment ID: I20160718001032 |
| Provider Name | Inelvis Del Rio Ramos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871850362 PECOS PAC ID: 8820428774 Enrollment ID: I20200417000635 |
| Provider Name | Petya Petrov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376610436 PECOS PAC ID: 2062496987 Enrollment ID: I20210325000906 |
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