| Vikrambeherallc | |
|
801 Oak St Green Cove Springs FL 32043-4317 | |
| (904) 284-9230 | |
| Not Available |
| Full Name | Vikrambeherallc |
|---|---|
| Speciality | Internal Medicine |
| Location | 801 Oak St, Green Cove Springs, Florida |
| Authorized Official Name and Position | Judy Payne (ADMIN) |
| Authorized Official Contact | 9043874778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vikrambeherallc 84 Waterline Dr St Johns FL 32259-2311 Ph: (212) 767-9891 | Vikrambeherallc 801 Oak St Green Cove Springs FL 32043-4317 Ph: (904) 284-9230 |
| NPI Number | 1043982606 |
|---|---|
| Provider Enumeration Date | 10/01/2021 |
| Last Update Date | 04/04/2022 |
| Medicare PECOS PAC ID | 7911398284 |
|---|---|
| Medicare Enrollment ID | O20211221000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043982606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Vikram Behera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134337892 PECOS PAC ID: 5799841391 Enrollment ID: I20141210000350 |
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