| Vipcare | |
|
13940 N Us Highway 441 Ste 102 Lady Lake FL 32159-8909 | |
| (352) 751-9900 | |
| (844) 388-6186 |
| Full Name | Vipcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 13940 N Us Highway 441 Ste 102, Lady Lake, Florida |
| Authorized Official Name and Position | Sriram Sundaramoorthy (VP - OPERATIONS) |
| Authorized Official Contact | 3526227000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vipcare 601 S Harbour Island Blvd Ste 200 Tampa FL 33602-5735 Ph: (352) 509-9900 | Vipcare 13940 N Us Highway 441 Ste 102 Lady Lake FL 32159-8909 Ph: (352) 751-9900 |
| NPI Number | 1336153709 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 0648271155 |
|---|---|
| Medicare Enrollment ID | O20070126000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336153709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Thomas Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669470746 PECOS PAC ID: 2365347564 Enrollment ID: I20031201000758 |
| Provider Name | Wendy L Worsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497858724 PECOS PAC ID: 5890692149 Enrollment ID: I20031216000215 |
| Provider Name | John Wilker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770540361 PECOS PAC ID: 2466351739 Enrollment ID: I20040107000078 |
| Provider Name | Charles K Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285691881 PECOS PAC ID: 2365341633 Enrollment ID: I20040107000099 |
| Provider Name | John J Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255318572 PECOS PAC ID: 3375437924 Enrollment ID: I20040213000110 |
| Provider Name | Lawrence C Campo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801884978 PECOS PAC ID: 7517953144 Enrollment ID: I20040421000392 |
| Provider Name | Jolanta Tombarkiewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326262320 PECOS PAC ID: 8921095779 Enrollment ID: I20040426001272 |
| Provider Name | Joseph A Sassano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477545663 PECOS PAC ID: 9234128372 Enrollment ID: I20040512000487 |
| Provider Name | Beth D Yedwab Oliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659358604 PECOS PAC ID: 6103808001 Enrollment ID: I20040603001350 |
| Provider Name | Hanimi Challa |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1730111550 PECOS PAC ID: 7214910066 Enrollment ID: I20040611000476 |
| Provider Name | Javier J Urdaneta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063499119 PECOS PAC ID: 1658343603 Enrollment ID: I20040810000787 |
| Provider Name | Israel Caro |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1427031707 PECOS PAC ID: 8628043205 Enrollment ID: I20040827000340 |
| Provider Name | Hoa V Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699769281 PECOS PAC ID: 5698740207 Enrollment ID: I20040827000623 |
| Provider Name | Margaret R Yee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669405114 PECOS PAC ID: 4183678519 Enrollment ID: I20050309000405 |
| Provider Name | Marilyn L Juricic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497758338 PECOS PAC ID: 6204882590 Enrollment ID: I20050330000272 |
| Provider Name | Eladio J Dieguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881631877 PECOS PAC ID: 5991746794 Enrollment ID: I20050520000796 |
| Provider Name | Dwaraknadh R Banala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437106614 PECOS PAC ID: 5193764033 Enrollment ID: I20050922000404 |
| Provider Name | Gil F Gutierrez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659427532 PECOS PAC ID: 5597790568 Enrollment ID: I20050928000738 |
| Provider Name | Leslie M Kidd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033127840 PECOS PAC ID: 3072547348 Enrollment ID: I20061129000168 |
| Provider Name | Darrell L Pugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962489427 PECOS PAC ID: 0143262006 Enrollment ID: I20070308000228 |
| Provider Name | Michael Barimo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598746570 PECOS PAC ID: 9032201926 Enrollment ID: I20070823000245 |
| Provider Name | James Biggerstaff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245239607 PECOS PAC ID: 3072605682 Enrollment ID: I20070827000474 |
| Provider Name | Mariel Gonzalez-mendoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194836825 PECOS PAC ID: 2769457555 Enrollment ID: I20070915000096 |
| Provider Name | Vipinchandra K Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609951623 PECOS PAC ID: 3375639628 Enrollment ID: I20071017000736 |
| Provider Name | Christopher S Yuvienco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659316925 PECOS PAC ID: 0345326658 Enrollment ID: I20080327000280 |
| Provider Name | Stephen K Seecharan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821160664 PECOS PAC ID: 1850465394 Enrollment ID: I20080801000249 |
| Provider Name | Mabel Gonzalez Novo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285643486 PECOS PAC ID: 6305848946 Enrollment ID: I20081216000207 |
| Provider Name | Jayaprakash N Shetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720081896 PECOS PAC ID: 1254493158 Enrollment ID: I20081231000495 |
| Provider Name | Arlene H Radcliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215172499 PECOS PAC ID: 5092872333 Enrollment ID: I20090331000565 |
| Provider Name | Wayne Burnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811977903 PECOS PAC ID: 0042113607 Enrollment ID: I20091111000425 |
| Provider Name | Hector Esteban Guevara Garay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376719971 PECOS PAC ID: 7618015355 Enrollment ID: I20091117000465 |
| Provider Name | Kathryn Majarwitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225032824 PECOS PAC ID: 0840335097 Enrollment ID: I20100226000733 |
| Provider Name | Christopher J Grainger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255398798 PECOS PAC ID: 9335274547 Enrollment ID: I20100312000681 |
| Provider Name | Reyna I Lajara |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366503583 PECOS PAC ID: 4082716097 Enrollment ID: I20100505000462 |
| Provider Name | Sandra Faye Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386975845 PECOS PAC ID: 3678602554 Enrollment ID: I20100602000820 |
| Provider Name | Stephen Edward Fischer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598758799 PECOS PAC ID: 5597889154 Enrollment ID: I20100902001085 |
| Provider Name | Luz E Peguero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760469654 PECOS PAC ID: 4880719731 Enrollment ID: I20100928000334 |
| Provider Name | Ciceron Lazo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962567156 PECOS PAC ID: 7517159312 Enrollment ID: I20101012000969 |
| Provider Name | Talha Shamim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376573295 PECOS PAC ID: 1052203320 Enrollment ID: I20110215000024 |
| Provider Name | David Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093754657 PECOS PAC ID: 4385695428 Enrollment ID: I20110317000202 |
| Provider Name | Charles R Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295863322 PECOS PAC ID: 2466620141 Enrollment ID: I20110725000205 |
| Provider Name | David B Kuhn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982868303 PECOS PAC ID: 7810027059 Enrollment ID: I20110726000145 |
| Provider Name | Jorge A. Figueroa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225100803 PECOS PAC ID: 4789571837 Enrollment ID: I20120201000953 |
| Provider Name | Marc A Guerrier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124007364 PECOS PAC ID: 5991698680 Enrollment ID: I20120620000757 |
| Provider Name | Sangeeta Hans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447488978 PECOS PAC ID: 2163679176 Enrollment ID: I20120827000750 |
| Provider Name | Thomas Woodrow Smith |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194935825 PECOS PAC ID: 5193972834 Enrollment ID: I20120830000692 |
| Provider Name | Greyson C Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467682104 PECOS PAC ID: 0042467623 Enrollment ID: I20120904000788 |
| Provider Name | Roy G Bassett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922113232 PECOS PAC ID: 3072761352 Enrollment ID: I20120911000365 |
| Provider Name | Silvia V Abreu Read |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871523886 PECOS PAC ID: 9931102431 Enrollment ID: I20121231000208 |
| Provider Name | James E Peterzell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487623187 PECOS PAC ID: 4981605953 Enrollment ID: I20130123000132 |
| Provider Name | Rosa E Zapata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255600177 PECOS PAC ID: 7012155237 Enrollment ID: I20130530000173 |
| Provider Name | Linda D Jean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376862987 PECOS PAC ID: 4486895646 Enrollment ID: I20130730000956 |
| Provider Name | Christina M Mehriary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699812057 PECOS PAC ID: 7517109937 Enrollment ID: I20130815000065 |
| Provider Name | Yair R Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407286305 PECOS PAC ID: 3072740489 Enrollment ID: I20131210001532 |
| Provider Name | Claudine Frederiks |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1821051764 PECOS PAC ID: 5193728301 Enrollment ID: I20140210000154 |
| Provider Name | Lourdes Colon-cacho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881841237 PECOS PAC ID: 7810173150 Enrollment ID: I20140326002306 |
| Provider Name | Jeronimo Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316350697 PECOS PAC ID: 8123246311 Enrollment ID: I20140829001896 |
| Provider Name | Clary Ann Montalvo Galiano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548557168 PECOS PAC ID: 0143543405 Enrollment ID: I20141218000652 |
| Provider Name | Vidya Jaimungal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821493891 PECOS PAC ID: 1759605793 Enrollment ID: I20150121001722 |
| Provider Name | Veronica Machado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548213051 PECOS PAC ID: 5698792828 Enrollment ID: I20150601000612 |
| Provider Name | Rebecca M Corcoran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255724712 PECOS PAC ID: 2860703493 Enrollment ID: I20150623001315 |
| Provider Name | John Thomas Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285639047 PECOS PAC ID: 1456664242 Enrollment ID: I20150722006338 |
| Provider Name | William B Schurr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104051770 PECOS PAC ID: 7810042058 Enrollment ID: I20150727001538 |
| Provider Name | Esenbike Bek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659437093 PECOS PAC ID: 9133215528 Enrollment ID: I20151110001605 |
| Provider Name | Estrellita Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760850168 PECOS PAC ID: 1658681143 Enrollment ID: I20151112003064 |
| Provider Name | Claudia B Gonzalez Matos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114104296 PECOS PAC ID: 0244304699 Enrollment ID: I20151124001495 |
| Provider Name | Gilfredy Acevedo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114997699 PECOS PAC ID: 2961651419 Enrollment ID: I20151222002007 |
| Provider Name | Yanira Del Rosario Feliciano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962446831 PECOS PAC ID: 2567465339 Enrollment ID: I20160407001194 |
| Provider Name | Nanette A Ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487637476 PECOS PAC ID: 5092753814 Enrollment ID: I20160418001692 |
| Provider Name | Leslie Katherine Garcia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578773271 PECOS PAC ID: 9032274741 Enrollment ID: I20160519000575 |
| Provider Name | Ivette Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972714855 PECOS PAC ID: 7618951351 Enrollment ID: I20160707002514 |
| Provider Name | Sarah E Bendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619266947 PECOS PAC ID: 7416125000 Enrollment ID: I20160912000466 |
| Provider Name | Jose M. Llamas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366996738 PECOS PAC ID: 9830486455 Enrollment ID: I20160926002242 |
| Provider Name | Myriam A. Edwards Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851338099 PECOS PAC ID: 5890892277 Enrollment ID: I20161025003005 |
| Provider Name | Caterina B Ciccone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083160212 PECOS PAC ID: 6709164593 Enrollment ID: I20161029000065 |
| Provider Name | Kelly Martinkus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700290509 PECOS PAC ID: 5496976961 Enrollment ID: I20161121000209 |
| Provider Name | James Goszkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770571739 PECOS PAC ID: 8820095144 Enrollment ID: I20161213002524 |
| Provider Name | Lidzoe Correa- Mateo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1609040229 PECOS PAC ID: 5698844959 Enrollment ID: I20170418001661 |
| Provider Name | Carmen Milagros Echevarria |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639351380 PECOS PAC ID: 3678707726 Enrollment ID: I20170418002696 |
| Provider Name | Amarilys Colon Tirado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205804259 PECOS PAC ID: 5597730010 Enrollment ID: I20170529000037 |
| Provider Name | Joseph Burnsed Geffen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588081574 PECOS PAC ID: 8921227323 Enrollment ID: I20170602002090 |
| Provider Name | Haidy Carrasquillo Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639119340 PECOS PAC ID: 6901868009 Enrollment ID: I20170710001860 |
| Provider Name | Wanda Berrios |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932216496 PECOS PAC ID: 8426156241 Enrollment ID: I20170817001378 |
| Provider Name | Richard Dennis Santiago |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164466876 PECOS PAC ID: 3375719966 Enrollment ID: I20171110001329 |
| Provider Name | Janice Marie Rodriguez Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710156096 PECOS PAC ID: 4688852585 Enrollment ID: I20171229001288 |
| Provider Name | Mabel Rosa Sola |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568431419 PECOS PAC ID: 7315850278 Enrollment ID: I20180119000477 |
| Provider Name | Jibril Dixon Skaden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902281025 PECOS PAC ID: 2163782368 Enrollment ID: I20180208001230 |
| Provider Name | Gerardo Antonio Pedroza-sierra |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124026117 PECOS PAC ID: 6800822255 Enrollment ID: I20180214000564 |
| Provider Name | Diana Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124412564 PECOS PAC ID: 6406101880 Enrollment ID: I20180626003395 |
| Provider Name | Jason Acosta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689033201 PECOS PAC ID: 4587912381 Enrollment ID: I20180810001785 |
| Provider Name | Aileen Edith Rosario |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386601284 PECOS PAC ID: 3072785112 Enrollment ID: I20181008000546 |
| Provider Name | Laura Charlene Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558842245 PECOS PAC ID: 9537412010 Enrollment ID: I20181031000056 |
| Provider Name | Jose A Pares |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912115445 PECOS PAC ID: 6800780057 Enrollment ID: I20181109000028 |
| Provider Name | Atiyeh Amer Atiyeh |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437602422 PECOS PAC ID: 9931463387 Enrollment ID: I20190104001960 |
| Provider Name | Johanna M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891260329 PECOS PAC ID: 7810233095 Enrollment ID: I20190109000030 |
| Provider Name | Baoquang Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447411525 PECOS PAC ID: 4385962240 Enrollment ID: I20190308001672 |
| Provider Name | Hamidreza Ebneshahidi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710473889 PECOS PAC ID: 4688919954 Enrollment ID: I20190329002192 |
| Provider Name | Lynnette Michele Santana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124582986 PECOS PAC ID: 2860734340 Enrollment ID: I20190502001842 |
| Provider Name | Patrycja Garces |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528448636 PECOS PAC ID: 3476804931 Enrollment ID: I20190604002338 |
| Provider Name | Robert Morris Harpold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134172497 PECOS PAC ID: 5698725836 Enrollment ID: I20190617002356 |
| Provider Name | Suzanne Johnson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912944984 PECOS PAC ID: 1153359864 Enrollment ID: I20190618000513 |
| Provider Name | Blanca Celina Quintanilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306387204 PECOS PAC ID: 2163756248 Enrollment ID: I20190624001344 |
| Provider Name | Robert Harrison Hummer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902886260 PECOS PAC ID: 2062556590 Enrollment ID: I20190731003679 |
| Provider Name | Anthony Espinoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316307242 PECOS PAC ID: 2567794050 Enrollment ID: I20191104000136 |
| Provider Name | Shelly M Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013559061 PECOS PAC ID: 9830522473 Enrollment ID: I20191212000029 |
| Provider Name | Maria Margarita Castro Gonzalez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1376001966 PECOS PAC ID: 1759716079 Enrollment ID: I20200115000453 |
| Provider Name | Nela F Ballesteros |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174026348 PECOS PAC ID: 8527493212 Enrollment ID: I20200128000682 |
| Provider Name | Ryan W Novince |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164865259 PECOS PAC ID: 6204062029 Enrollment ID: I20200219002203 |
| Provider Name | William Scott Blanchard |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386101376 PECOS PAC ID: 7618208935 Enrollment ID: I20200224000371 |
| Provider Name | Jackeline Nunez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912032558 PECOS PAC ID: 8123064458 Enrollment ID: I20200226001175 |
| Provider Name | Adam Kachelman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659812105 PECOS PAC ID: 1557782810 Enrollment ID: I20200522001703 |
| Provider Name | Amy Jean Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356780787 PECOS PAC ID: 1052614310 Enrollment ID: I20200612002182 |
| Provider Name | John Clarence Ehrmann |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861691032 PECOS PAC ID: 3274801899 Enrollment ID: I20200925000469 |
| Provider Name | Gregory A Avetisov |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679917280 PECOS PAC ID: 9335470400 Enrollment ID: I20201027000040 |
| Provider Name | Luis Garcia Fresneda |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326539388 PECOS PAC ID: 1456681873 Enrollment ID: I20201112002004 |
| Provider Name | Elisa Gordon Perez Mena |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720680887 PECOS PAC ID: 3678700879 Enrollment ID: I20201210000690 |
| Provider Name | Thomas Auxter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902865470 PECOS PAC ID: 9133023302 Enrollment ID: I20201214002758 |
| Provider Name | Deborah Maria Ball Mora |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245895887 PECOS PAC ID: 6406268291 Enrollment ID: I20201221000679 |
| Provider Name | Fabian Alexander Turushina Montano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326658899 PECOS PAC ID: 7517371156 Enrollment ID: I20210122001227 |
| Provider Name | Ulises F Garcia Sanchez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962870741 PECOS PAC ID: 3870907686 Enrollment ID: I20210205000602 |
| Provider Name | Richard Faust Satriale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306816921 PECOS PAC ID: 7517092430 Enrollment ID: I20210511001871 |
| Provider Name | Cobra A Chamblee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366461741 PECOS PAC ID: 9234144114 Enrollment ID: I20210524001039 |
| Provider Name | Julia Belanger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871993436 PECOS PAC ID: 6709152887 Enrollment ID: I20210716001660 |
| Provider Name | Lisa A Mattingly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104186907 PECOS PAC ID: 5799091542 Enrollment ID: I20210812002465 |
| Provider Name | Andrea M Prince |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841364577 PECOS PAC ID: 8022187426 Enrollment ID: I20210819000765 |
| Provider Name | Aileen Denisse Velez Ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1538561543 PECOS PAC ID: 1850798356 Enrollment ID: I20210927001513 |
| Provider Name | Sylvia Boloczko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063400893 PECOS PAC ID: 1951204221 Enrollment ID: I20211013003174 |
| Provider Name | Italo Andres Neira Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235809369 PECOS PAC ID: 0840698114 Enrollment ID: I20211018002191 |
| Provider Name | Natalya Korneyeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871169847 PECOS PAC ID: 8921498122 Enrollment ID: I20211202000321 |
| Provider Name | Gabriel Szmigiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841462892 PECOS PAC ID: 5597925487 Enrollment ID: I20211209002282 |
| Provider Name | Noel Espinosa Sanchez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841831146 PECOS PAC ID: 4082004767 Enrollment ID: I20211213001257 |
| Provider Name | Wendy M Kingsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346712379 PECOS PAC ID: 7810388725 Enrollment ID: I20220104002229 |
| Provider Name | Raybert Llorente Fuentes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053969691 PECOS PAC ID: 7719373737 Enrollment ID: I20220331000076 |
| Provider Name | Obianuju Amadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538419759 PECOS PAC ID: 0244513414 Enrollment ID: I20220427000632 |
| Provider Name | Luis Almaguer Alvarez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972160232 PECOS PAC ID: 8224425632 Enrollment ID: I20220503000743 |
| Provider Name | Alexzavier Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497384846 PECOS PAC ID: 2961820840 Enrollment ID: I20220601001466 |
| Provider Name | Maribel Lopez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649349697 PECOS PAC ID: 2860408366 Enrollment ID: I20220620000284 |
| Provider Name | Veronica Cordero Fernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639665664 PECOS PAC ID: 8426389065 Enrollment ID: I20220711000167 |
| Provider Name | David Alexander Phillips |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194165688 PECOS PAC ID: 2264721661 Enrollment ID: I20220711000290 |
| Provider Name | James H Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518908045 PECOS PAC ID: 1557456258 Enrollment ID: I20220719004049 |
| Provider Name | Samuel Alfano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588764872 PECOS PAC ID: 7315044013 Enrollment ID: I20220726002306 |
| Provider Name | Cruz Ranea |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497409593 PECOS PAC ID: 2163807215 Enrollment ID: I20220910000281 |
| Provider Name | Michael Lee Carr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063505139 PECOS PAC ID: 3173511516 Enrollment ID: I20221013003082 |
| Provider Name | Angelica Roman Rivera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982110276 PECOS PAC ID: 7214290352 Enrollment ID: I20221014000012 |
| Provider Name | Jason A Waugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629123906 PECOS PAC ID: 2264666247 Enrollment ID: I20221117000910 |
| Provider Name | Lynnette Michele Santana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124582986 PECOS PAC ID: 2860734340 Enrollment ID: I20230203001555 |
| Provider Name | Juan Carlos De Los Santos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003885823 PECOS PAC ID: 4284531500 Enrollment ID: I20230209001992 |
| Provider Name | Fara Castillo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578227849 PECOS PAC ID: 8123490463 Enrollment ID: I20230214001554 |
| Provider Name | Yanira Raza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194838904 PECOS PAC ID: 8820068562 Enrollment ID: I20230522003414 |
| Provider Name | Katie Mcclelland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346403177 PECOS PAC ID: 5395898944 Enrollment ID: I20230524003425 |
| Provider Name | Brian K Shablin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194701771 PECOS PAC ID: 6103717582 Enrollment ID: I20230607000013 |
| Provider Name | Elvira Perez Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902139587 PECOS PAC ID: 7618136722 Enrollment ID: I20230614000121 |
| Provider Name | Jose Gutierrez-holguin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942428826 PECOS PAC ID: 0840336962 Enrollment ID: I20230620001934 |
| Provider Name | Robert Guido |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962898791 PECOS PAC ID: 5698136323 Enrollment ID: I20230727003988 |
| Provider Name | Shing Ko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144857913 PECOS PAC ID: 3779945324 Enrollment ID: I20230814001472 |
| Provider Name | Raul Breton Gamiotea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750028932 PECOS PAC ID: 3870955917 Enrollment ID: I20230822000375 |
| Provider Name | Kevin Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356423420 PECOS PAC ID: 7517918469 Enrollment ID: I20230830000848 |
| Provider Name | Yolanda Molinaris-gelpi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710984919 PECOS PAC ID: 8123105152 Enrollment ID: I20230830004343 |
| Provider Name | Gregory Bahtiarian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295738250 PECOS PAC ID: 2264334986 Enrollment ID: I20230914000819 |
| Provider Name | Anne Butler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629422613 PECOS PAC ID: 0345521050 Enrollment ID: I20230925001945 |
| Provider Name | Valerie Smith |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134313802 PECOS PAC ID: 3678742632 Enrollment ID: I20230926000806 |
| Provider Name | Michael Fortunato |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841291226 PECOS PAC ID: 5799863965 Enrollment ID: I20231009001596 |
| Provider Name | Shervin Sarmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639524556 PECOS PAC ID: 7911288717 Enrollment ID: I20231023000195 |
| Provider Name | Christine Michel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134733157 PECOS PAC ID: 1254747983 Enrollment ID: I20231025000480 |
| Provider Name | Melissa Yvette Beltre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407492143 PECOS PAC ID: 1759730088 Enrollment ID: I20231212004020 |
| Provider Name | Alejandro Sierra-ocampo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548049562 PECOS PAC ID: 1759733082 Enrollment ID: I20240123000078 |
| Provider Name | Yunior Moya Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790423549 PECOS PAC ID: 4385087329 Enrollment ID: I20240207001455 |
| Provider Name | Shabriel Javier Vazquez Ocasio |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598416265 PECOS PAC ID: 3971984220 Enrollment ID: I20240207001775 |
| Provider Name | Berenice Colon Colon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306414453 PECOS PAC ID: 6800231226 Enrollment ID: I20240226001345 |
Health First Internal Medicine Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8562 Ne 138th Ln, Lady Lake, FL 32159 Phone: 352-633-8681 | |
Optimum Health Wellness Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1503 Buenos Aires Blvd Ste 160, Lady Lake, FL 32159 Phone: 352-350-6241 | |
Mesos, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 757 County Road 466, Lady Lake, FL 32159 Phone: 352-259-8599 Fax: 352-259-8559 | |
Pulse Medical Doctors Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 871 County Road 466, Suite 200, Lady Lake, FL 32159 Phone: 352-350-5130 Fax: 352-350-1684 | |
Cogent Healthcare Of Jacksonville, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Highway 466, Lady Lake, FL 32159 Phone: 352-430-0017 | |
Vqol Primary Care Physician Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8550 Ne 138th Ln Ste 102, Lady Lake, FL 32159 Phone: 352-314-2922 | |
New Traditions In Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13940 N Us Highway 441, Suite 906, Lady Lake, FL 32159 Phone: 352-205-8305 Fax: 352-750-1933 |