| Walsh Family Medicine Llc | |
|
1533 4th Ave W Bradenton FL 34205-5949 | |
| (941) 243-9613 | |
| (941) 417-8008 |
| Full Name | Walsh Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1533 4th Ave W, Bradenton, Florida |
| Authorized Official Name and Position | Joseph Walsh (OWNER) |
| Authorized Official Contact | 9412439613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walsh Family Medicine Llc 4654 E State Road 64 Ste 509 Bradenton FL 34208-9029 Ph: (941) 243-9613 | Walsh Family Medicine Llc 1533 4th Ave W Bradenton FL 34205-5949 Ph: (941) 243-9613 |
| NPI Number | 1356826770 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 06/22/2022 |
| Medicare PECOS PAC ID | 3173877909 |
|---|---|
| Medicare Enrollment ID | O20181114003010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356826770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | David N. Ratcliffe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952339103 PECOS PAC ID: 1557353869 Enrollment ID: I20040330000569 |
| Provider Name | Joseph Walsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255309340 PECOS PAC ID: 5799739553 Enrollment ID: I20050304000496 |
| Provider Name | James P Floyd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083708861 PECOS PAC ID: 9133172869 Enrollment ID: I20090909000243 |
| Provider Name | Kenneth R Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396970646 PECOS PAC ID: 2668514589 Enrollment ID: I20110208000525 |
| Provider Name | Crystal M Vanleeuwen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659684181 PECOS PAC ID: 6305138629 Enrollment ID: I20160707000605 |
| Provider Name | Jean M Hafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881224491 PECOS PAC ID: 4688087091 Enrollment ID: I20210104000885 |
| Provider Name | Mark W Nickels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679520837 PECOS PAC ID: 9739363532 Enrollment ID: I20230228001015 |
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