| Whole Health Premier Medical Group Llc | |
|
6272 Lake Osprey Dr Lakewood Ranch FL 34240-8425 | |
| (941) 290-5400 | |
| (941) 289-2492 |
| Full Name | Whole Health Premier Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6272 Lake Osprey Dr, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Kimberly Borsheim (MANAGING PARTNER) |
| Authorized Official Contact | 9412905400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Health Premier Medical Group Llc 6272 Lake Osprey Dr Lakewood Ranch FL 34240-8425 Ph: () - | Whole Health Premier Medical Group Llc 6272 Lake Osprey Dr Lakewood Ranch FL 34240-8425 Ph: (941) 290-5400 |
| NPI Number | 1386429652 |
|---|---|
| Provider Enumeration Date | 08/25/2023 |
| Last Update Date | 05/02/2024 |
| Medicare PECOS PAC ID | 6103368634 |
|---|---|
| Medicare Enrollment ID | O20240611004636 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386429652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kinga Zosia Porter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154646099 PECOS PAC ID: 2860635794 Enrollment ID: I20130826000259 |
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