2017 florida provider directory - WellCare

2017 FLORIDA PROVIDER DIRECTORY

Hardee, Hillsborough, Manatee

FL037744_CAD_DIR_MLT State Approved 04022014 ©WellCare 2017 FL_07_17

FL7M61DIR82236M_0617

Table of Contents Provider Directory Introduction How to Read Our Provider Listings Icon Guide

I II II

List of Plan Providers Primary Care Physicians De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota Specialty Physicians De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota Hospitals De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota

1 2 4 7 30 35 43 66 79 83 85 89 99 276 309 349 454 521 550 551 552 553 554 555 556 557 558 FL7M61DIR82236M_0617

List of Plan Providers Behavioral Health De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota Ancillary Providers All De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota Allied Providers De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota Pharmacy Hardee Highlands Hillsborough

559 560 561 562 575 580 584 594 600 606 607 608 609 611 623 626 631 640 645 649 651 652 654 683 688 696 722 736 744 745 746

List of Plan Providers Pharmacy Manatee Pasco Pinellas Polk Sarasota

760 763 767 776 781

Indexes Alternate Languages Index Specialty Index Extended Hours Index Provider Index

785 816 824 847

Here is your Staywell provider directory. It lists all of the providers in our network. These providers include: • Primary care providers (PCPs) and specialists • Hospitals • Pharmacies Each of these providers will make his or her own decisions about the care you need. Staywell is not responsible for these decisions. Some providers may not perform certain services due to their religious or moral beliefs. We've listed all of the providers by county. Then we've grouped them together by the type of care or services they give. We've also included: • The providers' addresses and phone numbers • Symbols to tell you whether the provider is accepting new patients, board certified or wheelchair accessible We have a provider look-up tool on our website. Go to www.wellcare.com/Florida. Then click on the "Find a Provider" icon. You'll be able to search for providers right in your area. This is the best place to get our most current directory information. Call us if you have questions about this directory. We can help you find a provider. We can even help set up an appointment for you. Our toll-free number is 1-866-334-7927. TTY/TDD users can call 1-877-247-6272. You can reach us Monday-Friday, 8 a.m. to 7 p.m. We wish you good health.

www.wellcare.com/Florida | I

How to Read Our Provider Listings

Indicates provider is board certified Indicates provider has wheelchair access Provider name

Smith, Joe, MD Provider ID: 111111

Practice name

Your Family Medical Center

Provider gender

Male

Provider address and phone number

{

Indicates provider is not accepting new patients

123 Main Street Anytown, FL 12345 (555) 555-5555 00 Yrs/99 Yrs

Ages of patients seen by provider

Sunshine Hospital

Hospital the provider is associated with

Language: Spanish

Language spoken by provider or staff

9:00 am-5:00 pm

Hours of operation

PCMH: YES/NO. Level 1, 2, 3

Takes part in the PCMH* Model

Icon Guide Indicates provider is board certified

Indicates provider has wheelchair access

Indicates provider is not accepting new patients

*PCMH stands for Patient Centered Medical Home. This is a way of giving care that involves a team of health care professionals. The team works together to meet the needs of each patient. Providers are placed in one of three levels; Level 1 (lowest), Level 2 and Level 3 (highest). www.wellcare.com/Florida | II

Este es su directorio de proveedores de Staywell. Aquí se listan todos los proveedores en nuestra red. Estos proveedores incluyen: • Proveedores de cuidado primario (PCP) y especialistas • Hospitales • Farmacias Cada uno de estos proveedores tomará sus propias decisiones sobre el cuidado que usted necesita. Staywell no es responsable de esas decisiones. Es posible que algunos proveedores no proporcionen ciertos servicios debido a sus creencias religiosas o morales. Hemos listado a todos los proveedores por condado. Luego los hemos agrupado por el tipo de cuidado o servicios que ofrecen. También hemos incluido: • Las direcciones y los números de teléfono de los proveedores • Símbolos para indicarle si el proveedor está aceptando nuevos pacientes, si es certificado por una junta o si cuenta con acceso para silla de ruedas En nuestro sitio web contamos con una herramienta de búsqueda de proveedores. Visite www.wellcare.com/Florida. Luego haga clic en el icono “Find a Provider” (Buscar un proveedor). Usted podrá buscar proveedores exactamente en su área. Este es el mejor lugar para obtener nuestra información de directorio más actual. Si tiene alguna pregunta sobre este directorio, llámenos. Podemos ayudarle a encontrar un proveedor. Incluso podemos ayudarle a programar una cita. Nuestro número sin cargo es 1-866-334-7927. Los usuarios de TTY/TDD pueden llamar al 1-877-247-6272. Puede comunicarse con nosotros de lunes a viernes de 8 a.m. a 7 p.m. Le deseamos una buena salud.

www.wellcare.com/Florida | III

Cómo leer nuestros listados de proveedores Indica que el proveedor es certificado por la junta médica Indica que el proveedor tiene acceso para silla de ruedas

Nombre del proveedor

Smith, Joe, MD Provider ID: 111111

Nombre de la práctica

Your Family Medical Center

Sexo del proveedor

Male

Dirección y número de teléfono del proveedor

{

Indica que el proveedor no está aceptando a nuevos pacientes

123 Main Street Anytown, FL 12345 (555) 555-5555 00 Yrs/99 Yrs

Edades de pacientes vistos por el proveedor

Sunshine Hospital

Hospital con el que está asociado el proveedor

Language: Spanish

Idioma hablado por el proveedor o personal

9:00 am-5:00 pm

Horario de atención

PCMH: YES/NO. Level 1, 2, 3 Participa en el modelo PCMH*

Guía de íconos Indica que el proveedor es certificado por la junta médica

Indica que el proveedor tiene acceso para silla de ruedas

Indica que el proveedor no está aceptando a nuevos pacientes

*PCMH se refiere a Hogar Médico Enfocado en el Paciente. Es una manera de proporcionar cuidado que involucra a un equipo de profesionales de la salud. El equipo trabaja en conjunto para satisfacer las necesidades de cada paciente. Los proveedores son asignados a uno de tres niveles: Nivel 1 (el más bajo), Nivel 2 y Nivel 3 (el más alto). www.wellcare.com/Florida | IV

Spanish to English Provider Types*/Tipos de proveedores de español a inglés* Español

Inglés

Español

Inglés

Acupuntura

Acupuncture

Psiquiatría de adicciones Medicina para adolescentes

Addiction Psychiatry

Electrofisiología cardíaca

Cardiac Electrophysiology

Monitoreo cardíaco

Cardiac Monitoring

Cardiología

Cardiology

Servicios de acompañante para adultos Cuidado diurno para adultos Hogar de cuidado sustituto para adultos

Adult Companion Services

Cuidado médico diurno para adultos

Adult Medical Day Care

Cuidado residencial para adultos Administración de casos enfocados en adultos

Adult Residential Care Home Adult Targeted Case Management

Adolescent Medicine

Adult Day Care Adult Foster Care Home

Centro para tratar AIDS Center el SIDA Alergias e inmunología Allergy & Immunology Centro de cirugía ambulatoria Servicios de vida asistida Audiología

Ambulatory Surgery Center Assisted Living Services Audiology

Asesoramiento en salud del comportamiento Centro de salud del comportameinto

Behavioral Health Counseling Behavioral Health Facility

Centro de maternidad Birthing Center Laboratorio de Cardiac Cath cateterismo cardíaco Laboratory

Cirugía cardiovascular Cardiovascular Surgery Cirugía cardiovascular Cardiovascular Surgery Servicios de Case Management administración Services de casos Pediatría de abuso Child Abuse infantil Pediatrics Centro de desarrollo Child Development para niños Center Administración de Children Targeted casos enfocados Case Management en niños Niños con necesidades Children With especiales de cuidado Special Health Care de la salud Needs Quiropráctica Chiropractic Servicios de tareas Chore/Housekeeping domésticas y limpieza Services del hogar Clínica Clinic Neurofisiología clínica Cirugía de colon y recto Centro de salud comunitario Centro de salud mental comunitario Junta de servicios a la comunidad

www.wellcare.com/Florida | V

Clinical Neurophysiology Colon & Rectal Surgery Community Health Center Community Mental Health Center Community Service Board

Español

Inglés

Español

Inglés

Cirugía cardíaca congénita

Congenital Cardiac Surgery

Servicios de suministros médicos descartables Clínica de cuidado conveniente Hospital de acceso crítico Odontología

Consumable Medical Supply Services

Planificación familiar Medicina familiar Servicios de capacitación familiar

Family Planning Family Practice Family Training Services

Convenient Care Clinic Critical Access Hospital Dentistry

Dermatología

Dermatology

Dermatopatología

Dermatopathology

Centro designado para el sida Educación sobre la diabetes Centro de diagnóstico y tratamiento Centro de diagnóstico

Designated Aids Center Diabetes Education

Diagnóstico por imágenes Diálisis

Diagnostic Imaging

Diagnostic And Treatment Center Diagnostic Center

Dialysis

Equipo médico Durable Medical duradero Equipment Otorrinolaringología Ear, Nose & Throat Endocrinología, diabetes, metabolismo Endodoncia Servicios de adaptaciones de accesibilidad al entorno Servicios especiales de EPSDT Servicios de acompañante

Endocrinology, Diabetes, Metabolism Endodontics Environmental Accessibility Adaptation Services EPSDT Special Services Escort Services

Centro de salud con Federally Qualified calificación federal Health Center Servicios de Financial Risk evaluación/reducción Assessment/Risk de riesgos financieros Reduction Services Centro de aptitud física Gastroenterología

Fitness Center

Gastroenterología y hepatología

Gastroenterology & Hepatology

Medicina general

General Practice

Cirugía general

General Surgery

Asesoramiento genético

Genetic Counseling

Medicina geriátrica

Geriatric Medicine

Psiquiatría geriátrica

Geriatric Psychiatry

Oncología ginecológica Ginecología Cirugía de la mano

Gynecological Oncology Gynecology Hand Surgery

Oncología de cabeza y cuello Cirugía de cabeza y cuello Control de la seguridad de la salud

Head & Neck Oncology Head & Neck Surgery Health Safety Monitoring

Proveedor de audífonos Terapia y especialista en audífonos Hematología

Hearing Aid Supplier

www.wellcare.com/Florida | VI

Gastroenterology

Hearing Aid Therapy & Specialist Hematology

Español

Inglés

Español

Inglés

Hematología y oncología

Hematology & Oncology

Mobile Diagnostic

VIH/SIDA

HIV/AIDS

Diagnóstico con equipos portátiles MRI, equipos abiertos Medicina perinatal neonatal Nefrología

MRI Open Neonatal Perinatal Medicine Nephrology

Neurooncología

Neuro Oncology

Discapacidades del desarrollo neurológico Neurodiagnóstico

Neurodevelopmental Disabilities Neurodiagnostic

Neurología

Neurology

Comidas entregadas Home-Delivered a domicilio Meals Cuidado de la salud Home Health Care en el hogar Hospicio

Hospice

Cuidado de hospicio Hospice & Palliative y paliativo Care Hospital Hospital Servicios de limpieza Housekeeping/ del hogar y tareas Chore Services domésticas Medicina hiperbárica Hyperbaric Medicine

Neurología/otología Neurology/Otology

Enfermedades infecciosas Terapia de infusión

Infectious Disease

Medicina neuromuscular Neurooncología

Infusion Therapy

Neuropsicología

Neuropsychology

Medicina interna

Internal Medicine

Neurorradiología

Neuroradiology

Neurocirugía

Neurosurgery

Pruebas de laboratorio Laboratory de patología Pathology Testing

Neuromuscular Medicine Neuro-Oncology

Agencia licenciada de servicios de cuidado en el hogar

Licensed Home Care Service Agency

Servicios de transporte Non-Emergency sin carácter de Transportation emergencia Cardiología nuclear Nuclear Cardiology

Litotripsia

Lithotripsy

Medicina nuclear

Nuclear Medicine

Radiología nuclear

Nuclear Radiology

Enfermeras parteras Nutrición Obstetricia Obstetricia/ Ginecología Medicina ocupacional

Nurse Midwife Nutrition Obstetrics Obstetrics/ Gynecology Occupational Medicine Occupational Therapy Ophthalmology

Imágenes por Magnetic Resonance resonancia magnética Imaging Mamografía

Mammography

Masoterapia

Massage Therapy

Medicina maternofetal Genética médica

Maternal Fetal Medicine Medical Genetics

Oncología médica

Medical Oncology

Administración de medicamentos

Medication Administration

Terapia ocupacional Oftalmología

www.wellcare.com/Florida | VII

Español

Inglés

Español

Inglés

Óptico Optometría Cirugía oral y maxilofacial Ortodoncia Cirugía ortopédica Ortésica Ortopedia y prostética Establecimiento quirúrgico para pacientes ambulatorios Tratamiento del dolor Apoyo para el tratamiento del el dolor Alergias e inmunología pediátricas Medicina pediátrica del comportamiento Monitoreo cardíaco pediátrico Cardiología pediátrica Cirugía cardiovascular pediátrica Dermatología pediátrica Otorrinolaringología pediáatrica Endocrinología pediátrica Gastroenterología pediátrica

Optician Optometry Oral & Maxillofacial Surgery Orthodontics Orthopaedic Surgery Orthotics Orthotics & Prosthetics Outpatient Surgical Facility

Hematología/ Pediatric Hematology/ oncología pediátricas Oncology

Genética pediátrica

Pediatric Genetics

Enfermedades Pediatric Infectious infecciosas pediátricas Disease Nefrología pediátrica Pediatric Nephrology Neurología pediátrica Pediatric Neurology Neurocirugía pediátrica

Pediatric Neurosurgery

Oncología pediátrica Pediatric Oncology Oftalmología Pediatric pediátrica Ophthalmology Ortopedia pediátrica Pediatric Orthopaedics

Pain Management

Cirugía ortopédica pediátrica

Pain Management Support

Psiquiatría pediátrica Pediatric Psychiatry

Pediatric Orthopedic Surgery

Neumonología pediátrica

Pediatric Pulmonology

Medicina de rehabilitación pediátrica

Pediatric Rehabilitation Medicine

Pediatric Cardiac Monitoring Pediatric Cardiology Pediatric Cardiovascular Surgery Pediatric Dermatology

Reumatología pediátrica

Pediatric Rheumatology

Medicina deportiva pediátrica

Pediatric Sports Medicine

Cirugía pediátrica

Pediatric Surgery

Pediatric Ear, Nose & Throat Pediatric Endocrinology Pediatric Gastroenterology

Urología pediátrica

Pediatric Urology

Pediatría

Pediatrics

Comportamiento y desarollo pediátrico

Pediatrics Behavioral & Developmental

Pedodoncia Periodoncia

Pedodontics Periodontics

Pediatric Allergy & Immunology

Pediatric Behavioral Medicine

Hepatología pediátrica Pediatric Transplant y trasplante Hepatology

www.wellcare.com/Florida | VIII

Español

Inglés

Servicios de cuidado Personal Care personal Services Servicios personales de respuesta de emergencias

Personal Emergency Response System

Farmacia

Pharmacy

Medicina física y rehabilitación

Physical Medicine & Rehabilitation

Terapia física

Physical Therapy

Laboratorio de fisiología

Physiological Lab

Cirugía plástica y reconstructiva

Plastic & Reconstructive Surgery

Podiatría

Podiatry

Medicina preventiva Preventive Medicine Centro de cuidado primario

Primary Care Center

Aparatos protésicos

Prosthetics

Prostodoncia

Prosthodontics

Psiquiatría

Psychiatry

Psicología

Psychology

Medicina psicosomática

Psychosomatic Medicine

Enfermedad pulmonar Oncología radioterápica Radioterapia

Pulmonary Disease

Centro de radioterapia

Radiation Therapy Center

Radiología intervencional y vascular

Radiology Interventional & Vascular

Radiation Oncology Radiation Therapy

Español

Inglés

Centro de rehabilitación Medicina de rehabilitación Terapia de rehabilitación Endocrinología reproductiva Terapia respiratoria

Rehabilitation Facility Rehabilitation Medicine Rehabilitation Therapy Reproductive Endocrinology Respiratory Therapy

Servicios de cuidado Respite Care de relevo Services Reumatología Rheumatology Centro de salud rural Rural Health Center Cuidado autodirigido Self-Directed Care Centro de enfermería especializada Estudios de diagnóstico del sueño Medicina del sueño

Skilled Nursing Facility Sleep Diagnostic Studies Sleep Medicine

Cuidado diurno social Terapia del habla

Social Day Care

Medicina para lesiones de médula espinal Medicina deportiva

Spinal Cord Injury Medicine Sports Medicine

Cuidado subagudo

Sub-Acute Care

Speech Therapy

Abuso de sustancias Substance Abuse Oncología quirúrgica Surgical Oncology Monitoreo telecardíaco Cirugía torácica y cardiovascular

Tele-Cardiac Monitoring Thoracic & Cardiovascular Surgery

Cirugía torácica

Thoracic Surgery

www.wellcare.com/Florida | IX

Español

Inglés

Español

Inglés

Tórax/sistema vascular Hepatología de trasplante

Thoracic/Vascular

Oncología urológica

Urology Oncology

Centro de cuidado urgente

Urgent Care Center

Urología

Urology

Transplant Hepatology

Urología/ginecología Urology/Gynecology Laboratorio vascular Vascular Lab Medicina vascular

Vascular Medicine

Cirugía vascular

Vascular Surgery

*These are only some of the provider types. You can find a specific kind of provider in the Specialty Index. It can be found in the back of this book. *Estos son solo algunos de los tipos de proveedores. Usted puede encontrar un tipo específico de proveedor en el Índice de especialidades que encontrará en la parte posterior de este libro. www.wellcare.com/Florida | X

Men anyè pwofesyonèl swen medikal Staywell lan. Li gen lis non pwofesyonèl swen medikal ki nan sistèm nou an. Nan pwofesyonèl swen medikal sa yo, gen: • Doktè prensipal (PCP) ak espesyalis • Lopital • Famasi Chak pwofesyonèl swen medikal sa yo pran pwòp desizyon pa yo konsènan swen ou bezwen an. Staywell pa responsab desizyon sa yo. Gen kèk pwofesyonèl swen medikal ki pa fè kèk sèvis poutèt kwayans relijye oswa kwayans moral. Nou mete non pwofesyonèl swen medikal yo sou yon lis dapre konte kote to ye a. Lèfini, nou mete yo ansanm an gwoup dapre kalite swen oswa sèvis yo fè yo. Epitou, nou mete: • Adrès ak nimewo telefòn pwofesyonèl swen medikal yo • Senbòl ki pou fè ou konnen si pwofesyonèl swen medikal la ap aksepte nouvo malad, si pwofesyonèl swen medikal la sètifye oswa si klinik pwofesyonèl la aksesib pou moun ki sou chèz-woulant Nou gen yon zouti pou gade enfòmasyon sou yon pwofesyonèl swen medikal sou sitwèb nou an. Ale nan www.wellcare.com/Florida. Lèfini, klike sou senbòl “Find a Provider” a (Jwenn yon pwofesyonèl swen medikal). W ap kapab chèche pwofesyonèl swen medikal ki egzakteman nan zòn kote ou rete a. Se pi bon kote pou jwenn enfòmasyon ki pi ajou nan anyè a. Rele nou si ou gen kesyon konsènan anyè sa a. Nou ka ede ou jwenn yon pwofesyonèl swen medikal. Nou ka menm ede ou pran yon randevou. Nimewo telefòn gratis nou an se 1-866-334-7927. Moun ki itilize TTY/TDD kapab rele 1-877-247-6272. Ou ka kontakte nou lendi jiska vandredi, depi 8 a.m. jiska 7 p.m. Nou swete ou bòn sante.

www.wellcare.com/Florida | XI

Kijan pou Li Anyè Pwofesyonèl Swen Medikal nou an

Li fè konnen si pwofesyonèl la sètifye Li fè konnen si klinik la gen aksè pou chèz-woulant

Non pwofesyonèl la

Smith, Joe, MD Provider ID: 111111

Non klinik la

Your Family Medical Center

Sèks pwofesyonèl swen sante Pwofesyonèl la adrès ak nimewo telefòn

Male

{

Li fè konnen si pwofesyonèl la pap aksepte nouvo malad

123 Main Street Anytown, FL 12345 (555) 555-5555 00 Yrs/99 Yrs

Laj malad pwofesyonèl swen medikal la wè yo

Sunshine Hospital Lopital kote pwofesyonèl swen medikal la gen afilyasyon Language: Spanish Lang pwofesyonèl la oswa pèsonèl la pale 9:00 am-5:00 pm

Lè klinik la ouvri pou travay

PCMH: YES/NO. Level 1, 2, 3 Patisipe nan Modèl PCMH*

Gid pou senbòl yo Li fè konnen si pwofesyonèl la sètifye

Li fè konnen si klinik la gen aksè pou chèz-woulant

Li fè konnen si pwofesyonèl la ap aksepte nouvo malad

*PCMH vle di Kay Medikal ki Konsantre sou Pasyan. Sa a se yon fason pou bay swen ki gen pou wè ak yon ekip pwofesyonèl swen sante. Ekip la travay ansanm pou satisfè bezwen chak pasyan. Nou mete pwofesyonèl swen sante yo nan youn nan twa (3) nivo; Nivo 1 (pi ba a), Nivo 2, ak Nivo 3 (pi wo a). www.wellcare.com/Florida | XII

Creole to English Provider Types*/Lis pwofesyonèl yo depi lang Kreyòl jiska lang Angle* Kreyòl Ayisyen

Angle

Kreyòl Ayisyen

Angle

Akiponkti

Acupuncture

Kadyoloji

Cardiology

Sikyatri pou Akoutimans

Addiction Psychiatry

Lamedsin Adolesan

Adolescent Medicine

Sèvis Konpay pou Adilt Gadri Adilt

Adult Companion Services Adult Day Care

Operasyon KadyoVaskilè Operasyon KadyoVaskilè Sèvis Jesyon Dosye

Fanmi Plasman pou Adilt Swen Medikal Lajounen pou Adilt Kay Plasman pou Adilt Jesyon dosye ki vize

Adult Foster Care Home Adult Medical Day Care Adult Residential Care Home Adult Targeted Case Management AIDS Center

Sant pou Moun ki gen SIDA Alèji ak Iminoloji

Allergy & Immunology Sant Operasyon san Ambulatory Surgery Pasyan an pa Entène Center Sèvis pou Viv avèk Assisted Living Asistans Services Odyoloji Audiology Konsèy sou Sante Behavioral Health Konpòtmantal Counseling Sant Sante Behavioral Health Konpòtmantal Facility Sant Akouchman Birthing Center Laboratwa Kateteris Kadyak Elektwo-Fizyoloji Kadyak Siveyans Kadyak

Cardiac Cath Laboratory Cardiac Electrophysiology Cardiac Monitoring

Cardiovascular Surgery Cardiovascular Surgery Case Management Services Pedyatri pou Abi Child Abuse sou Timoun Pediatrics Sant Devlopman Child Development Timoun Center Jesyon dosye ki Vize Children Targeted pou Timoun Case Management Children With Special Timoun ki Bezwen Swen Sante Espesyal Health Care Needs Kiwopratik

Chiropractic

Sèvis pou Travay nan Chore/Housekeeping Kay/Pwòpte nan Kay Services Klinik

Clinic

Newo-Fizyoloji Klinik Operasyon Kolon ak Rektòm

Clinical Neurophysiology Colon & Rectal Surgery

Sant Sante Kominotè Sant Sante Mantal Kominotè

Community Health Center Community Mental Health Center

Konsèy Sèvis Kominotè Operasyon Kè nan Moman Akouchman Sèvis Materyèl Medikal pou Renouvle Souvan

Community Service Board Congenital Cardiac Surgery Consumable Medical Supply Services

www.wellcare.com/Florida | XIII

Kreyòl Ayisyen

Angle

Kreyòl Ayisyen

Angle

Klinik Swen Sante Pratik Lopital ki Gen Aksè Enpòtan Dantistri Dèmatoloji

Convenient Care Clinic Critical Access Hospital Dentistry Dermatology

Sèvis Evalyasyon/ Rediksyon Risk Finansye Sant pou Antrènman an Gastwo-antewoloji

Financial Risk Assessment/Risk Reduction Services Fitness Center

Dèmato-Patoloji

Dermatopathology

Sant Èd ki Deziyen

Designated Aids Center Diabetes Education

Gastwo-Antewoloji ak Epatoloji Pratik Jeneral

Gastroenterology & Hepatology General Practice

Edikasyon sou Dyabèt Sant pou Dyagnostik Diagnostic And ak Tretman Treatment Center Sant Dyagnostik Diagnostic Center

Chiriji Jeneral

General Surgery

Konsèy Jenetik

Genetic Counseling

Lamedsin Jeryatrik

Geriatric Medicine

Sikyatri Timoun

Geriatric Psychiatry

Imajri Dyagnostik

Diagnostic Imaging

Onkoloji Jinekolojik

Dyaliz

Dialysis

Gynecological Oncology

Ekipman Medikal Dirab Zòrèy, Nen ak Gòj

Durable Medical Equipment Ear, Nose & Throat

Jinekoloji

Gynecology

Chiriji Men

Hand Surgery

Lamedsin Espò Timoun Andodonti

Endocrinology, Diabetes, Metabolism Endodontics

Sèvis Adaptasyon Aksesibilite nan Anviwònman Sèvis Espesyal EPSDT Sèvis Akonpayman

Environmental Accessibility Adaptation Services EPSDT Special Services Escort Services

Planing Familyal

Family Planning

Pratik pou Lafanmi

Family Practice

Sèvis Fòmasyon Fanmi Sant Sante ki Gen Kalifikasyon Federal

Family Training Services Federally Qualified Health Center

Gastroenterology

Onkoloji Men ak Kou Head & Neck Oncology Head & Neck Surgery Chiriji Men ak Kou Kontwòl Sekirite Kadyak Founisè Pwotèz Oditif Terapi ak Espesyalis Pwotèz Oditif Ematoloji

Health Safety Monitoring Hearing Aid Supplier

Ematoloji ak Onkoloji VIH/SIDA

Hematology & Oncology HIV/AIDS

Hearing Aid Therapy & Specialist Hematology

Repa ki Distribiye Home-Delivered nan Kay Meals Swen Sante nan Kay Home Health Care Enstitisyon ki Ofri Hospice Swen pou Soulajman

www.wellcare.com/Florida | XIV

Kreyòl Ayisyen

Angle

Enstitisyon Swen Hospice & Palliative pou Soulajman ak Care Swen pou Soulajman Lopital Hospital Sèvis pou Pwòpte nan Housekeeping/ Kay/Travay nan Kay Chore Services Lamedsin Ipèbarik Hyperbaric Medicine

Kreyòl Ayisyen

Angle

Newoloji

Neurology

Newoloji/Otoloji

Neurology/Otology

Lamedsin NewoMiskilè Newo-Onkoloji

Neuromuscular Medicine Neuro-Oncology

Newo-Sikoloji

Neuropsychology

Maladi Enfektye

Infectious Disease

Newo-Radyoloji

Neuroradiology

Terapi Enjeksyon

Infusion Therapy

Newo-Chiriji

Neurosurgery

Lamedsin Entèn

Internal Medicine

Tès Patoloji Laboratwa Ajans Sèvis Swen nan Kay ki gen Lisans Litotripsi

Laboratory Pathology Testing Licensed Home Care Service Agency Lithotripsy

Sèvis Transpò ki pa pou Ijans Kadyoloji Nikleyè

Non-Emergency Transportation Nuclear Cardiology

Lamedsin Nikleyè

Nuclear Medicine

Radyoloji Nikleyè

Nuclear Radiology

Fanmsaj Enfimyè

Nurse Midwife

Nitrisyon

Nutrition

Obstetrik

Obstetrics

Oftalmoloji

Obstetrics/ Gynecology Occupational Medicine Occupational Therapy Ophthalmology

Optisyen

Optician

Optometri

Optometry

Imajri avèk Rezonans Magnetic Resonance Mayetik Imaging Mamografi Mammography Terapi nan Masaj

Massage Therapy

Obstetrik/Jinekoloji

Lamedsin Fetis Matènèl Jenetik Medikal

Maternal Fetal Medicine Medical Genetics

Lamedsin Travay

Onkoloji Medikal

Medical Oncology

Administrasyon Medikaman Dyagnostik Mobil

Medication Administration Mobile Diagnostic

MRI Ouvè

MRI Open

Ègoterapi

Nefwoloji

Nephrology

Operasyon nan Oral & Maxillofacial Bouch, nan Maksilyè Surgery ak nan Figi Òtodonti Orthodontics

Newo-Onkoloji

Neuro Oncology

Operasyon Òtopedik Orthopaedic Surgery

Andikap NewoDevlòpmantal Newo-Dyagnostik

Neurodevelopmental Disabilities Neurodiagnostic

Òtetik

Orthotics

Òtetik ak Pwostetik

Orthotics & Prosthetics

Lamedsin pou Tibebe Neonatal Perinatal Apre Akouchman Medicine

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Kreyòl Ayisyen

Angle

Kreyòl Ayisyen

Angle

Sant Chirijikal pou Pasyan ki pa Entène Kontwòl Doulè

Outpatient Surgical Facility Pain Management

Chiriji Òtopedik Timoun Sikyatri Timoun

Pediatric Orthopedic Surgery Pediatric Psychiatry

Sipò pou Kontwole Doulè Alèji ak Iminoloji Timoun Lamedsin Konpòtmantal Timoun Kontwòl Kadyak Timoun Kadyoloji Timoun

Pain Management Support Pediatric Allergy & Immunology Pediatric Behavioral Medicine

Nemoloji Timoun

Pediatric Pulmonology

Lamedsin Reyabilitasyon Timoun Rimatoloji Timoun

Pediatric Rehabilitation Medicine Pediatric Rheumatology Pediatric Sports Medicine Pediatric Surgery

Pediatric Cardiac Monitoring Pediatric Cardiology

Operasyon KadyoVaskilè Timoun Dèmatoloji Timoun

Pediatric Cardiovascular Surgery Pediatric Dermatology

Zòrèy, Nen ak Gòj Timoun Andokrinoloji Timoun Gastwo-Antewoloji Timoun Jenetik Timoun

Pediatric Ear, Nose & Throat Pediatric Endocrinology Pediatric Gastroenterology Pediatric Genetics

Ematoloji/Onkoloji Timoun Maladi Kontajye Timoun Nefwoloji Timoun

Pediatric Hematology/ Oncology Pediatric Infectious Disease Pediatric Nephrology

Newoloji Timoun

Pediatric Neurology

Newo-Chiriji Timoun Onkoloji Timoun

Pediatric Neurosurgery Pediatric Oncology

Oftalmoloji Timoun Pediatric Ophthalmology Òtopedik Timoun

Pediatric Orthopaedics

Lamedsin Espò Timoun Chiriji Timoun Epatoloji Transplantasyon Timoun Iwoloji Timoun

Pediatric Transplant Hepatology Pediatric Urology

Pedyatri

Pediatrics

Konpòtman ak Devlopman Timoun

Pediatrics Behavioral & Developmental

Pedodonti

Pedodontics

Pawodonti

Periodontics

Sèvis Swen Pèsonèl

Personal Care Services

Sistèm Repons pou Ijans Pèsonèl

Personal Emergency Response System

Famasi

Pharmacy

Lamedsin ak Reyabilitasyon Fizik Terapi Fizik

Physical Medicine & Rehabilitation Physical Therapy

Laboratwa Fizyolojik Physiological Lab Chiriji Plastik ak Rekonstwiktif Podoloji

Plastic & Reconstructive Surgery Podiatry

Lamedsin pou Prekosyon

Preventive Medicine

www.wellcare.com/Florida | XVI

Kreyòl Ayisyen

Angle

Kreyòl Ayisyen

Angle

Sant Swen Sante Prensipal Pwotèz

Primary Care Center

Kay Retrèt Kalifye

Skilled Nursing Facility

Prosthetics

Etid Dyagnostik Somèy

Sleep Diagnostic Studies

Pwostodonti

Prosthodontics

Lamedsin Somèy

Sleep Medicine

Sikyatri

Psychiatry

Gadri Sosyal

Social Day Care

Sikoloji

Psychology

Òtofoni

Speech Therapy

Lamedsin SikoSomatik Maladi Poumon

Psychosomatic Medicine Pulmonary Disease

Lamedsin Chòk nan Mwal Epinyè

Spinal Cord Injury Medicine

Lamedsin Espò

Sports Medicine

Radyo-Onkoloji

Radiation Oncology

Swen Kontini

Sub-Acute Care

Radyoterapi

Radiation Therapy

Abi Dwòg/Alkòl

Substance Abuse

Sant Radyoterapi

Radiation Therapy Center Radiology Interventional & Vascular Rehabilitation Facility Rehabilitation Medicine Rehabilitation Therapy Reproductive Endocrinology Respiratory Therapy

Onkoloji Chirijikal

Surgical Oncology

Tele-Kontwòl Kadyak Chiriji Torasik ak Kadyo-Vaskilè

Tele-Cardiac Monitoring Thoracic & Cardiovascular Surgery

Chiriji Torasik

Thoracic Surgery

Torasik/Vaskilè

Thoracic/Vascular

Epatoloji Transplantasyon

Transplant Hepatology

Sant Swen Ijan

Urgent Care Center

Iwoloji

Urology

Onkoloji Iwoloji

Urology Oncology

Iwoloji/Jinekoloji

Urology/Gynecology

Laboratwa Vaskilè

Vascular Lab

Radyoloji Entèvansyon ak Vaskilè Sant Reyabilitasyon Medikaman pou Reyabilitasyon Terapi Reyabilitasyon Andokrinoloji Repwodiktif Terapi Respiratwa

Sèvis Swen pou Pran Respite Care Repo Services Rimatoloji Rheumatology Sant Sante Riral

Rural Health Center

Lamedsin Vaskilè

Vascular Medicine

Swen Endepandan

Self-Directed Care

Chiriji Vaskilè

Vascular Surgery

*These are only some of the provider types. You can find a specific kind of provider in the Specialty Index. It can be found in the back of this book. *Sa yo se kèk kalite pwofesyonèl swen medikal sèlman. Ou ka jwenn yon kalite pwofesyonèl an patikilye nan Lis Espesyalite a. Ou ka jwenn li nan dènye paj liv sa a. www.wellcare.com/Florida | XVII

List of Plan Providers

Last update 08/14/2017

Primary Care Physicians De Soto Family Practice Desoto County Health Dept Provider ID: 207978 34 S Baldwin Ave Arcadia, FL 34266 (863) 993-4601 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

General Practice Gagot-Rivera, Mirza MD Provider ID: 991771 Gender: Female Desoto County Dept of Health 1031 E Oak St Arcadia, FL 34266 (863) 491-7580 Fax: (863) 491-7598 00 Yrs/130 Yrs Desoto Memorial Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Internal Medicine Dawod Rajiiha, Samir MD Provider ID: 1344844 Gender: Male Arcadia Medical Associates 425 Nursing Home Dr Arcadia, FL 34266 (863) 993-2966 Fax: (863) 494-5491 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Mora Rasquin, Georges MD

Pediatrics

Hernandez, Ana MD Provider ID: 973622 Provider ID: 241093 Gender: Male Arcadia Medical Associates PA Gender: Female Arcadia Childrens Healthcare 425 Nursing Home Dr Center Arcadia, FL 34266 250 N Brevard Ave (863) 993-2966 Arcadia, FL 34266 Fax: (863) 494-5491 (863) 494-4433 18 Yrs/130 Yrs Fax: (863) 494-4005 Desoto Memorial Hospital 00 Yrs/18 Yrs Doctors Hospital Sarasota Desoto Memorial Hospital Languages: Spanish, Hindi Languages: Spanish M-TH 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No PCMH: No Patel, Mahendrakumar MD Provider ID: 1202455 Gender: Male Twin Rivers Medical Center 888 N Robert Ave Arcadia, FL 34266 (863) 494-6222 Fax: (863) 993-7622 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM PCMH: No

Rucker, Rajivi MD Provider ID: 1211551 Gender: Female 6040 53rd Ave E Ste B Arcadia, FL 34266 (941) 366-2273 Fax: (863) 993-7622 00 Yrs/18 Yrs MTWTHFSat 8:00 AM - 8:00 PM PCMH: No

Villanueva, Pedro MD Provider ID: 1166792 Patel, Mahendrakumar MD Gender: Male Community Care Family Center Provider ID: 806469 1148 E Gibson St Bldg C Gender: Male Community Care Family Clinic Arcadia, FL 34266 (863) 494-6222 1148 E Gibson St Bldg C Fax: (863) 494-3227 Arcadia, FL 34266 00 Yrs/18 Yrs (863) 494-8401 Languages: Spanish Fax: (863) 494-5709 M-F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs Sat 8:00 AM - 8:00 PM M-F 9:00 AM - 5:00 PM Sun 9:00 AM - 5:00 PM PCMH: No PCMH: No

Deray, Dipesh MD Provider ID: 893393 Gender: Male 425 Nursing Home Dr Arcadia, FL 34266 (863) 993-2966 Fax: (863) 494-5491 00 Yrs/130 Yrs Desoto Memorial Hospital Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No

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Villanueva, Pedro MD Provider ID: 749461 Gender: Male Twin Rivers Medical Center 888 N Robert Ave Arcadia, FL 34266 (863) 494-8401 Fax: (863) 993-7622 00 Yrs/18 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:30 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hardee Family Practice Amin, Sapnalaxmi MD Provider ID: 1272050 Gender: Female Central Florida Health Care 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-6946 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Delikat, Terrence DO Provider ID: 210195 Gender: Male Florida Hospital Wauchula Pioneer M 515 Carlton St Wauchula, FL 33873 (863) 773-6606 Fax: (863) 773-9542 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No Geldart, Donald MD Provider ID: 1161934 Gender: Male Fh Wauchula Pioneer Medical Center 515 Carlton St Wauchula, FL 33873 (863) 773-6606 Fax: (863) 773-9542 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No

Hein, Andrew DO Provider ID: 709040 Gender: Male Central Florida Health Care 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3284 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Thomas, Rebecca MD Provider ID: 1198725 Gender: Female Florida Hospital Wauchula Pioneer M 515 Carlton St Wauchula, FL 33873 (863) 773-6606 Fax: (863) 773-9542 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:30 AM - 12:30 PM PCMH: No

General Practice Bhatia, Gitashree MD Provider ID: 715915 Gender: Female Central Florida Health Care Inc Wau 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 12 Yrs/130 Yrs Languages: Hindi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:00 PM PCMH: No Palomado, Raul MD Provider ID: 192803 Gender: Male 302 W Main St Bowling Green, FL 33834 (863) 375-2214 Fax: (863) 375-2212 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Vasquez, Kimber MD Provider ID: 658564 Gender: Male Central Florida Health Care Wauchul 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 00 Yrs/130 Yrs Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Internal Medicine Mora Rasquin, Georges MD Provider ID: 1254492 Gender: Male Arcadia Medical Associates, PA 324 S 6th Ave Wauchula, FL 33873 (863) 473-4733 Fax: (863) 222-3177 18 Yrs/130 Yrs Languages: Spanish, Hindi M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Pediatrics Anchundia, Maria MD Provider ID: 987274 Gender: Female Central Florida Health Care Inc Wau 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 452-3069 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

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Brar, Sardul MD Provider ID: 987279 Gender: Male Central Florida Health Care Inc 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 452-3069 00 Yrs/18 Yrs Lakeland Reg Medical Center Languages: Hindi, Punjabi M-F 7:30 AM - 5:30 PM Sat 8:00 AM - 12:00 PM PCMH: No Cosic, Sanja MD Provider ID: 987286 Gender: Female Central Florida Health Care Inc Win 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 452-3069 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Spanish, French M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No D'Aunoy, Mary MD Provider ID: 1320107 Gender: Female Central Florida Healthcare Wachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-6946 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hardee Pediatrics - cont. Manik, Apurba MD Provider ID: 712246 Gender: Male Heartland Pediatrics Association of 120 Heartland Way Wauchula, FL 33873 (863) 767-1414 Fax: (863) 767-1763 00 Yrs/21 Yrs Highlands Regional Medical M-F 8:30 AM - 5:00 PM PCMH: No

Sonni, Rajeswari MD Provider ID: 670709 Gender: Female Sonni's Pediatrics PA 1125 S 6th Ave Wauchula, FL 33873 (863) 767-1616 Fax: (863) 767-1619 00 Yrs/21 Yrs Highlands Regional Medical M-F 8:30 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Perez, Maria MD Provider ID: 717519 Gender: Female Sebring Pediatrics, PA 1125 S 6th Ave Wauchula, FL 33873 (863) 767-1616 Fax: (863) 767-1619 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Polk, Sara MD Provider ID: 1087811 Gender: Female Central Florida Health Care, Inc. 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 767-0697 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 3

Last update 08/14/2017

Primary Care Physicians Highlands Family Practice Amin, Sapnalaxmi MD Provider ID: 1272052 Gender: Female Central Florida Health Care 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Geldart, Donald MD Provider ID: 179782 Gender: Male Family Practice Center of Avon Park 1006 W Pleasant St Avon Park, FL 33825 (863) 453-3121 Fax: (863) 452-2823 05 Yrs/130 Yrs Florida Hospital Heartland M-W 8:30 AM - 5:00 PM TH 9:00 AM - 1:00 PM PCMH: No Geldart, Donald MD Provider ID: 194609 Gender: Male Heartland Occupational Srvs 4421 Sun N Lake Blvd Ste B Sebring, FL 33872 (863) 382-9600 Fax: (863) 382-0107 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Highlands Regional Medical M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Khurana, Sunaina MD Provider ID: 287357 Gender: Female Florida Hospital Heartland Division 2315 US 27 N Avon Park, FL 33825 (863) 453-4040 Fax: (863) 453-6694 12 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Lake Placid Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Lim, Donnabelle MD Provider ID: 1354668 Gender: Female Florida Hospital Heartland Medical 5909 US Hwy 27 N Sebring, FL 33870 (863) 382-4040 Fax: (863) 382-3533 12 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Louisville, Tommy MD Provider ID: 1132960 Gender: Male First Family Practice Inc 1023 US 27 N Avon Park, FL 33825 (863) 452-2980 Fax: (863) 452-2587 00 Yrs/130 Yrs M-F 8:00 AM - 6:30 PM PCMH: No Palosky, Eric DO Provider ID: 810435 Gender: Male Dr Eric Palosky 4511 Sun N Lake Blvd Ste 108 Sebring, FL 33872 (863) 385-1777 Fax: (863) 385-8668 05 Yrs/130 Yrs Florida Hospital Heartland M-TH 9:00 AM - 5:00 PM F 9:00 AM - 1:00 PM PCMH: No

Tangunan, Ray MD Provider ID: 188891 Gender: Male Heartland Medical Inc 6801 US Hwy 27 N Ste B4 Sebring, FL 33870 (863) 314-8440 Fax: (863) 314-0845 12 Yrs/130 Yrs Florida Hospital Heartland Languages: Filipino, Tagalog M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Ware II, Donald DO Provider ID: 177501 Gender: Male 2341 US Hwy 27 S Sebring, FL 33870 (863) 471-3500 Fax: (863) 382-8104 18 Yrs/130 Yrs Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No

General Practice Gagot-Rivera, Mirza MD Provider ID: 979751 Gender: Female 7205 S George Blvd Sebring, FL 33875 (863) 386-6040 Fax: (863) 386-3048 00 Yrs/130 Yrs Desoto Memorial Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Seralde, Cirilo MD Provider ID: 152433 Gender: Male Fairmount Medical Walkin Clinic 343 S Commerce Ave Sebring, FL 33870 (863) 382-2772 Fax: (863) 382-3172 18 Yrs/130 Yrs Languages: Spanish, Tagalog M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

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Seralde, Victor MD Provider ID: 1154645 Gender: Male Fairmount Medical Walkin Clinic 3750 US Hwy 27 N Ste 4F Sebring, FL 33870 (863) 382-4949 Fax: (863) 382-3811 18 Yrs/130 Yrs Florida Hospital Heartland M-F 8:00 AM - 5:00 PM PCMH: No Seralde Jr, Circilo MD Provider ID: 1154647 Gender: Male Fairmount Medical Walkin Clinic 3750 US Hwy 27 N Ste 4F Sebring, FL 33870 (863) 382-4949 Fax: (863) 382-3811 18 Yrs/130 Yrs Florida Hospital Heartland M-F 8:00 AM - 5:00 PM PCMH: No Ton, Liem MD Provider ID: 1111109 Gender: Male First Family Practice Inc 1023 US Hwy 27 S Avon Park, FL 33825 (863) 452-2980 Fax: (863) 452-2587 00 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Vasquez, Kimber MD Provider ID: 519455 Gender: Male Central Florida Health Care Avon PA 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/130 Yrs Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Highlands Internal Medicine Arumugam, Roger MD Provider ID: 321297 Gender: Male Center Florida Int Occ and Prev Med 7200 S George Blvd Sebring, FL 33875 (863) 471-9377 Fax: (863) 471-9477 12 Yrs/130 Yrs Highlands Regional Medical M-F 8:30 AM - 5:30 PM PCMH: No

Joshi, Shailesh MD Provider ID: 1179908 Gender: Male Shailesh Joshi MD PLLC 5825 US Hwy 27 N Sebring, FL 33870 (863) 385-8505 Fax: (863) 658-6848 12 Yrs/130 Yrs Florida Hospital Heartland M-F 8:00 AM - 5:00 PM PCMH: No

Marmolejos Baez, Euclides MD Provider ID: 621814 Beltre, Miguel MD Gender: Male Provider ID: 158321 Sebring Hma Physician Management LL Gender: Male Sun N Lake Medical Group PA 3700 Emergency Ln Sebring, FL 33870 4958 Sun N Lake Blvd Ste A (863) 386-4302 Sebring, FL 33872 Fax: (863) 386-3928 (863) 385-8004 60 Yrs/130 Yrs Fax: (863) 385-2330 Highlands Regional Medical 18 Yrs/130 Yrs Languages: Spanish Florida Hospital Heartland M-TH 8:00 AM - 5:00 PM Languages: Spanish F 8:00 AM - 12:00 PM M-F 8:30 AM - 5:00 PM PCMH: No PCMH: No Bhatia, Gitashree MD Provider ID: 232280 Gender: Female Central Florida Health Care Inc Avo 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 12 Yrs/130 Yrs Languages: Hindi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Midence, Robert MD Provider ID: 609658 Gender: Male 3700 Emergency Ln Sebring, FL 33870 (863) 386-4302 Fax: (863) 382-3928 50 Yrs/110 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Roa, Antonio MD Provider ID: 813012 Gender: Male Fhhmc Family Care Center Sebring 844 Poinsettia Ave Sebring, FL 33870 (863) 385-8890 Fax: (863) 385-8896 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Tagalog MT 8:00 AM - 5:00 PM W 8:00 AM - 4:00 PM TH 8:00 AM - 12:00 PM PCMH: No Tamayo, Percival MD Provider ID: 664785 Gender: Male Florida Hospital Heartland Medical 6801 US Hwy 27 N Ste B2 Sebring, FL 33870 (863) 385-2244 Fax: (863) 385-4661 18 Yrs/130 Yrs Florida Hospital Heartland Languages: Tagalog M-TH 8:30 AM - 4:00 PM F 8:30 AM - 12:00 PM PCMH: No

Pediatrics Asis, Maria Belina MD Provider ID: 550450 Gender: Female Heartland Pediatrics of Lake Placid 344 E Royal Palm St Ste 3 Lake Placid, FL 33852 (863) 699-1414 Fax: (863) 699-9790 00 Yrs/18 Yrs Languages: Tagalog M-F 8:30 AM - 5:00 PM PCMH: No

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Asis, Maria Belina MD Provider ID: 789632 Gender: Female Sebring Pediatrics 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs Highlands Regional Medical Languages: Spanish M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No Brar, Sardul MD Provider ID: 215440 Gender: Male Central Florida Health Care Inc Avo 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/18 Yrs Languages: Hindi, Punjabi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Camilo, Raisa MD Provider ID: 160064 Gender: Female Sun N Lake Medical Group 4958 Sun N Lake Blvd Sebring, FL 33872 (863) 386-4711 Fax: (863) 386-4301 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M 8:00 AM - 6:00 PM TW 8:00 AM - 5:00 PM TH 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Highlands Pediatrics - cont. Camilo, Raisa MD Provider ID: 220402 Gender: Female 511 W Interlake Blvd Lake Placid, FL 33852 (863) 699-1220 Fax: (863) 699-1811 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Cosic, Sanja MD Provider ID: 187737 Gender: Female Central Florida Health Care Inc Avo 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Spanish, French M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No D'Aunoy, Mary MD Provider ID: 1320110 Gender: Female Central Florida Healthcare Avon Par 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Depauda, Maria MD Provider ID: 186545 Gender: Female Central Florida Health Care Inc Avo 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/21 Yrs Languages: Filipino M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Krishnadas, Praveen MD Provider ID: 348106 Gender: Male Sebring Pediatrics, LLC 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No Krishnadas, Praveen MD Provider ID: 609700 Gender: Male Heartland Pediatrics of Lake Placid 344 E Royal Palm St Ste 3 Lake Placid, FL 33852 (863) 699-1414 Fax: (863) 699-9790 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 8:30 AM - 5:00 PM PCMH: No

Perez, Maria MD Provider ID: 607446 Gender: Female Sebring Pediatrics 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No Perez, Maria MD Provider ID: 685324 Gender: Female Heartland Pediatrics of Lake Placid 344 E Royal Palm St Ste 3 Lake Placid, FL 33852 (863) 699-1414 Fax: (863) 699-9790 00 Yrs/21 Yrs Highlands Regional Medical M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No Raghuveera, Anavatti MD Provider ID: 244291 Gender: Male Caladium Pediatrics 77 US Hwy 27 N Lake Placid, FL 33852 (863) 699-5437 Fax: (863) 699-9000 00 Yrs/21 Yrs Highlands Regional Medical Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No

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Sonni, Rajeswari MD Provider ID: 244297 Gender: Female Heartland Pediatrics of Lake Placid 344 E Royal Palm St Ste 3 Lake Placid, FL 33852 (863) 699-1414 Fax: (863) 699-9790 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Sonni, Rajeswari MD Provider ID: 344789 Gender: Female Sebring Pediatrics, LLC 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:30 PM PCMH: No Sonni, Rajeswari MD Provider ID: 504487 Gender: Female Avon Park Pediatrics Inc 1571 US Hwy 27 N Avon Park, FL 33825 (863) 453-7337 Fax: (863) 452-9790 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish MW 8:30 AM - 7:00 PM TTHF 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Family Practice Bassil, Nadijda MD Provider ID: 1217388 Gender: Female Fhpg Patient's First of Countryway 6918 Gunn Hwy Tampa, FL 33625 (813) 915-5626 Fax: (813) 891-6889 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Bassil, Nadijda MD Provider ID: 1217389 Gender: Female Fhpg Carrollwood Primary Care 14310 N Dale Mabry Hwy Ste 300 Tampa, FL 33618 (813) 968-1727 Fax: (813) 256-8920 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Berland, Gregory MD Provider ID: 757697 Gender: Male Fhpg Patients First of Citrus Park 6918 Gunn Hwy Ste B Tampa, FL 33625 (813) 891-6310 Fax: (813) 749-7938 00 Yrs/130 Yrs Tampa Community Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Berland, Gregory MD Provider ID: 799708 Gender: Male Fhpg Patients First of Contryway 11663 Countryway Blvd Tampa, FL 33626 (813) 891-6310 Fax: (813) 891-6889 00 Yrs/130 Yrs Tampa Community Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Carpenter, Thomas DO Provider ID: 703973 Gender: Male Foundationa Health 3031 W Cypress St Ste A Tampa, FL 33609 (813) 527-0445 Fax: (813) 527-9491 00 Yrs/130 Yrs Tampa Community Hospital M-F 8:00 AM - 5:00 PM PCMH: No Chintakayala, Durga MD Provider ID: 1153488 Gender: Male Sveta Medical PLLC 507 E MLK Blvd Ste 112 Tampa, FL 33603 (813) 229-6139 Fax: (813) 229-3180 00 Yrs/18 Yrs M-F 8:30 AM - 4:30 PM PCMH: No Cruz, Jose MD Provider ID: 713706 Gender: Male MD and Wellness Center Inc 4600 N Habana Ave Ste 12 Tampa, FL 33614 (813) 876-7700 Fax: (813) 876-8700 12 Yrs/130 Yrs Morton Plant North Bay Hospital Languages: Spanish M-F 7:30 AM - 4:30 PM PCMH: No

Davis, Michael MD Provider ID: 1310884 Gender: Male Fhpg Brandon Family Medical Care 1218 Millennium Pkwy Brandon, FL 33511 (813) 684-5255 Fax: (813) 654-7457 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Davis, Michael MD Provider ID: 1310887 Gender: Male Fhpg Brandon Family Medical Care 13007 Summerfield Square Dr Riverview, FL 33578 (813) 684-5255 Fax: (813) 654-7457 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Desai, Sanjiv MD Provider ID: 1418078 Gender: Male Forest Hills Health Care Inc 613 W MLK Blvd Ste 101 Tampa, FL 33603 (813) 237-1958 Fax: (813) 237-8147 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No Desai, Sanjiv MD Provider ID: 299409 Gender: Male Forest Hills Health Care Inc 116 W Bougainvillea Ave Tampa, FL 33612 (813) 932-4381 Fax: (813) 933-6875 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No

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Diwadkar, Vijay MD Provider ID: 149316 Gender: Male 701 W MLK Jr Blvd Ste 3 Tampa, FL 33603 (813) 237-2500 Fax: (813) 237-2871 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Espinoza, Daniel MD Provider ID: 1003234 Gender: Male Tgmg Fcc 30th Street 5802 N 30th St Tampa, FL 33610 (813) 236-5350 Fax: (813) 234-2904 12 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, Hungarian, Tagalog M-F 7:30 AM - 5:00 PM PCMH: Yes, Level 3 Florida Dept of Health In Hillsborough C Provider ID: 488241 Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Florida Dept of Health In Hillsborough C Provider ID: 488243 Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Family Practice - cont. Frazier, Brett MD Provider ID: 1135317 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33566 (813) 349-7600 Fax: (813) 349-7661 00 Yrs/130 Yrs MWTHF 7:45 AM - 5:00 PM T 7:45 AM - 7:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Frazier, Brett MD Provider ID: 1135326 Gender: Male Brandon Community Health Center 710 Oakfield Dr Ste 120 Brandon, FL 33510 (813) 423-7101 Fax: (813) 423-7102 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Korivi, Praveen MD Provider ID: 1035487 Gender: Male Complete Primary/Urgent Care 2304 E Fletcher Ave Tampa, FL 33612 (813) 615-2273 Fax: (813) 632-2000 00 Yrs/130 Yrs Central Florida Regional Hospital Florida Hospital Tampa Orlando Regional Medical Center Languages: Telugu M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Frazier, Brett MD Provider ID: 1135332 Gender: Male Frazier, Brett MD Wimauma Community Health Center Provider ID: 1135320 5121 State Rd 674 Gender: Male Wimauma, FL 33598 Ruskin Health Center (813) 653-6100 2814 14th Ave SE Kurakula, Satya MD Fax: (813) 633-2669 Ruskin, FL 33570 00 Yrs/130 Yrs (813) 653-6100 Provider ID: 717801 M-F 8:00 AM - 5:00 PM Fax: (813) 349-7861 Gender: Female PCMH: No 00 Yrs/130 Yrs Florida Health Sciences MWTHF 8:00 AM - 5:00 PM Iezzi, Alan MD Center Inc T 8:00 AM - 7:00 PM 5802 N 30th St Provider ID: 1365558 PCMH: No Tampa, FL 33610 Gender: Male (813) 236-5300 Fhpg Family Medical Center Frazier, Brett MD of Tampa Fax: (813) 237-5402 Provider ID: 1135322 15511 N Florida Ave Ste 401 00 Yrs/130 Yrs Gender: Male Tampa, FL 33613 Tampa General Hospital Tom Lee Community Health (813) 963-3124 Languages: Hindi, Telugu Center Fax: (813) 908-7808 M-F 7:30 AM - 4:00 PM 14254 SR 574 00 Yrs/130 Yrs PCMH: Yes, Level 3 Dover, FL 33527 Florida Hospital Carrollwood (813) 349-7700 Medidi, Subhakararao MD Florida Hospital Tampa Fax: (813) 349-7761 M-F 9:00 AM - 5:00 PM 18 Yrs/110 Yrs PCMH: No Provider ID: 1114662 MWTHF 8:00 AM - 5:00 PM Gender: Male T 8:00 AM - 7:00 PM Kolanko, Przemyslaw MD Plant City Fc PCMH: No 508 N Maryland Ave Provider ID: 1195733 Frazier, Brett MD Plant City, FL 33563 Gender: Male (813) 349-7600 Provider ID: 1135324 Tgmg Fcc Lois Fax: (813) 349-7661 Gender: Male 00 Yrs/130 Yrs Palm River Community Health 2106 S Lois Ave Tampa, FL 33629 Center Tampa General Hospital (813) 844-2252 7728 Palm River Rd MWTHF 7:45 AM - 5:00 PM Fax: (813) 844-1919 Tampa, FL 33619 T 7:45 AM - 7:00 PM 00 Yrs/130 Yrs (813) 630-3600 Sat 8:00 AM - 2:00 PM Languages: Polish Fax: (813) 620-1614 PCMH: No M-F 7:30 AM - 5:00 PM 18 Yrs/110 Yrs PCMH: Yes, Level 3 M-F 8:00 AM - 5:00 PM PCMH: No

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Medidi, Subhakararao MD Provider ID: 1114664 Gender: Male Brandon CHC 313 S Lakewood Dr Brandon, FL 33511 (813) 423-7101 Fax: (813) 423-7102 00 Yrs/130 Yrs Tampa General Hospital MWTHF 8:00 AM - 5:00 PM T 8:80 AM - 5:00 PM PCMH: No Medidi, Subhakararao MD Provider ID: 1114665 Gender: Male Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/130 Yrs Tampa General Hospital MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Medidi, Subhakararao MD Provider ID: 1114668 Gender: Male Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 349-7880 Fax: (813) 633-2669 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Medidi, Subhakararao MD Provider ID: 1114670 Gender: Male Suncoast Mobile Medical Bus 14254 SR 574 Dover, FL 33527 (813) 312-1558 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Family Practice - cont. Medidi, Subhakararao MD Provider ID: 1114671 Gender: Male Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Mehuron, Sarah MD Provider ID: 1065522 Gender: Female Fhpg Patients First of Countryway 6918 Gunn Hwy Tampa, FL 33625 (813) 891-6310 Fax: (813) 891-6889 00 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:00 AM - 5:00 PM PCMH: No Mehuron, Sarah MD

Medidi, Subhakararao MD Provider ID: 1114673 Gender: Male Ruskin HC 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/130 Yrs Tampa General Hospital MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Medidi, Subhakararao MD Provider ID: 149384 Gender: Male Suncoast Community Health Centers 14254 Martin Luther King Blvd Dover, FL 33527 (813) 349-7700 Fax: (813) 349-7761 00 Yrs/130 Yrs Tampa General Hospital MTHF 7:00 AM - 5:00 PM TW 10:00 AM - 7:00 PM PCMH: No

Provider ID: 798418 Gender: Female Fhpg Patient's First of Countryway 11663 Countryway Blvd Tampa, FL 33626 (813) 891-6310 Fax: (813) 891-6889 00 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Naran, Sage MD Provider ID: 1311832 Gender: Male Fhpg Brandon Family Medical Care 1218 Millennium Pkwy Brandon, FL 33511 (813) 684-5255 Fax: (813) 654-7457 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Naran, Sage MD Provider ID: 1311834 Gender: Male Fhpg Brandon Family Medical Care 13007 Summerfield Square Dr Riverview, FL 33578 (813) 684-5255 Fax: (813) 654-7457 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Noorani, Nazneen MD Provider ID: 698607 Gender: Female Noorani Medical Center LLC 4320 Bell Shoals Rd Valrico, FL 33596 (813) 571-1111 Fax: (813) 571-1120 18 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish, Hindi, Urdu MTWF 8:00 AM - 4:00 PM TH 8:00 AM - 6:00 PM PCMH: No Obrien, James DO Provider ID: 1073464 Gender: Male Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 349-7880 Fax: (813) 633-2669 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Obrien, James DO Provider ID: 1073465 Gender: Male Brandon CHC 710 Oakfield Dr Ste 120 Brandon, FL 33511 (813) 423-7101 Fax: (813) 423-7102 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Obrien, James DO Provider ID: 1073467 Gender: Male Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Obrien, James DO Provider ID: 1073469 Gender: Male Suncoast Mobile Medical Bus 14254 SR 574 Dover, FL 33527 (813) 312-1558 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No O'Brien, James DO Provider ID: 918979 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No O'Brien, James DO Provider ID: 918991 Gender: Male Oakfield Community Health Center 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Pinilla, Sandra MD Provider ID: 1231597 Gender: Female Fhpg Tampa Primary Care 13801 Bru B Downs Blvd Ste 201 Tampa, FL 33613 (813) 559-9287 Fax: (813) 559-9299 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Family Practice - cont. Pothiawala, Yakub MD Provider ID: 27354 Gender: Male Northdale Family Doctor 3865 Northdale Blvd Tampa, FL 33624 (813) 960-4401 Fax: (813) 265-1258 00 Yrs/130 Yrs Florida Hospital Tampa Manatee Memorial Hospital St Josephs Hospital Languages: Spanish, Hindi, Urdu M-F 9:00 AM - 5:00 PM PCMH: No Rahman, Farhana MD Provider ID: 1354713 Gender: Female Fhpg Temple Terrace Primary Care 11420 N 56th St Tampa, FL 33613 (813) 971-3136 Fax: (813) 910-3569 12 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Ross-Johnson, Angela MD Provider ID: 580986 Gender: Female Continucare Medical Group At South 200 S Macdill Ave Tampa, FL 33609 (813) 837-2814 Fax: (813) 839-4336 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Santiago, Sylvia MD Provider ID: 1132935 Gender: Female Wimauma Community Health Center 5121 SR 674 Wimauma, FL 33598 (813) 349-7880 Fax: (813) 633-2669 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Santiago, Sylvia MD Provider ID: 1132937 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7600 Fax: (813) 349-7661 00 Yrs/130 Yrs MWTHF 7:45 AM - 5:00 PM T 7:45 AM - 7:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Santiago, Sylvia MD Provider ID: 1132953 Gender: Female Tom Lee Community Health Center 14254 SR 574 Dover, FL 33527 (813) 349-7700 Fax: (813) 349-7761 00 Yrs/130 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Sehres, Randell MD Provider ID: 1314032 Gender: Male Fhpg Brandon Family Medical Care 13007 Summerfield Square Dr Riverview, FL 33578 (813) 684-5255 Fax: (813) 654-7457 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Sehres, Randell MD Provider ID: 1314033 Gender: Male Fhpg Brandon Family Medical Care 1218 Millennium Pkwy Brandon, FL 33511 (813) 684-5255 Fax: (813) 654-7457 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Shaub, Brian DO Provider ID: 1111739 Gender: Male Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 349-7880 Fax: (813) 633-2669 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Shaub, Brian DO Provider ID: 1355825 Gender: Male Brandon Community Health Center 313 S Lakewood Dr Brandon, FL 33511 (813) 653-6100 Fax: (813) 938-6428 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Shaub, Brian DO Provider ID: 1355827 Gender: Male Suncoast Mobile Medical Bus 14254 State Rd 574 Dover, FL 33527 (813) 653-6100 Fax: (813) 938-6422 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Shaub, Brian DO Provider ID: 202801 Gender: Male Brandon CHC 710 Oakfield Dr Ste 120 Brandon, FL 33511 (813) 423-7101 Fax: (813) 423-7102 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Shaub, Brian DO Provider ID: 294012 Gender: Male Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Shaub, Brian DO Provider ID: 382907 Gender: Male Tom Lee Community Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7761 00 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Shaub, Brian DO Provider ID: 382908 Gender: Male Tom Lee Community Health Center 14254 SE 574 Dover, FL 33527 (813) 653-6100 Fax: (813) 349-7761 00 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Family Practice - cont. Shaub, Brian DO Provider ID: 382909 Gender: Male Tom Lee Community Health Center 508 N Maryland Ave Plant City, FL 33566 (813) 653-6100 Fax: (813) 349-7761 00 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Tejiram Martinez, Romeena DO Provider ID: 1064321 Gender: Female Fhpg Temple Terrace Family Care 11420 N 56th St Temple Terrace, FL 33617 (813) 971-3136 Fax: (813) 910-3459 18 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Urso, Gaetano DO Provider ID: 4757 Gender: Male Gaetano Urso MD 10866 Sheldon Rd Tampa, FL 33626 (813) 920-0746 Fax: (813) 920-5250 02 Yrs/130 Yrs Florida Hospital Tampa Tampa Community Hospital Tampa General Hospital Languages: Spanish, Italian M-F 9:00 AM - 5:00 PM PCMH: No

Valdes, Ruben DO Provider ID: 27458 Gender: Male Drs Urso & Valdes 7519 Paula Dr Tampa, FL 33615 (813) 884-1478 Fax: (813) 884-1798 18 Yrs/130 Yrs Florida Hospital Carrollwood Tampa Community Hospital Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Velasco Segarra, Luis MD Provider ID: 1426169 Gender: Male Renaissance Medical Center Corp 3832 W Humphrey St Tampa, FL 33614 (813) 298-9740 Fax: (813) 502-0290 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

General Practice

Vana, Ted DO Provider ID: 1076798 Gender: Male Continuecare South Tampa 200 S Macdill Ave Ste 100 Tampa, FL 33609 (813) 837-2814 Fax: (813) 839-4336 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Alvarez, Edel MD Provider ID: 1174553 Gender: Male North Tampa Medical Center 8726 W Waters Ave Tampa, FL 33615 (813) 712-1726 Fax: (813) 925-4640 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Vana, Ted DO Provider ID: 1076800 Gender: Male Continuecare Medical Center Plant C 228 W Alexander St Plant City, FL 33563 (813) 754-5480 Fax: (813) 754-2251 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Alvarez, Edel MD Provider ID: 1174555 Gender: Male North Tampa Medical Center 11211 N Nebraska Ave A-5 Tampa, FL 33612 (813) 517-4888 Fax: (813) 482-0015 02 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Vargas, Gisela MD Provider ID: 1176770 Gender: Female Jay Care Medical Center 5015 E Busch Blvd Tampa, FL 33617 (813) 988-4400 Fax: (813) 988-4401 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Del Toro Rivera, Eliud MD Provider ID: 1209896 Gender: Male American Care of Tampa Inc 8726 W Waters Ave Tampa, FL 33615 (813) 712-1726 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Esoga, Kelechi MD Provider ID: 1223007 Gender: Male Jay Care Medical Center 1509 W Reynolds St Plant City, FL 33563 (813) 704-6905 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fernandez, Juan MD Provider ID: 644951 Gender: Male 4618 N Armenia Ave Tampa, FL 33603 (813) 876-0400 Fax: (813) 876-0440 02 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Garcia, Nestor MD Provider ID: 1162086 Gender: Male Jay Care Medical Center 1509 W Reynolds St Plant City, FL 33563 (813) 704-6905 Fax: (813) 704-5998 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gomez Cordoba, Gerardo MD Provider ID: 1202863 Gender: Male American Care 11211 N Nebraska Ave Ste A 5 Tampa, FL 33612 (813) 514-2333 Fax: (813) 482-0015 02 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough General Practice - cont. Herrera, Cesar MD Provider ID: 1170021 Gender: Male American Care 11211 N Nebraska Ave Ste A5 Tampa, FL 33612 (813) 514-2333 Fax: (813) 482-0015 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lafontant, Anne MD Provider ID: 1223026 Gender: Female Jay Care Medical Center 1509 W Reynolds St Plant City, FL 33563 (813) 704-6905 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Miranda-Genaro, Luis MD Provider ID: 903367 Gender: Male Luis S Miranda Genaro 6800 N Dale Mabry Hwy Ste 198B Tampa, FL 33614 (813) 935-1944 Fax: (813) 884-1955 05 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM PCMH: No Patel, Mangesh MD Provider ID: 25429 Gender: Male Mangesh Patel 1030 S 78th St Tampa, FL 33619 (813) 740-0646 Fax: (813) 849-0894 02 Yrs/130 Yrs Florida Hospital Tampa Languages: Spanish, Hindi, Gujarati MTTHF 8:30 AM - 5:30 PM W 8:30 AM - 12:30 PM PCMH: No

Sanchez, Ramon MD Provider ID: 806673 Gender: Male 4600 N Habana Ave Ste 32 Tampa, FL 33614 (813) 423-6515 Fax: (813) 876-6677 18 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Talero, Guillermo MD Provider ID: 302038 Gender: Male Meditech Medical Centers 5110 N Habana Ave Ste 2 Tampa, FL 33614 (813) 915-9000 Fax: (813) 915-2701 00 Yrs/130 Yrs Armenia Ambulatory Surgery Center Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wilson Chan, Jessica DO Provider ID: 587796 Gender: Female Hillsborough Medical Associates LLC 7519 Paula Dr Tampa, FL 33615 (813) 884-1478 Fax: (813) 884-1798 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Internal Medicine Ackley, Karen MD Provider ID: 395513 Gender: Female Internal Medicine Pediatrics of Ta 10111 Wilsky Blvd Tampa, FL 33625 (813) 961-2222 00 Yrs/21 Yrs St Josephs Hospital Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM PCMH: No

Alarcon, Rene MD Provider ID: 484 Gender: Male Meditech Medical Centers LLC 1783 S Kings Ave Brandon, FL 33511 (813) 315-9896 Fax: (813) 662-4818 16 Yrs/130 Yrs Columbia South Bay Hospital M-F 8:00 AM - 5:00 PM PCMH: No Amin, Mukund MD Provider ID: 207699 Gender: Male 3120 W Hillsborough Ave Tampa, FL 33614 (813) 877-7773 Fax: (813) 877-3771 21 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital Languages: Spanish, Hindi, Gujarati, Swahili M-F 9:00 AM - 4:45 PM PCMH: No Atluri, Tej MD Provider ID: 729104 Gender: Male Health Associates of Tampa Bay PA 608 S Tampania Ave Tampa, FL 33609 (813) 887-6770 Fax: (813) 877-6771 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital Languages: Hindi, Telugu M-F 9:00 AM - 5:00 PM PCMH: No

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Bhadja, Kantilal MD Provider ID: 789 Gender: Male Crosstown Medical Center 4223 W El Prado Blvd Tampa, FL 33629 (813) 839-5253 Fax: (813) 839-2953 21 Yrs/130 Yrs Languages: Spanish, Gujarati MTTHF 8:00 AM - 4:00 PM W 8:00 AM - 5:00 PM PCMH: No Bilella, Mark MD Provider ID: 224474 Gender: Male Internal Medicine and Pediatrics 10111 Wilsky Blvd Tampa, FL 33625 (813) 961-2222 Fax: (813) 961-2220 00 Yrs/130 Yrs St Josephs Hospital Languages: Spanish M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Bowman, Steven MD Provider ID: 324499 Gender: Male Seffner Premier Healthcare PA 907 N Parsons Ave Brandon, FL 33510 (813) 689-8020 Fax: (813) 689-8381 12 Yrs/130 Yrs Mease Hospital Dunedin M-TH 9:00 AM - 5:00 PM F 9:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Internal Medicine - cont. Chazhikattu, Ambrose John Braver, Yvonne MD Provider ID: 1217407 Gender: Female Brandon Internal Medicine 511 W Alexander St Ste 2 Plant City, FL 33563 (813) 659-8960 Fax: (813) 754-3130 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Brinn, Nathan MD Provider ID: 1109914 Gender: Male 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brinn, Nathan MD Provider ID: 1109916 Gender: Male 128 S W. Shore Blvd Ste C Tampa, FL 33609 (813) 974-2201 Fax: (813) 281-5508 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Cannon, Aileen MD Provider ID: 708856 Gender: Female 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

MD Provider ID: 1013838 Gender: Male The Health Associates of Tampa 508 S Habana Ave Tampa, FL 33609 (813) 877-6770 Fax: (813) 877-6771 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital Languages: Hindi, Malayalam, Kannada M-F 9:00 AM - 5:00 PM PCMH: No Choksi, Tarak MD Provider ID: 292393 Gender: Male Sunmed Primary Care 18928 N Dale Mabry Hwy Ste 101 Lutz, FL 33548 (813) 909-1146 Fax: (813) 909-4334 18 Yrs/130 Yrs Florida Hospital Carrollwood Languages: Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Craft, Mark MD Provider ID: 801298 Gender: Male Fhpg Brandon Primary Care 428 W Brandon Blvd Brandon, FL 33511 (813) 681-4444 Fax: (813) 661-8763 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No

Cuevas, Hiram MD Provider ID: 7449 Gender: Male Meditech Medical Centers LLC 7926 W Hillsborough Ave Ste A Tampa, FL 33615 (813) 885-6538 Fax: (813) 885-9684 18 Yrs/130 Yrs Florida Hospital Tampa Tampa Community Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

Datta, Indrani MD Provider ID: 927353 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 12 Yrs/130 Yrs Languages: Bengali MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

Datta, Indrani MD Provider ID: 927354 Gender: Female Plant City Family Care Datta, Indrani MD 508 N Maryland Ave Provider ID: 1097130 Plant City, FL 33563 Gender: Female (813) 349-7600 Wimauma Community Health Fax: (813) 349-7661 Center 12 Yrs/130 Yrs 5121 SR 674 Languages: Bengali Wimauma, FL 33598 MWTHF 9:00 AM - 5:00 PM (813) 349-7880 T 9:00 AM - 7:00 PM Fax: (813) 633-2669 PCMH: No 12 Yrs/130 Yrs Languages: Bengali Datta, Indrani MD M-F 8:00 AM - 5:00 PM Provider ID: 927355 PCMH: No Gender: Female Tom Lee Community Health Datta, Indrani MD Center Provider ID: 1097132 14254 SR 574 Gender: Female Dover, FL 33527 Palm River CHC (813) 349-7700 7728 Palm River Rd Fax: (813) 349-7761 Tampa, FL 33619 12 Yrs/130 Yrs (813) 653-6100 Languages: Bengali Fax: (813) 620-1614 MWTHF 9:00 AM - 5:00 PM 12 Yrs/130 Yrs T 9:00 AM - 7:00 PM Languages: Bengali PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Datta, Indrani MD Provider ID: 927357 Gender: Female Oakfield Community Health Center 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 12 Yrs/130 Yrs Languages: Bengali MWTHF 9:00 AM - 5:00 PM T 9:00 AM - 7:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Hillsborough Internal Medicine - cont. Eldin, Adel MD Demery, Frank MD Provider ID: 224476 Gender: Male Internal Medicine and Pediatrics 10111 Wilsky Blvd Tampa, FL 33625 (813) 961-2222 Fax: (813) 961-2220 00 Yrs/130 Yrs St Josephs Hospital M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Diasti, Sam MD Provider ID: 982125 Gender: Male Pinnacle Health Gorup PA 2605 W Swann Ave Ste 100 Tampa, FL 33609 (813) 874-5500 Fax: (813) 874-5505 12 Yrs/130 Yrs M-TH 8:00 AM - 4:30 PM F 8:00 AM - 12:00 PM PCMH: No Durojaiye, Babatola MD Provider ID: 983910 Gender: Male New Tampa Medical Center PA 5381 Primrose Lake Cir Tampa, FL 33647 (813) 615-2488 Fax: (813) 615-2504 18 Yrs/130 Yrs St Josephs Hospital Languages: Mandarin MTTHF 8:00 AM - 5:00 PM W 9:00 AM - 6:00 PM PCMH: No

Provider ID: 22560 Gender: Male Terrace Family Health 10801 N 56th St Temple Terrace, FL 33617 (813) 988-2700 Fax: (813) 988-2779 18 Yrs/110 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill CRMC At Bayonet Point Languages: Arabic M-F 8:00 AM - 5:00 PM PCMH: No Farooqui, Zubair MD Provider ID: 1124820 Gender: Male Zubair Farooqui MD LLC 14486 University Cove Pl Tampa, FL 33613 (813) 252-2770 Fax: (813) 252-2772 18 Yrs/130 Yrs Languages: Spanish, Hindi, Urdu M-F 8:30 AM - 5:00 PM PCMH: No Garcia Jr, Jose MD Provider ID: 1170915 Gender: Male American Care of Tampa Inc 8726 W Waters Ave Tampa, FL 33615 (813) 712-1726 Fax: (813) 925-4640 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Ghaly, Milia MD Provider ID: 1431418 Gender: Female Tampa General Medical Group Inc/Tgm 1647 Scc Plz Ste 104 Sun City Center, FL 33573 (813) 844-4700 Fax: (813) 844-1976 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Guerra, Lucy MD Provider ID: 230255 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5200 Fax: (813) 236-5332 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Hanna, Maher MD Provider ID: 1324956 Gender: Male Sun Med Primary Care 13701 N Nebraska Ave Ste 107 Tampa, FL 33613 (813) 374-9266 Fax: (813) 374-9267 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Hardiman, James MD Provider ID: 1055594 Gender: Male Specialist Doctors Group 1910 W Reynolds St Plant City, FL 33563 (813) 752-7255 Fax: (813) 719-3175 00 Yrs/130 Yrs Languages: Spanish, Cambodian MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Holt, Douglas MD Provider ID: 1016306 Gender: Male Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8060 Fax: (813) 276-2999 12 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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King, Kelly MD Provider ID: 1053253 Gender: Female Help US Help U 3228 Cove Bend Dr Tampa, FL 33613 (813) 279-6787 Fax: (813) 330-3129 05 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Knox, Brian MD Provider ID: 564904 Gender: Male 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Knox, Brian MD Provider ID: 709264 Gender: Male USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Lamartin, Kimberly MD Provider ID: 1289497 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5200 Fax: (813) 236-5332 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Internal Medicine - cont. Maningo, Evelyn MD Machado, Francisco MD Provider ID: 241560 Gender: Male Continucare Medical Group 228 W Alexander St Plant City, FL 33563 (813) 754-5480 Fax: (813) 754-2251 18 Yrs/130 Yrs JFK Medical Center Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Maningo, Evelyn MD Provider ID: 1071932 Gender: Female Brandon CHC 710 Oakfield Dr Ste 120 Brandon, FL 33511 (813) 423-7101 Fax: (813) 423-7102 12 Yrs/130 Yrs Columbia South Bay Hospital Putnam Community Hospital Tampa General Hospital Languages: Filipino M-F 8:00 AM - 5:00 PM PCMH: No Maningo, Evelyn MD Provider ID: 1073137 Gender: Female Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 12 Yrs/130 Yrs Columbia South Bay Hospital Putnam Community Hospital Tampa General Hospital Languages: Filipino MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

Provider ID: 1073139 Gender: Female Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 349-7880 Fax: (813) 633-2669 12 Yrs/130 Yrs Languages: Filipino MWTHF 8:00 AM - 5:00 PM T 10:00 AM - 5:00 PM PCMH: No Maningo, Evelyn MD Provider ID: 1073141 Gender: Female Suncoast Mobile Medical Bus 14254 SR 574 Dover, FL 33527 (813) 653-6100 12 Yrs/130 Yrs Languages: Filipino M-F 8:00 AM - 5:00 PM PCMH: No Maningo, Evelyn MD Provider ID: 1073142 Gender: Female Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 12 Yrs/130 Yrs Languages: Filipino M-F 8:00 AM - 5:00 PM PCMH: No

Maningo, Evelyn MD Provider ID: 801173 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 12 Yrs/130 Yrs Columbia South Bay Hospital Putnam Community Hospital Tampa General Hospital Languages: Filipino M-F 8:00 AM - 5:00 PM PCMH: No Mehta, Shital DO Provider ID: 273721 Gender: Male Citrus Park Medical Care 6328 Gunn Hwy Tampa, FL 33625 (813) 964-8526 Fax: (813) 964-8536 21 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No Mena Perez, Raysa MD Provider ID: 1014601 Gender: Female Jay Care Medical Center 1509 W Reynolds St Plant City, FL 33563 (813) 704-6905 Fax: (813) 704-5998 12 Yrs/130 Yrs Bartow Regional Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Mole, Jose MD Provider ID: 1144375 Gender: Male Jose R Mole MD PA 2931 W Hillsborough Ave Tampa, FL 33614 (813) 930-0930 Fax: (813) 930-0950 18 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Moran, Byron MD Provider ID: 1108168 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2142 Fax: (813) 974-7550 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Narvarte, Hugo MD Provider ID: 292672 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-4280 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Nnadi, Chinyere MD Provider ID: 329231 Gender: Female Continucare Medical Group 228 W Alexander St Plant City, FL 33563 (813) 754-5480 Fax: (813) 754-2251 18 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Internal Medicine - cont. Pagan, Carlos MD Oliva, Adela MD Provider ID: 1163986 Gender: Female Fhpg Internal Medicine of Brandon 1439 Oakfield Dr Brandon, FL 33511 (813) 689-2853 Fax: (813) 654-1722 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Oliva, Robert MD Provider ID: 1156672 Gender: Male Fhpg Internal Medicine of Brandon 1439 Oakfield Dr Brandon, FL 33511 (813) 689-2853 Fax: (813) 654-1722 16 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 9:00 AM - 5:00 PM PCMH: No Oxner, ASA MD Provider ID: 1008069 Gender: Female 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7550 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 2 Oxner, ASA MD Provider ID: 1008069 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5200 Fax: (813) 236-5332 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 21523 Gender: Male Carlos B Pagan MD 3677 W Waters Ave Tampa, FL 33614 (813) 933-7805 Fax: (813) 935-3564 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital Languages: Spanish M-F 8:00 AM - 4:30 PM PCMH: No

Patel, Chandravadan MD Provider ID: 1418081 Gender: Male Forest Hills Health Care Inc 613 W MLK Blvd Ste 101 Tampa, FL 33603 (813) 237-1958 Fax: (813) 237-8147 18 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Panchigar, Nimesh MD Provider ID: 246118 Patel, Chandravadan MD Gender: Male Tampa Internist PA Provider ID: 200020 4543 S Manhattan Ave Ste 103 Gender: Male Tampa, FL 33611 Alpha Medical Clinic (813) 831-8888 1115A E Hillsborough Ave Fax: (813) 831-6292 Tampa, FL 33604 18 Yrs/130 Yrs (813) 238-4499 Memorial Hospital of Tampa Fax: (813) 237-0040 Tampa General Hospital 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Florida Hospital Tampa PCMH: No St Josephs Hospital Languages: Spanish Parker, Glenda MD M-F 8:00 AM - 5:00 PM Provider ID: 987334 PCMH: No Gender: Female Patel, Chandravadan MD Fhpg Carrollwood Family Practice Provider ID: 28877 3615 W Hamilton Ave Gender: Male Tampa, FL 33614 Forest Hills Health Care Inc (813) 977-0281 116 W Bougainvillea Ave Fax: (813) 977-0536 Tampa, FL 33612 18 Yrs/130 Yrs (813) 932-4381 Memorial Hospital of Tampa Fax: (813) 933-6875 M-TH 8:00 AM - 5:00 PM 18 Yrs/130 Yrs F 8:00 AM - 6:00 PM Florida Hospital Tampa PCMH: No St Josephs Hospital Languages: Spanish, Gujarati Patel, Ankit MD M-F 8:00 AM - 5:00 PM Provider ID: 1354686 PCMH: No Gender: Male Fhpg Temple Terrace Primary Care 11420 N 56th St Tampa, FL 33613 (813) 971-3136 Fax: (813) 910-3569 18 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

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Patel, Krunal MD Provider ID: 1208656 Gender: Male Forest Hills Health Care 116 W Bougainvillea Ave Tampa, FL 33612 (813) 932-4381 Fax: (813) 933-6875 18 Yrs/110 Yrs Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Patel, Krunal MD Provider ID: 1208657 Gender: Male Alpha Medical Clinic 1115A E Hillsborough Ave Tampa, FL 33604 (813) 238-4499 Fax: (813) 237-0040 18 Yrs/110 Yrs Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Patel, Krunal MD Provider ID: 1418084 Gender: Male Forest Hills Health Care 613 W MLK Blvd Ste 101 Tampa, FL 33612 (813) 237-1958 Fax: (813) 237-8147 18 Yrs/110 Yrs Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Internal Medicine - cont. Quadri, A H Zehra MD Patel, Pritesh MD Provider ID: 273629 Gender: Male Sunmed Primary Care 18928 N Dale Mabry Hwy Ste 101 Lutz, FL 33548 (813) 909-1146 Fax: (813) 909-4334 18 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi, Gujarati MWTH 8:00 AM - 5:00 PM T 1:30 AM - 4:00 PM F 9:00 AM - 12:30 PM PCMH: No Patel, Rajnikant MD Provider ID: 307030 Gender: Male Wellmed At Stonerock Lake 10616 Main St Thonotosassa, FL 33592 (813) 986-1346 Fax: (813) 986-6642 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Poblete, Sarah Jessica MD Provider ID: 169073 Gender: Female 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-0344 Fax: (813) 254-0230 18 Yrs/130 Yrs Tampa General Hospital Languages: Filipino M-F 7:30 AM - 10:00 PM Sat 9:00 AM - 4:00 PM PCMH: Yes, Level 3

Provider ID: 555132 Gender: Female Continucare Medical Center Plant Ci 228 W Alexander St Plant City, FL 33563 (813) 754-5480 Fax: (813) 754-2251 18 Yrs/130 Yrs Brandon Outpatient Surgery Center Languages: Hindi, Urdu M-F 8:00 AM - 5:00 PM PCMH: No Ramiro, Lucila MD Provider ID: 2662 Gender: Female Tgmg Fcc Kennedy 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-0344 Fax: (813) 254-0230 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital Languages: Spanish, French M-F 7:30 AM - 10:00 PM Sat 9:00 AM - 4:00 PM PCMH: Yes, Level 3 Samper-Pena, Carolina MD Provider ID: 1181 Gender: Female Primary Care Group LLC 7820 N Armenia Ave Tampa, FL 33604 (813) 935-6334 Fax: (813) 930-2835 12 Yrs/130 Yrs Florida Hospital Tampa Tampa Community Hospital Tampa General Hospital Languages: Spanish MWTH 8:30 AM - 5:00 PM TF 8:30 AM - 12:30 PM PCMH: No

Santiago, Yvonne MD Provider ID: 1109354 Gender: Female Fhpg Carrollwood Primary Care 14310 N Dale Mabry Hwy Ste 300 Tampa, FL 33618 (813) 915-5626 Fax: (813) 915-5634 00 Yrs/130 Yrs Florida Hospital Carrollwood M-F 8:00 AM - 5:00 PM PCMH: No Saprounova-Hopf, Vera MD Provider ID: 313999 Gender: Female Complete Health of Tampa Bay PA 1426 Bloomingdale Ave Valrico, FL 33596 (813) 684-8020 Fax: (813) 684-8206 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Lakeland Reg Medical Center Languages: Spanish, Russian M 8:00 AM - 6:00 PM TTH 9:00 AM - 6:00 PM WF 9:00 AM - 5:00 PM PCMH: No Serrano, Gustavo MD Provider ID: 1158247 Gender: Male Gustavo Serrano, MD 5101 N Armenia Ave Ste A Tampa, FL 33603 (813) 870-6477 Fax: (813) 870-6567 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital M-F 8:00 AM - 4:30 PM PCMH: No

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Shires-Waldron, Sarah MD Provider ID: 2661 Gender: Female Tgmg Fcc Kennedy 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-1385 Fax: (813) 254-0230 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, French, Tagalog, Malayalam M-F 7:30 AM - 8:00 PM Sat 9:00 AM - 4:00 PM PCMH: Yes, Level 3 Silva, Luis MD Provider ID: 426879 Gender: Male Seffner Premier Healthcare PA 907 N Parsons Ave Brandon, FL 33510 (813) 689-8020 Fax: (813) 689-8381 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Singh, Japinder MD Provider ID: 365354 Gender: Male Jaycare Medical Center 5015 E Busch Blvd Tampa, FL 33617 (813) 988-4400 Fax: (813) 988-4401 18 Yrs/130 Yrs Brandon Regional Hospital Lakeland Reg Medical Center Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Internal Medicine - cont. Talakkottur, Charles MD Somboonwit, Charurut MD Provider ID: 1007146 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Spoor, Lori DO Provider ID: 900952 Gender: Female Tampa General Medical Group 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-0344 Fax: (813) 254-0230 00 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 10:00 PM Sat 9:00 AM - 4:00 PM PCMH: Yes, Level 3 Tabatabaian, Farnaz MD Provider ID: 1129503 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2142 Fax: (813) 974-7550 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 443330 Gender: Male TLC Medical Inc 5106 N Armenia Ave Ste 1 Tampa, FL 33603 (813) 874-1852 Fax: (813) 227-8526 18 Yrs/130 Yrs Florida Hospital Tampa Memorial Hospital of Tampa Tampa General Hospital Languages: Spanish M-TH 9:00 AM - 4:45 PM F 9:00 AM - 11:45 PM PCMH: No Toribio, Fiordaliza MD Provider ID: 224851 Gender: Female Toribio Medical Inc 6301 Memorial Hwy Ste 104 Tampa, FL 33615 (813) 886-0713 Fax: (813) 881-1848 18 Yrs/130 Yrs Florida Hospital Tampa Lakeland Reg Medical Center Memorial Hospital of Tampa Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Ventura, Hugo MD Provider ID: 1163936 Gender: Male Healthy Family Medical Group, PLLC 1138 Nikki View Dr Brandon, FL 33511 (813) 393-1500 Fax: (813) 393-1501 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Warner, Elizabeth MD Provider ID: 7293 Gender: Female Tgmg Fcc Kennedy 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-1385 Fax: (813) 254-0230 18 Yrs/130 Yrs Tampa General Hospital M-TH 7:30 AM - 8:00 PM F 9:00 AM - 4:00 PM PCMH: Yes, Level 3

Pediatrics Abaunza-Fiallos, Yanina MD Provider ID: 951502 Gender: Female 17541 N Dale Mabry Hwy Lutz, FL 33548 (813) 964-1800 Fax: (813) 964-1880 00 Yrs/18 Yrs St Josephs Hospital MTTHF 8:30 AM - 5:30 PM W 8:30 AM - 3:30 PM PCMH: No Ackley, Karen MD Provider ID: 395513 Gender: Female Internal Medicine Pediatrics of Ta 10111 Wilsky Blvd Tampa, FL 33625 (813) 961-2222 00 Yrs/21 Yrs St Josephs Hospital Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM PCMH: No

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Adnan, Khan MD Provider ID: 17998 Gender: Male N Pinellas Childrens Medical Center 12780 Race Track Rd Ste 305 Tampa, FL 33626 (813) 891-6501 Fax: (813) 891-6502 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Aime, John MD Provider ID: 1428 Gender: Male John S Aime MD 212 N Alexander St Plant City, FL 33563 (813) 752-9556 Fax: (813) 754-5709 00 Yrs/18 Yrs Languages: Spanish MWTHF 9:00 AM - 5:00 PM T 9:00 AM - 12:00 PM PCMH: No Albanna, Issam MD Provider ID: 152700 Gender: Male 3288 Cove Bend Dr Tampa, FL 33613 (813) 979-4435 Fax: (813) 979-4026 00 Yrs/18 Yrs Bayfront Health Dade City Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Arabic M-TH 8:00 AM - 4:30 PM F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Alfaro, Carmen MD Provider ID: 1084038 Gender: Female Schc Pediatrics 502 N Mobley St Plant City, FL 33563 (813) 349-7450 Fax: (813) 349-7655 00 Yrs/18 Yrs Tampa General Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Alfaro, Carmen MD Provider ID: 1084041 Gender: Female Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/18 Yrs Tampa General Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Alfaro, Carmen MD Provider ID: 1084045 Gender: Female Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 653-6100 Fax: (813) 633-2669 00 Yrs/18 Yrs Tampa General Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

Alfaro, Carmen MD Provider ID: 1084048 Gender: Female Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/18 Yrs Tampa General Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Alfaro, Carmen MD Provider ID: 1138363 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7861 00 Yrs/18 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Alfaro, Carmen MD Provider ID: 314228 Gender: Female Tom Lee Community Health Center 14254 SR 574 Dover, FL 33527 (813) 349-7600 Fax: (303) 744-6983 00 Yrs/18 Yrs Tampa General Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No

Allison, Joanna MD Provider ID: 199464 Gender: Female N Pinellas Childrens Medical Center 12780 Race Track Rd Ste 305 Tampa, FL 33626 (813) 891-6501 Fax: (813) 891-6502 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Languages: Spanish, Greek M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Arango, Jan MD Provider ID: 816278 Gender: Female St Petersburg Pediatrics Tampa 2550 W MLK Jr Blvd Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1760 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Armstrong, Christine MD Provider ID: 200311 Gender: Female North Pinellas Pediatrics 12780 Race Track Rd Ste 305 Tampa, FL 33626 (813) 891-6501 Fax: (813) 891-6502 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Medical Center of Trinity Morton Plant Hospital Languages: Spanish, German M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3

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Arroyo Jr, Jose MD Provider ID: 1100365 Gender: Male Ruskin HC 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Arroyo Jr, Jose MD Provider ID: 1100367 Gender: Male Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Arroyo Jr, Jose MD Provider ID: 1100368 Gender: Male Suncoast Mobile Medical Bus 14254 SR 574 Dover, FL 33527 (813) 312-1558 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Arroyo Jr, Jose MD Provider ID: 1100369 Gender: Male Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Barriga, Julia MD Provider ID: 208288 Gender: Female 5001 E Busch Blvd Tampa, FL 33617 (813) 984-8846 Fax: (813) 984-8827 00 Yrs/18 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish MTTHF 9:00 AM - 5:00 PM W 9:00 AM - 1:00 PM PCMH: No Bartelt, Erica MD Provider ID: 723237 Gender: Female Nadal Pediatrics 376 E Bloomingdale Ave Brandon, FL 33511 (813) 681-7101 Fax: (813) 571-7158 00 Yrs/21 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM F 8:00 AM - 5:00 PM PCMH: No Bilella, Mark MD Provider ID: 224474 Gender: Male Internal Medicine and Pediatrics 10111 Wilsky Blvd Tampa, FL 33625 (813) 961-2222 Fax: (813) 961-2220 00 Yrs/130 Yrs St Josephs Hospital Languages: Spanish M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No

Bou-Gauthier, Salvador MD Provider ID: 14575 Gender: Male Doctor Bou Pediatrics Inc 1507 W Reynolds St Ste A Plant City, FL 33563 (813) 719-3716 Fax: (813) 759-2487 00 Yrs/17 Yrs Brandon Regional Hospital Languages: Spanish MTTHF 9:00 AM - 5:00 PM W 9:00 AM - 12:00 PM PCMH: No Brinn, Nathan MD Provider ID: 1109914 Gender: Male 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brinn, Nathan MD Provider ID: 1109916 Gender: Male 128 S W. Shore Blvd Ste C Tampa, FL 33609 (813) 974-2201 Fax: (813) 281-5508 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Burton, Tracy MD Provider ID: 789825 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Burton, Tracy MD Provider ID: 789827 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 234-2803 00 Yrs/21 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Cannon, Aileen MD Provider ID: 708856 Gender: Female 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cibran, Mariano MD Provider ID: 817040 Gender: Male St Petersburg Pediatrics Tampa 2550 W MLK Jr Blvd Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1760 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Dabrow, Sharon MD Provider ID: 7060 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8749 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Dabrow, Sharon MD Provider ID: 921650 Gender: Female USF Physicians Group 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital University Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Dabrow, Sharon MD Provider ID: 921653 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 234-2803 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital University Hospital M-F 8:00 AM - 5:00 PM PCMH: No De Brigard, Tomas MD Provider ID: 228168 Gender: Male De Brigard Pediatrics PA 711 N Parsons Ave Brandon, FL 33510 (813) 662-1200 Fax: (813) 662-1151 00 Yrs/18 Yrs Brandon Regional Hospital Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Demery, Frank MD Provider ID: 224476 Gender: Male Internal Medicine and Pediatrics 10111 Wilsky Blvd Tampa, FL 33625 (813) 961-2222 Fax: (813) 961-2220 00 Yrs/130 Yrs St Josephs Hospital M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Derasari, Kalyani MD Provider ID: 692922 Gender: Female 4202 E Fowler Ave Shs 100 Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 00 Yrs/130 Yrs Languages: Hindi, Gujarati, Swahili M-F 9:00 AM - 5:00 PM PCMH: No Desrosiers, Florence MD Provider ID: 1119160 Gender: Female USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-0604 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Donkor, Cynthia MD Provider ID: 688148 Gender: Female Tampa Family Health Centers, Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 865-0158 00 Yrs/21 Yrs Languages: Spanish M 8:00 AM - 8:80 PM TWTHF 8:00 AM - 8:00 PM Sat 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Duggirala, Sita MD Provider ID: 369592 Gender: Female 7730 W Waters Ave Tampa, FL 33615 (813) 887-1010 Fax: (813) 887-1021 00 Yrs/21 Yrs Bayfront Health Spring Hill Languages: Telugu M-F 8:00 AM - 5:00 PM PCMH: No Edwards, Denise MD Provider ID: 334762 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 2 Edwards, Denise MD Provider ID: 435901 Gender: Female USF Physicicans Group 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Edwards, Denise MD Provider ID: 798114 Gender: Female USF Physicians Group 128 S W. Shore Blvd Tampa, FL 33609 (813) 974-2201 Fax: (813) 281-5508 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Emara, Magdi MD Provider ID: 179607 Gender: Male All Kids Pediatrics 5415 E Busch Blvd Tampa, FL 33617 (813) 984-6200 Fax: (813) 984-6066 00 Yrs/21 Yrs Florida Hospital Tampa Languages: Spanish, Arabic M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No Fauber, Dean MD Provider ID: 475032 Gender: Male N Pinellas Childrens Medical Center 12780 Race Track Rd Ste 305 Tampa, FL 33626 (813) 891-6501 Fax: (813) 891-6502 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Garay Claudio, Maria MD Provider ID: 1109489 Gender: Female 2 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8749 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Garcia, Rolando MD Provider ID: 420679 Gender: Male Big Bend Pediatric Care LLC 13131 Kings Lake Dr Ste 101 Gibsonton, FL 33534 (813) 672-6092 Fax: (813) 677-1892 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish MTTHF 8:30 AM - 5:30 PM W 10:00 AM - 7:00 PM PCMH: No Gomez, Danielle MD Provider ID: 1018207 Gender: Female 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gomez, Danielle MD Provider ID: 1018208 Gender: Female 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Grant, Stewart MD Provider ID: 221083 Gender: Male Total Pediatric Healthcare 131 N Oakwood Ave Brandon, FL 33510 (813) 655-5106 Fax: (813) 655-4460 00 Yrs/18 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Grant, Stewart MD Provider ID: 684126 Gender: Male Total Pediatric Healthcare 10036 Water Works Ln Riverview, FL 33578 (813) 671-1872 Fax: (813) 671-1056 00 Yrs/18 Yrs Brandon Regional Hospital Languages: Spanish MWF 8:00 AM - 5:00 PM TTH 1:00 AM - 8:00 PM PCMH: No Hiben, Eugene MD Provider ID: 4829 Gender: Male Pediatrics of Tampa Bay 13381 N 56th St Tampa, FL 33617 (813) 983-9495 Fax: (813) 983-9496 00 Yrs/18 Yrs Florida Hospital Tampa Lakeland Reg Medical Center MTH 8:30 AM - 9:00 PM TF 8:30 AM - 6:00 PM W 8:30 AM - 2:00 PM PCMH: No Hicks, Mary MD Provider ID: 1044579 Gender: Female Westchase Pediatric Care 10941 Countryway Blvd Unit A Tampa, FL 33626 (813) 818-1543 Fax: (813) 818-1544 00 Yrs/21 Yrs Morton Plant Hospital M-F 8:30 AM - 5:00 PM Sat 9:00 AM - 11:30 PM PCMH: No

Hughes, Teena MD Provider ID: 174671 Gender: Female 4444 E Fletcher Ave Ste C Tampa, FL 33613 (813) 903-0060 Fax: (813) 903-1773 00 Yrs/18 Yrs Florida Hospital Tampa St Josephs Hospital M-F 8:30 AM - 5:00 PM PCMH: No Jennings, Jessica MD Provider ID: 1174570 Gender: Female Tampa Family Health Centers 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 549-7855 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Johnson-Towson, Michele MD Provider ID: 175662 Gender: Female Pediatric Place of Tampa 1338 W Fletcher Ave Tampa, FL 33612 (813) 264-2288 Fax: (813) 264-1677 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 7:30 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Kamisetty, Sudarsan MD

Kazmi, Ishrat MD Provider ID: 1328287 Gender: Male Total Pediatric Healthcare PA 131 N Oakwood Ave Brandon, FL 33510 (813) 655-5106 Fax: (863) 655-4460 00 Yrs/18 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 244683 Gender: Male 681 W Lumsden Rd Brandon, FL 33511 (813) 655-7726 Fax: (813) 655-5617 00 Yrs/18 Yrs Brandon Regional Hospital Johns Hopkins All Childrens Hospital Inc South Florida Baptist Hospital Languages: Hindi, Tamil, Kilaru, Anusha MD Telugu Provider ID: 1155363 MTWF 9:00 AM - 6:00 PM Gender: Female TH 9:00 AM - 2:00 PM Ruskin Health Center Sat 9:00 AM - 12:00 PM 2814 14th Ave SE PCMH: No Ruskin, FL 33570 (813) 349-7800 Kanarek, Mark MD Fax: (813) 349-7861 Provider ID: 176107 00 Yrs/18 Yrs Gender: Male MWTHF 8:00 AM - 5:00 PM Nadal Pediatrics T 8:00 AM - 7:00 PM 621 Victoria St PCMH: No Brandon, FL 33510 (813) 655-0292 Kilaru, Anusha MD Fax: (813) 655-4302 Provider ID: 1155364 00 Yrs/12 Yrs Gender: Female Brandon Regional Hospital Schc Pediatrics St Josephs Hospital 502 N Mobley St Languages: Spanish Plant City, FL 33563 M-TH 8:00 AM - 8:00 PM (813) 349-7450 F 8:00 AM - 5:00 PM Fax: (813) 349-7655 PCMH: Yes, Level 2 00 Yrs/18 Yrs M-F 7:00 AM - 5:30 PM Kazmi, Ishrat MD Sat 8:00 AM - 2:00 PM Provider ID: 1328285 PCMH: No Gender: Male Total Pediatric Healthcare PA Kilaru, Anusha MD 10036 Water Works Ln Provider ID: 1155366 Riverview, FL 33578 Gender: Female (863) 671-1842 Ruskin Health Center Fax: (863) 671-1056 2814 14th Ave SE 00 Yrs/18 Yrs Ruskin, FL 33570 Brandon Regional Hospital (813) 349-7800 M-F 8:00 AM - 5:00 PM Fax: (813) 938-6421 PCMH: No 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont.

Kilaru, Anusha MD Knox, Brian MD Provider ID: 1155376 Provider ID: 709264 Kilaru, Anusha MD Gender: Female Gender: Male Provider ID: 1155367 Palm River Community Health USF Physicians Group Center Gender: Female 2 Tampa General Cir 2nd Fl Wimauma Community Health 7728 Palm River Rd Tampa, FL 33606 Center Tampa, FL 33619 (813) 259-8700 5121 SR 674 (813) 630-3600 Fax: (813) 250-2101 Wimauma, FL 33598 Fax: (813) 620-1614 00 Yrs/130 Yrs (813) 349-7880 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Fax: (813) 633-2669 M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 00 Yrs/18 Yrs PCMH: No Kosoff, Peter MD M-F 8:00 AM - 5:00 PM Kilbride, Pamela MD PCMH: No Provider ID: 241080 Gender: Male Kilaru, Anusha MD Provider ID: 1044571 We Care Pediatrics PA Provider ID: 1155370 Gender: Female 9406 Balm Riverview Rd Gender: Female Westchase Pediatric Care Riverview, FL 33569 Plant City Family Care 10941 Countryway Blvd Unit A (813) 236-9310 508 N Maryland Ave Tampa, FL 33626 Fax: (813) 236-9311 Plant City, FL 33563 (813) 818-1543 00 Yrs/21 Yrs (813) 349-7600 Fax: (813) 818-1544 Brandon Regional Hospital Fax: (813) 349-7661 Lakeland Reg Medical Center 00 Yrs/21 Yrs 00 Yrs/18 Yrs Languages: Spanish Morton Plant Hospital MWTHF 7:45 AM - 5:00 PM M-F 8:00 AM - 5:00 PM M-F 8:30 AM - 5:00 PM T 7:45 AM - 7:00 PM Sat 9:00 AM - 1:00 PM Sat 8:30 AM - 12:00 PM Sat 8:00 AM - 2:00 PM PCMH: No PCMH: No PCMH: No Kumar, Mudra MD Kiluk, Vinita MD Kilaru, Anusha MD Provider ID: 174173 Provider ID: 480129 Provider ID: 1155373 Gender: Female Gender: Female Gender: Female USF Physicicans Group University Medical Service Tom Lee Community Health Assoc 2 Tampa General Cir 2nd Fl Center 17 Davis Blvd Ste 100 Tampa, FL 33606 14254 SR 574 Tampa, FL 33606 (813) 259-8700 Dover, FL 33527 (813) 259-8700 Fax: (813) 250-2101 (813) 349-7700 Fax: (813) 259-8710 00 Yrs/21 Yrs Fax: (813) 349-7761 00 Yrs/21 Yrs Languages: Hindi 00 Yrs/18 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM MWTHF 8:00 AM - 5:00 PM Languages: Spanish PCMH: No T 8:00 AM - 7:00 PM M-F 8:00 AM - 5:00 PM Levitt, Laura MD PCMH: No PCMH: Yes, Level 2 Provider ID: 1017726 Kilaru, Anusha MD Knox, Brian MD Gender: Female Provider ID: 1155374 Provider ID: 564904 Internal Medicine and Gender: Female Pediatrics of Gender: Male Oakfield Community Health 10111 Wilsky Blvd 17 Davis Blvd Ste 100 Center Tampa, FL 33625 Tampa, FL 33606 1463 Oakfield Dr Ste 113 (813) 961-2222 (813) 259-8700 Brandon, FL 33511 Fax: (813) 961-2220 Fax: (813) 259-8710 (813) 280-4328 00 Yrs/21 Yrs 00 Yrs/130 Yrs Fax: (813) 498-2823 M-TH 8:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM 00 Yrs/18 Yrs F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 MWTHF 8:00 AM - 5:00 PM PCMH: No T 8:00 AM - 7:00 PM PCMH: No

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Lilly, Carol Marie MD Provider ID: 7731 Gender: Female USF Physicicans Group 2 Tampa General Cir Fl 2 Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lilly, Carol Marie MD Provider ID: 921623 Gender: Female USF Physicians Group 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Lilly, Carol Marie MD Provider ID: 921624 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 234-2803 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Lilly, Carol Marie MD Provider ID: 921627 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8700 Fax: (813) 396-9678 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Mak, Sheila DO Provider ID: 1053845 Gender: Female Westchase Pediatric Care 10941 Countryway Blvd Ste A Tampa, FL 33626 (813) 818-1543 Fax: (813) 818-1544 00 Yrs/21 Yrs Morton Plant Hospital MTTHF 8:30 AM - 5:00 PM W 12:00 AM - 5:00 PM Sat 8:30 AM - 12:00 PM PCMH: No Maldonado, Luis MD Provider ID: 21611 Gender: Male USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8862 00 Yrs/21 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Maldonado, Luis MD Provider ID: 28263 Gender: Male USF Physicicans Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 234-2803 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Martin, Agustin MD Provider ID: 223502 Gender: Male All Kids Clinic 1922 W Martin Luther King Blvd Tampa, FL 33607 (813) 849-5437 Fax: (813) 849-2624 00 Yrs/21 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No McCormick, John MD Provider ID: 365640 Gender: Male University Medical Svc Associates 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 McCormick, John MD Provider ID: 798132 Gender: Male University Medical Svc Associates 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

McCormick, John MD Provider ID: 798139 Gender: Male University Medical Svc Associates 128 S W. Shore Blvd Tampa, FL 33609 (813) 974-2201 Fax: (813) 281-5508 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No McPhie, Ashley MD Provider ID: 1025131 Gender: Female Tampa Family Health Centers 3901 S W. Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 866-0929 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Mehta, Saumeel MD Provider ID: 563083 Gender: Male Sunshine Pediatrics of Lutz 18934 N Dale Mabry Hwy Ste 101 Lutz, FL 33548 (813) 948-2679 Fax: (813) 948-8694 00 Yrs/21 Yrs St Josephs Hospital Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No Montane, Jorge MD Provider ID: 28691 Gender: Male Pediatric Care Center 1383 Providence Rd Brandon, FL 33511 (813) 681-5714 Fax: (813) 689-9557 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Moore, Dayna MD Provider ID: 1175375 Gender: Female Florida Pediatric Associates, LLC 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8093 Fax: (813) 554-8657 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Munoz, Avilio MD Provider ID: 347934 Gender: Male Holistic Pediatrics Group LLC 2906 W Tampa Bay Blvd Tampa, FL 33607 (813) 879-1985 Fax: (813) 876-0336 00 Yrs/18 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Murphy, Melinda MD Provider ID: 964270 Gender: Female USF Physicians Group 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Nadal, Florencio MD Provider ID: 28625 Gender: Male Nadal Pediatrics 621 Victoria St Brandon, FL 33510 (813) 655-0292 Fax: (813) 655-4302 00 Yrs/18 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-TH 8:00 AM - 8:00 PM F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Ong, Alicia MD Provider ID: 244530 Gender: Female My Pediatrician, PA 1037 Professional Park Dr Brandon, FL 33511 (813) 684-5659 Fax: (813) 685-2640 00 Yrs/18 Yrs Brandon Regional Hospital Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Patel, Anilkumar MD Provider ID: 175556 Gender: Male Kingsway Medical Center 301 N Parsons Ave Ste A Brandon, FL 33510 (813) 655-5807 Fax: (813) 655-9817 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Hindi M-F 8:30 AM - 5:00 PM PCMH: No Patel, Daksha MD Provider ID: 26481 Gender: Female My Kids Clinic 1213 W Hillsborough Ave Tampa, FL 33603 (813) 234-1315 Fax: (813) 234-3354 00 Yrs/21 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Hindi, Gujarati M-F 8:30 AM - 5:30 PM PCMH: No

Patel, Jaydeep MD Provider ID: 228318 Gender: Male 10311 Cross Creek Blvd Ste D Tampa Palms, FL 33647 Pai, Rajendra MD (813) 994-7670 Provider ID: 1044560 Fax: (813) 994-7640 Gender: Male 00 Yrs/21 Yrs Westchase Pediatric Care Bayfront Medical Center 10941 Countryway Blvd Unit A Florida Hospital Tampa Languages: Gujarati Tampa, FL 33626 M-TH 8:00 AM - 5:00 PM (813) 818-1543 F 8:00 AM - 3:00 PM Fax: (813) 818-1544 PCMH: No 00 Yrs/21 Yrs Bayfront Health Dade City Mease Hospital Dunedin Morton Plant Hospital M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:00 PM PCMH: No

Patel, Payal MD Provider ID: 283807 Gender: Female Sunshine Pediatrics of Lutz 18934 N Dale Mabry Hwy Ste 101 Lutz, FL 33548 (813) 948-2679 Fax: (813) 948-2694 00 Yrs/21 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Plasencia, Daniel MD

Pelaez, Robert MD Provider ID: 28692 Gender: Male Pediatric Care Center 1383 Providence Rd Brandon, FL 33511 (813) 681-5714 Fax: (813) 689-9557 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No

Preston, Marilyn MD

Plant, Rebecca MD Provider ID: 1419351 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 25

Provider ID: 194268 Gender: Male Florida Pediatric Associates LLC 3001 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (813) 554-8093 Fax: (813) 554-8657 00 Yrs/21 Yrs Morton Plant Hospital St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 588123 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 866-0929 00 Yrs/18 Yrs St Josephs Hospital M-F 8:00 AM - 7:00 PM Sat 8:00 AM - 5:00 PM PCMH: No Preston, Marilyn MD Provider ID: 588124 Gender: Female Tampa Family Health Centers Inc 1401 E 22nd Ave Tampa, FL 33605 (813) 248-6263 Fax: (813) 866-0929 00 Yrs/18 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Preston, Marilyn MD Provider ID: 588126 Gender: Female Tampa Family Health Centers Inc 3402 N 22nd St Tampa, FL 33605 (813) 272-6240 Fax: (813) 866-0929 00 Yrs/18 Yrs St Josephs Hospital M-F 8:00 AM - 7:00 PM Sat 8:00 AM - 5:00 PM PCMH: No Preston, Marilyn MD Provider ID: 588128 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 866-0929 00 Yrs/18 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Preston, Marilyn MD Provider ID: 588129 Gender: Female Tampa Family Health Centers Inc 8213 W Waters Ave Tampa, FL 33615 (813) 490-5420 Fax: (813) 866-0929 00 Yrs/18 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Pruitt, Rebecca MD Provider ID: 59583 Gender: Female Premier Care Pediatrics 16637 Fishhawk Blvd Ste 101 Lithia, FL 33547 (813) 657-7337 Fax: (813) 661-4702 00 Yrs/21 Yrs Brandon Regional Hospital Johns Hopkins All Childrens Hospital Inc St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Puccio, Joseph MD Provider ID: 699211 Gender: Male 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ranganathan, Radhika MD

Rau, Sathyanarayan MD Provider ID: 231809 Gender: Male We Care Pediatrics 9406 Balm Riverview Rd Riverview, FL 33569 (813) 236-9310 Fax: (813) 239-9311 00 Yrs/21 Yrs Languages: Spanish, Hindi MTTH 9:00 AM - 7:00 PM WF 9:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Reilly Hays, Elizabeth MD Provider ID: 816857 Gender: Female St Petersburg Pediatrics Tampa 2550 W MLK Jr Blvd Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1760 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Provider ID: 1431532 Gender: Female Richards-Rowley, Toni MD Plant City Pediatrics PA 2370 Walden Woods Dr Ste A Provider ID: 246700 Plant City, FL 33563 Gender: Female (813) 659-9800 Kids First Pediatric Care Fax: (813) 659-9807 16301 Fishhawk Blvd 00 Yrs/21 Yrs Lithia, FL 33547 Languages: Spanish, Kannada (813) 681-3800 M-TH 7:30 AM - 6:00 PM Fax: (813) 681-3883 F 7:30 AM - 3:30 PM 00 Yrs/21 Yrs PCMH: No Brandon Regional Hospital Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3

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Rivera, Ever MD Provider ID: 1080146 Gender: Male Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/18 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Rivera, Ever MD Provider ID: 1080147 Gender: Male Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 349-7880 Fax: (813) 633-2669 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rivera, Ever MD Provider ID: 1080149 Gender: Male Suncoast Mobile Medical Bus 14254 SR 574 Dover, FL 33527 (813) 312-1558 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rivera, Ever MD Provider ID: 1080151 Gender: Male Ruskin HC 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/18 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Rivera, Ever MD Provider ID: 1080152 Gender: Male Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rivera, Ever MD Provider ID: 348516 Gender: Male Schc Pediatrics 502 N Mobley St Plant City, FL 33563 (813) 341-7450 Fax: (813) 653-6100 00 Yrs/18 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Lisa MD Provider ID: 28372 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Rolland, Lilivette MD Provider ID: 449847 Gender: Female Bay Central Medical Group 4602 N Armenia Ave Ste A3 Tampa, FL 33603 (813) 873-1725 Fax: (813) 873-2924 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish M-TH 8:30 AM - 5:00 PM F 8:30 AM - 1:00 PM PCMH: No

Sabia, Francesca MD Provider ID: 1153528 Gender: Female Plant City Pediatrics 2370 Walden Woods Dr Ste A Plant City, FL 33563 (813) 659-9800 Fax: (813) 659-9807 00 Yrs/18 Yrs South Florida Baptist Hospital M-TH 7:30 AM - 6:00 PM F 7:30 AM - 3:30 PM PCMH: No Samter, Jordan MD Provider ID: 193315 Gender: Male The Kids Doctor 10549 N Florida Ave Ste B Tampa, FL 33612 (813) 978-1522 Fax: (813) 971-3330 00 Yrs/18 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Santa Maria, Ramon MD Provider ID: 171546 Gender: Male South Bay Pediatrics 4051 Upper Creek Dr Ste 110 Sun City Center, FL 33573 (813) 633-2504 Fax: (813) 633-2546 00 Yrs/18 Yrs Brandon Regional Hospital Columbia South Bay Hospital Languages: Filipino MTHF 8:30 AM - 5:00 PM T 8:30 AM - 6:00 PM W 8:30 AM - 12:00 PM PCMH: No

Shamim, Tabassum MD Provider ID: 1205028 Gender: Female Pediatric and Adolescent Health Assoc 3709 W Hamilton Ave Ste 4 Tampa, FL 33614 (813) 515-7988 Fax: (813) 515-7987 00 Yrs/18 Yrs Orlando Regional Medical Center Languages: Spanish, Urdu, Punjabi MTTH 10:00 AM - 5:00 PM W 10:00 AM - 1:00 PM PCMH: No Smith, Elizabeth MD Provider ID: 193317 Gender: Female My First Doctor 13043 Summerfield Square Dr Riverview, FL 33578 (813) 418-7282 Fax: (813) 677-7141 00 Yrs/21 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish MTHF 8:00 AM - 5:00 PM T 8:00 AM - 1:00 PM W 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Soylu, Lana MD Provider ID: 544925 Gender: Female USF Physicians Group 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Medical Center of Trinity Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

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Spoto Cannons, Antoinette MD Provider ID: 1208579 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Straub, Diane MD Provider ID: 202307 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 12 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 2 Szafranski, Christy MD Provider ID: 816784 Gender: Female St Petersburg Pediatrics Tampa 2550 W MLK Jr Blvd Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1760 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Takagishi, Jennifer MD Provider ID: 164424 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont.

Tayao, Maria Concepcion MD

Tayao, Maria Concepcion MD

Takagishi, Jennifer MD Provider ID: 196270 Gender: Female University Medical Svc Associates 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 4:30 PM PCMH: No

Provider ID: 1068981 Gender: Female Ruskin HC 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/21 Yrs Brandon Regional Hospital St Petersburg General Hospital Tampa General Hospital Languages: Spanish, Filipino M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1070256 Gender: Female Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 653-6100 Fax: (813) 633-2669 00 Yrs/21 Yrs Brandon Regional Hospital St Petersburg General Hospital Tampa General Hospital Languages: Spanish, Filipino M-F 8:00 AM - 5:00 PM PCMH: No

Tayao, Maria MD Provider ID: 210715 Gender: Female Schc Pediatrics 502 N Mobley St Plant City, FL 33563 (813) 341-7450 Fax: (813) 653-6100 00 Yrs/21 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish, Filipino, Tagalog M-F 7:00 AM - 5:30 PM Sat 8:00 AM - 2:00 PM PCMH: No

Tayao, Maria Concepcion MD

Tayao, Maria Concepcion MD

Provider ID: 1070214 Gender: Female Tom Lee CHC 14254 SR 574 Dover, FL 33527 (813) 349-7700 Fax: (813) 651-5783 00 Yrs/21 Yrs Brandon Regional Hospital St Petersburg General Hospital Tampa General Hospital Languages: Spanish, Filipino M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1070262 Gender: Female Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/21 Yrs Brandon Regional Hospital St Petersburg General Hospital Tampa General Hospital Languages: Spanish, Filipino M-F 8:00 AM - 5:00 PM PCMH: No

Tayao, Maria Concepcion MD

Tayao, Maria Concepcion MD

Provider ID: 1068044 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/21 Yrs Brandon Regional Hospital St Petersburg General Hospital Tampa General Hospital Languages: Spanish, Filipino MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

Provider ID: 1070244 Gender: Female Oakfield CHC 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/21 Yrs Brandon Regional Hospital St Petersburg General Hospital Tampa General Hospital Languages: Spanish, Filipino M-F 8:00 AM - 5:00 PM PCMH: No

Torres, Luz MD Provider ID: 1245890 Gender: Female Brandon Community Health Center 313 S Lakewood Dr Ste 120 Brandon, FL 33511 (813) 349-7900 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Torres, Luz MD Provider ID: 1245891 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 938-6421 00 Yrs/18 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No Torres, Luz MD Provider ID: 1245892 Gender: Female Schc Pediatrics 502 N Mobley St Plant City, FL 33563 (813) 349-7450 Fax: (813) 938-6424 00 Yrs/18 Yrs M-F 7:00 AM - 5:30 PM Sat 8:00 AM - 2:00 PM PCMH: No Torres, Luz MD Provider ID: 1245894 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 938-6428 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Torres De Carlo, Rita MD Provider ID: 1229478 Gender: Female Panda Care Pediatrics, LLC. 12179 W Linebaugh Ave Tampa, FL 33626 (813) 855-3535 Fax: (813) 855-3308 00 Yrs/21 Yrs Florida Hospital Tampa Languages: Spanish M-TH 8:30 AM - 4:00 PM F 8:30 AM - 12:30 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Hillsborough Pediatrics - cont. Tran, Thein MD Provider ID: 894719 Gender: Female St Petersburg Pediatrics Tampa 2550 W Dr MLK Blvd Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1760 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Valdes, Julio MD Provider ID: 1250295 Gender: Male Julio J. Valdes, MD, PA 4506 N Armenia Ave Tampa, FL 33603 (813) 879-3530 Fax: (813) 874-6608 00 Yrs/21 Yrs M-F 8:00 AM - 4:00 PM PCMH: No Valencia-Serafini, Maria DO Provider ID: 1005333 Gender: Female 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 866-0929 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Villegas, Fabio MD Provider ID: 1152439 Gender: Male Healthy Family Medical Group, PLLC 1138 Nikki View Dr Brandon, FL 33511 (813) 393-1500 Fax: (813) 393-1501 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Weathers, Laura MD Provider ID: 3231 Gender: Female University of South Florida, For Th 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/21 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Weathers, Laura MD Provider ID: 609370 Gender: Female University of South Florida, For Th 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/18 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Weiss, Amy MD Provider ID: 1105073 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8700 Fax: (813) 259-8862 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Weiss, Amy MD Provider ID: 1105092 Gender: Female USF Physicians Group 5 Tampa General Cir Tampa, FL 33606 (813) 844-7473 Fax: (813) 844-1966 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Weiss, Amy MD Provider ID: 672684 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8862 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Williams, Stephen MD Provider ID: 195135 Gender: Male 714 W MLK Jr Blvd Tampa, FL 33603 (813) 223-6222 Fax: (813) 223-6020 00 Yrs/21 Yrs Bayfront Health Dade City Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Wildcatt, Lisa MD Provider ID: 813043 Gender: Female Pediatric Associates of Tampa Yakubu, Elizabeth MD Bay L 11260 Sullivan St Ste 101 Provider ID: 176688 Riverview, FL 33578 Gender: Female (813) 689-7571 Childrens Health Center Fax: (813) 654-8129 11464 N 53rd St 00 Yrs/18 Yrs Tampa, FL 33617 MTTH 8:00 AM - 9:00 PM (813) 914-7772 WF 8:00 AM - 5:00 PM Fax: (813) 914-0014 Sat 8:00 AM - 12:00 PM 00 Yrs/21 Yrs Sun 9:00 AM - 12:00 PM Brandon Regional Hospital Florida Hospital Tampa PCMH: No Johns Hopkins All Childrens Hospital Inc Williams, Chandra MD Languages: Spanish M 8:00 AM - 6:00 PM Provider ID: 531796 TWTHF 8:00 AM - 5:00 PM Gender: Female Sat 8:00 AM - 12:00 PM Plant City Pediatrics 2370 Walden Woods Dr Ste A PCMH: No Plant City, FL 33563 Zhao, Wenying MD (813) 659-9800 Fax: (813) 659-8907 Provider ID: 199777 00 Yrs/18 Yrs Gender: Female Lakewood Ranch Medical St Petersburg Pediatrics Center 2550 W MLK Jr Blvd Manatee Memorial Hospital Tampa, FL 33607 M-TH 7:30 AM - 6:00 PM (813) 871-5437 F 7:30 AM - 3:00 PM Fax: (813) 425-1760 PCMH: No 00 Yrs/18 Yrs Languages: Chinese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Manatee Family Practice Arias, Carlos MD Provider ID: 148508 Gender: Male Bayview Medical LLC 5309 E State Rd 64 Bradenton, FL 34208 (941) 747-9818 Fax: (941) 747-9535 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 12:00 PM PCMH: No Bollegraf, Morris DO Provider ID: 1051208 Gender: Male Bradenton Family Medical Center 4805 26th St W Bradenton, FL 34207 (941) 753-7843 Fax: (941) 753-7845 00 Yrs/130 Yrs Manatee Memorial Hospital M-TH 7:30 AM - 5:30 PM F 7:30 AM - 4:30 PM PCMH: No Brochu, Robert MD Provider ID: 4817 Gender: Male Southeast Family Healthcare Center 919 53rd Ave E Bradenton, FL 34203 (941) 751-8100 Fax: (941) 751-8127 00 Yrs/130 Yrs Manatee Memorial Hospital MTWTHFSat 8:00 AM - 8:00 PM PCMH: No

Divita, David MD Provider ID: 282803 Gender: Male West Florida Physician Network LLC 6033 26th St W Bradenton, FL 34207 (941) 752-2025 Fax: (941) 752-3921 00 Yrs/130 Yrs Blake Medical Center M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Fishco, Robert MD Provider ID: 28489 Gender: Male West Florida Physician Network LLC 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 12 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital MTTHF 8:30 AM - 5:00 PM W 8:30 AM - 12:30 PM Sat 9:00 AM - 1:00 PM PCMH: Yes, Level 3 Greenfield, Steven MD Provider ID: 228492 Gender: Male Manatee County Rural Health Services 404 7th St W Palmetto, FL 34221 (941) 729-3856 Fax: (941) 729-3857 00 Yrs/130 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 9:30 AM - 12:30 PM PCMH: No

Greenfield, Steven MD Provider ID: 391049 Gender: Male Edgar J Price Family and Children 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/130 Yrs Languages: Spanish MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No Guzman, Andrew MD Provider ID: 1119609 Gender: Male Pinnacle Medical Group 6033 26th St W Bradenton, FL 34207 (941) 752-2025 Fax: (941) 752-3921 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Guzman, Andrew MD Provider ID: 1238203 Gender: Male Pinnacle Medical Group 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kouka, Nabeel DO Provider ID: 1228860 Gender: Male Southwest Healthcare Center 5325 26th St W Bradenton, FL 34207 (941) 708-8500 Fax: (941) 708-8503 00 Yrs/130 Yrs M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

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Patil, Dipti MD Provider ID: 1241628 Gender: Female Healthcare America Medical Gro 4015 US Hwy 301 N Bradenton, FL 34209 (941) 722-7222 Fax: (941) 723-1003 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Singh, Manju MD Provider ID: 279747 Gender: Female Family Medicare Care LLC 2107 59th St W Bradenton, FL 34209 (941) 798-9175 Fax: (941) 894-6221 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

General Practice Correa, Raul MD Provider ID: 816 Gender: Male 2505 Manatee Ave W Bradenton, FL 34205 (941) 748-1171 Fax: (941) 748-4531 12 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Spanish M 8:00 AM - 4:00 PM TWTH 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Manatee Internal Medicine Alexander, Jack MD Provider ID: 284594 Gender: Male West Florida Physician Network, LLC 315 75th St W Bradenton, FL 34209 (941) 792-2211 Fax: (941) 794-6199 18 Yrs/130 Yrs Blake Medical Center M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Ali, Asad MD Provider ID: 15187 Gender: Male Family Care Inc 6078 14th St W Bradenton, FL 34207 (941) 752-1400 Fax: (941) 752-0192 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Cabrera, Camilo MD Provider ID: 286046 Gender: Male Pinnacle Medical Group 7005 Cortez Rd W Bradenton, FL 34210 (941) 792-2122 Fax: (877) 446-1404 12 Yrs/130 Yrs Bethesda Memorial Hospital JFK Medical Center Lakewood Ranch Medical Center Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No Dabage Forzoli, Nemer MD Provider ID: 1174549 Gender: Male Pinnacle Medical Group 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Desai, Pratibha MD

Bhamber, Davinder MD Provider ID: 905141 Gender: Male Ishpaul Medical Inc 7032 US Hwy 301 N Ellenton, FL 34222 (941) 723-3377 Fax: (941) 723-8462 18 Yrs/130 Yrs Blake Medical Center Doctors Hospital Sarasota Manatee Memorial Hospital MW 9:00 AM - 5:00 PM TF 9:00 AM - 11:30 PM TH 1:30 AM - 5:00 PM PCMH: No

Provider ID: 1370129 Gender: Female Riverview Medical Center 300 Riverside Dr E Bradenton, FL 34208 (941) 405-1170 Fax: (941) 405-1175 00 Yrs/130 Yrs Languages: Hindi, Gujarati, Marathi M-F 8:00 AM - 5:00 PM PCMH: No

Grace, David MD Provider ID: 283964 Gender: Male West Florida Physician Nertwork, LL 315 75th St W Bradenton, FL 34209 (941) 795-3600 12 Yrs/130 Yrs Blake Medical Center Sarasota Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Hanusa, James MD Provider ID: 348484 Gender: Male James J Hanusa MD 2902 59th St W Ste M Bradenton, FL 34209 (941) 795-7401 Fax: (941) 795-7414 18 Yrs/130 Yrs Blake Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Kishun Jit, Nirmala MD Provider ID: 706368 Gender: Female Southeast Family Healthcare Center 919 53rd Ave E Bradenton, FL 34203 (941) 751-8100 Fax: (941) 751-8127 18 Yrs/130 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Mardones, Osvaldo MD Provider ID: 283957 Gender: Male West Florida Physician Network, LLC 315 75th St W Bradenton, FL 34209 (941) 792-2211 Fax: (941) 794-6199 12 Yrs/130 Yrs Blake Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Perez, Sergio MD Provider ID: 1240939 Gender: Male Pinnacle Urgent Care Center 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 12 Yrs/130 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Perez, Sergio MD Provider ID: 1240941 Gender: Male Pinnacle Medical Group 7005 Cortez Rd W Bradenton, FL 34210 (941) 465-4800 Fax: (877) 446-1404 12 Yrs/130 Yrs MTWTHFSat 9:00 AM - 5:00 PM PCMH: No Rao, Sukhdeep MD Provider ID: 1313520 Gender: Male East Manatee Family Healthcare Center 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 21 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Manatee Internal Medicine - cont. Capote-Dishaw, Jessica MD Rodriguez Mendoza, Carlos MD Provider ID: 283968 Gender: Male West Florida Physician Network LLC 315 75th St W Bradenton, FL 34209 (941) 792-2211 Fax: (941) 794-6199 12 Yrs/130 Yrs Blake Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Singh, Satnam MD Provider ID: 1143635 Gender: Male Westside Medical Care Inc 1810 59th St W Bradenton, FL 34209 (941) 792-1412 Fax: (941) 795-0753 12 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Pediatrics Blackman, Edward MD Provider ID: 1087180 Gender: Male Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/21 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM PCMH: No

Provider ID: 241081 Gender: Female Lawton Chiles Children & Family 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 00 Yrs/21 Yrs Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Capote-Dishaw, Jessica MD Provider ID: 391119 Gender: Female Edgar J Price Family and Children 12271 US Hwy 301 N Healthcare Center Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/21 Yrs Languages: Spanish MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No Capote-Dishaw, Jessica MD Provider ID: 391123 Gender: Female Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/21 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No

Capote-Dishaw, Jessica MD Provider ID: 574856 Gender: Female Edgar J Price Family and Children 8936 77th Ter E Bradenton, FL 34202 (941) 366-2273 Fax: (941) 953-6500 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No Cendana, Elisa MD Provider ID: 1208583 Gender: Female Lawton Chiles and Family Healt 1515 26th Ave E Bradenton, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/18 Yrs Languages: Spanish MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM PCMH: No Cendana, Elisa MD Provider ID: 499703 Gender: Female Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/18 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 8:00 AM - 8:00 PM PCMH: No

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Cendana, Elisa MD Provider ID: 574881 Gender: Female 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Cendana, Elisa MD Provider ID: 574882 Gender: Female 8936 77th Ter E Bradenton, FL 34202 (941) 366-2273 Fax: (941) 953-6500 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Charles-Logan, Constance MD Provider ID: 28673 Gender: Female Constance M Charles Logan 1414 59th St W Bradenton, FL 34209 (941) 761-0663 Fax: (941) 761-3347 00 Yrs/18 Yrs Blake Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Manatee Pediatrics - cont.

Herrygers, Canaan MD Provider ID: 929532 Chiritescu, Cristian MD Gender: Female Provider ID: 464442 Lawton Chiles and Family Healthcare Gender: Male 1515 26th Ave E Ellenton Pediatrics Bradenton, FL 34208 8425 US Hwy 301 N (941) 708-8600 Parrish, FL 34219 Fax: (941) 708-7645 (941) 723-7877 00 Yrs/18 Yrs Fax: (941) 723-7844 Lakewood Ranch Medical 00 Yrs/21 Yrs Center Lakewood Ranch Medical Manatee Memorial Hospital Center M-F 8:00 AM - 8:00 PM Manatee Memorial Hospital Languages: Spanish, Romanian PCMH: No M-F 9:00 AM - 5:00 PM Holt, Jayne MD PCMH: No Provider ID: 1250853 Frias, Frederico MD Gender: Female APC Pediatrics Provider ID: 224576 1862 Rye Rd Ste 101 Gender: Male Bradenton, FL 34212 APC Pediatrics PA (941) 755-7000 5255 Office Park Blvd Ste 110-111 Fax: (941) 209-7685 Bradenton, FL 34203 00 Yrs/18 Yrs (941) 755-7000 Languages: Spanish Fax: (941) 755-7088 M-F 8:00 AM - 5:00 PM 00 Yrs/21 Yrs PCMH: No Lakewood Ranch Medical Jngilles, Josie MD Center Manatee Memorial Hospital Provider ID: 1111520 Languages: Spanish Gender: Female M-F 9:00 AM - 5:00 PM Manatee Pediatrics PCMH: No 712 39th St W Bradenton, FL 34205 Frias, Frederico MD (941) 748-4602 Fax: (941) 747-9230 Provider ID: 267147 00 Yrs/21 Yrs Gender: Male MTWTHFSat 8:00 AM - 8:00 APC Pediatrics PA PM 5255 Office Park Blvd Ste Sun 9:00 AM - 5:00 PM 110-111 PCMH: No Bradenton, FL 34203 Kondabala, Rajani MD (941) 755-7000 Fax: (941) 755-7088 Provider ID: 1192623 00 Yrs/18 Yrs Gender: Female Lakewood Ranch Medical Manasota Pediatrics Center 3425 University Pkwy Ste 103 Manatee Memorial Hospital Sarasota, FL 34243 Languages: Spanish (941) 355-1777 M-F 9:00 AM - 5:00 PM Fax: (941) 355-7788 PCMH: No 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Telugu M-F 8:30 AM - 5:00 PM PCMH: Yes, Level 3

Kondabala, Rajani MD Provider ID: 314330 Gender: Female 218 9th St Dr W Palmetto, FL 34221 (941) 721-3900 Fax: (941) 721-7403 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Telugu MWTHF 8:30 AM - 5:00 PM T 8:30 AM - 6:00 PM PCMH: Yes, Level 3 Ladines, Cecilia MD Provider ID: 574898 Gender: Female 8936 77th Ter E Bradenton, FL 34202 (941) 366-2273 Fax: (941) 953-6500 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital M 8:00 AM - 8:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Langley, Charlotta MD Provider ID: 1159467 Gender: Female First Physicians Group At Pediatric 8430 Enterprise Cir Ste 130 Lakewood Ranch, FL 34202 (941) 366-3000 Fax: (941) 366-3002 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Mendez, Carlos MD Provider ID: 13574 Gender: Male Carlos A Mendez MD PA 802 40th St W Bradenton, FL 34205 (941) 748-5885 Fax: (941) 749-5664 00 Yrs/18 Yrs Manatee Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Montes, Luis MD Provider ID: 1120690 Gender: Male Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/21 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM PCMH: No Nair, Bindu MD Provider ID: 983620 Gender: Female Kids First Pediatrics LLC 6310 Health Park Way Ste 220 Lakewood Ranch, FL 34202 (941) 362-2800 Fax: (941) 209-1332 00 Yrs/130 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Manatee Pediatrics - cont. Palacio, Liliana MD Provider ID: 26074 Gender: Female Gulf Coast Pediatrics 5305 E State Rd 64 Bradenton, FL 34208 (941) 747-2242 Fax: (941) 747-4432 00 Yrs/18 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Parikh, Snehal MD Provider ID: 1192625 Gender: Male Manasota Pediatrics 3425 University Pkwy Ste 103 Sarasota, FL 34243 (941) 355-1777 Fax: (941) 355-7788 00 Yrs/21 Yrs Manatee Memorial Hospital Languages: Hindi M-F 8:30 AM - 5:00 PM PCMH: Yes, Level 3 Parikh, Snehal MD Provider ID: 189722 Gender: Male 218 9th St Dr W Palmetto, FL 34221 (941) 721-3900 Fax: (941) 721-7403 00 Yrs/21 Yrs Manatee Memorial Hospital Languages: Hindi M-F 8:30 AM - 5:00 PM PCMH: Yes, Level 3

Rippy, Steven MD Provider ID: 1242186 Gender: Male APC Pediatrics 1862 Rye Rd Ste 101 Bradenton, FL 34212 (941) 755-7000 Fax: (941) 755-7088 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rucker, Rajivi MD Provider ID: 273857 Gender: Female Whole Child Pediatrics 8936 77th Ter E Bradenton, FL 34202 (941) 366-2273 Fax: (941) 953-6500 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Strum, Neta MD Provider ID: 295006 Gender: Female Manatee County Rural Health Services 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 00 Yrs/21 Yrs Languages: Spanish, Russian M-F 8:00 AM - 8:00 PM PCMH: No Strum, Neta MD Provider ID: 391125 Gender: Female Edgar J Price Family and Children 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/21 Yrs Languages: Spanish, Russian MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No

Strum, Neta MD Provider ID: 391127 Gender: Female Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/21 Yrs Languages: Spanish, Russian M 8:00 AM - 8:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Strum, Neta MD Provider ID: 574915 Gender: Male 8936 77th Ter E Bradenton, FL 34202 (941) 366-2273 Fax: (941) 953-6500 00 Yrs/21 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish, Russian M-F 9:00 AM - 5:00 PM PCMH: No Van Buren, George MD Provider ID: 164052 Gender: Male Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/21 Yrs Manatee Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Victor-Linkenhoker, Vanessa MD Provider ID: 12454 Gender: Female Bayside Pediatrics Inc 5115 Manatee Ave W Bradenton, FL 34209 (941) 795-8588 Fax: (941) 795-5508 00 Yrs/21 Yrs Manatee Memorial Hospital MWF 8:00 AM - 5:00 PM TTH 9:30 AM - 6:30 PM PCMH: No

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Zide, Stacy MD Provider ID: 638900 Gender: Female Lawton Chiles Health Care 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 00 Yrs/21 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Zuniga-Pedrianes, Danilo MD Provider ID: 798271 Gender: Male Lawton Chiles Pediatrics 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 00 Yrs/18 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pasco Family Practice Abdelmalek, Hend MD Provider ID: 904281 Gender: Female Access 2 Healthcare 13911 Lakeshore Blvd Ste 111 Hudson, FL 34667 (727) 869-8800 Fax: (727) 869-8814 16 Yrs/130 Yrs Lake City Medical Center Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Azank, Karina MD Provider ID: 576495 Gender: Female Fhpg Meadow Point Family Practice 30000 County Line Rd Wesley Chapel, FL 33543 (813) 907-8430 Fax: (813) 907-8435 00 Yrs/130 Yrs MTTH 8:00 AM - 5:00 PM W 8:00 AM - 7:00 PM F 8:00 AM - 12:00 PM PCMH: No Brar, Gurinder MD Provider ID: 790686 Gender: Male Wesley Chapel Primary Care Associat 2607 Windguard Cir Ste 102 Wesley Chapel, FL 33544 (813) 907-6767 Fax: (813) 907-1911 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Caselnova, Michael MD Provider ID: 1269780 Gender: Male Pasco Hernando Hma Physician Manage 7209 Green Slope Dr Zephyrhills, FL 33541 (813) 602-8841 Fax: (813) 602-8858 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Chintakayala, Durga MD Provider ID: 343837 Gender: Male Tendercare Pediatrics 27432 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 973-9900 Fax: (813) 229-3180 00 Yrs/18 Yrs Languages: Spanish, Hindi M-F 8:30 AM - 4:30 PM PCMH: No Da Souza, Wilma MD Provider ID: 705663 Gender: Female Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:30 AM - 5:30 PM PCMH: No Dasouza, Wilma MD Provider ID: 1127118 Gender: Female 38724 Mudcat Grant Blvd Dade City, FL 33523 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 4:00 PM PCMH: No

Dasouza, Wilma MD Provider ID: 719900 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (727) 645-4185 Fax: (352) 567-5193 00 Yrs/130 Yrs MTTHF 7:30 AM - 5:30 PM W 7:30 AM - 1:00 PM PCMH: Yes, Level 3

Greenfield, Adam DO

Dasouza, Wilma MD Provider ID: 719901 Gender: Female Premier Community Healthcare Group 2114 Seven Spgs Blvd Ste 300 New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-5193 00 Yrs/130 Yrs MTTHF 7:30 AM - 5:30 PM W 7:30 AM - 1:00 PM PCMH: No

Greenfield, Adam DO

Dasouza, Wilma MD Provider ID: 786391 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Gavino, Belinda MD Provider ID: 1145937 Gender: Female Fhpg Primary Care of Wesley Chapel 2700 Healing Way Ste 112 Wesley Chapel, FL 33543 (813) 929-5330 Fax: (813) 929-5332 05 Yrs/130 Yrs Florida Hospital Wesley Chapel M 10:00 AM - 7:30 PM TWTH 7:00 AM - 4:00 PM F 8:00 AM - 12:00 PM PCMH: No

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Provider ID: 1279613 Gender: Male Asg Doctors Inc 2208 Duck Slough Blvd New Port Richey, FL 34655 (727) 375-5885 Fax: (727) 375-5841 00 Yrs/130 Yrs CRMC At Bayonet Point M-F 9:00 AM - 6:00 PM PCMH: No

Provider ID: 653542 Gender: Male Asg Doctors Inc 10806 US Hwy 19 Ste 102A Port Richey, FL 34668 (727) 861-7043 Fax: (727) 861-7382 00 Yrs/130 Yrs CRMC At Bayonet Point Florida Hospital Carrollwood Languages: Spanish M-F 9:00 AM - 6:00 PM PCMH: No Herndon, David DO Provider ID: 803423 Gender: Male 7633 Cita Ln New Port Richey, FL 34653 (727) 372-1005 Fax: (727) 372-1009 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Heron, Delisa MD Provider ID: 1159485 Gender: Female Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: Yes, Level 3

Last update 08/14/2017

Primary Care Physicians Pasco Family Practice - cont. Heron, Delisa MD Provider ID: 1159486 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Heron, Delisa MD Provider ID: 1159487 Gender: Female Premier Community Healthcare Group 2114 Seven Spgs Blvd Ste 300 New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Heron, Delisa MD Provider ID: 1417970 Gender: Female Premier Community Healthcare Group 7551 Forest Oaks Blvd Zephyrhills, FL 33541 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No John, Tobin MD Provider ID: 1354658 Gender: Male Fhpg Florida Hospital Prompt Care 12880 US Hwy 301 Dade City, FL 33525 (352) 567-3325 Fax: (352) 567-3385 12 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Kay, Richard MD Provider ID: 1311457 Gender: Male Fhpg Wesley Chapel Family Practice 2700 Healing Way Ste 100 Wesley Chapel, FL 33543 (813) 994-0611 Fax: (813) 994-0085 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kay, Richard MD Provider ID: 485298 Gender: Male Fhpg Wesley Chapel Family Practice 2734 Windguard Cir Wesley Chapel, FL 33544 (813) 994-0611 Fax: (813) 994-0085 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kiriluk, Randy MD Provider ID: 1179969 Gender: Male Fhpg Meadow Point Family Practice 30000 County Line Rd Wesley Chapel, FL 33543 (813) 907-8430 Fax: (813) 907-8435 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mahajan, Neeraj MD Provider ID: 1041074 Gender: Male Wesley Chapel Medical Clinic 5819 Argerian Dr Wesley Chapel, FL 33545 (813) 994-0800 Fax: (813) 994-0086 00 Yrs/130 Yrs MT 1:15 AM - 5:00 PM PCMH: No

Mankodi, Kshemal MD Provider ID: 213352 Gender: Male Chapel Primary Care 28959 Wesley Chapel Blvd Wesley Chapel, FL 33543 (813) 994-4749 Fax: (813) 994-0474 00 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills St Josephs Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Marrero, Ailis MD Provider ID: 1159446 Gender: Female Fhpg Wellness Primary Care 2700 Healing Way Wesley Chapel, FL 33543 (813) 929-5330 Fax: (813) 929-5332 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Morrison III, John MD Provider ID: 1350653 Gender: Male Fhpg Wesley Chapel Family Practice 2700 Healing Way Ste 100 Wesley Chapel, FL 33543 (813) 994-0611 Fax: (813) 994-0085 16 Yrs/130 Yrs Florida Hospital Wesley Chapel M-F 9:00 AM - 5:00 PM PCMH: No Nystrom, Joseph MD Provider ID: 1198098 Gender: Male Bayfront Health Medical Group 13933 17th St Ste 101 Dade City, FL 33525 (352) 567-6763 Fax: (352) 567-2146 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Marrero, Ailis MD Provider ID: 1159447 Petrilli, John MD Gender: Female Fhpg Wellness Family Provider ID: 1265849 Medicine Gender: Male 7040 Land O Lks Blvd Unit 103 Premier Community Land O Lakes, FL 34638 Healthcare (813) 803-7907 11611 Denton Ave Fax: (813) 528-8960 Hudson, FL 34667 05 Yrs/130 Yrs (352) 518-2000 Florida Hospital Tampa Fax: (352) 567-0218 Florida Hospital Wesley 00 Yrs/130 Yrs Chapel M-F 7:00 AM - 4:00 PM M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 PCMH: No Petrilli, John MD Provider ID: 1347181 Gender: Male Premier Community Healthcare 38724 Mudcat Grant Blvd Dade City, FL 33523 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Pasco Family Practice - cont. Petrilli, John MD Provider ID: 1347185 Gender: Male Premier Community Healthcare 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Petrilli, John MD Provider ID: 1347187 Gender: Male Premier Community Healthcare 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Petrilli, John MD Provider ID: 1347190 Gender: Male Premier Community Healthcare 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Rehman, Farhan MD Provider ID: 1293689 Gender: Male Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

Rehman, Farhan MD Provider ID: 1293691 Gender: Male Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Rehman, Farhan MD Provider ID: 1293693 Gender: Male Premier Community Healthcare Group 38724 Mudcat Grant Blvd Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Rehman, Farhan MD Provider ID: 1293694 Gender: Male Premier Community Healthcare Group 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

Rehman, Farhan MD Provider ID: 1293696 Gender: Male Premier Community Healthcare Group 11611 Denton Ave Hudson, FL 34667 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

Talton Williamson, Stephanie MD Provider ID: 1090190 Gender: Female Tgmc Fcc Wesley Chapel 2324 Oak Myrtle Ln Wesley Chapel, FL 33544 (813) 844-8300 Fax: (813) 844-1119 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: Yes, Level 3

Thompson, Elisa MD Provider ID: 1313476 Renelus, Deborah MD Gender: Female Fhpg Sunlake Lutz Medical Center Provider ID: 1354752 18923 SR 54 Gender: Female Fhpg Trinity Tampa Bay Sports Lutz, FL 33558 (813) 803-7150 Medic Fax: (813) 803-7167 11103 Trinity Blvd 00 Yrs/130 Yrs New Port Richey, FL 34655 M-F 9:00 AM - 5:00 PM (727) 312-3355 PCMH: No Fax: (727) 312-3356 05 Yrs/130 Yrs Valez Gaetan, Jelexza MD MTWTHFSat 8:00 AM - 5:00 PM Provider ID: 1163933 PCMH: No Gender: Female Stoyanov, Veselin MD Continucare Medical Center Land O 21507 Vlg Lks Shopping Center Provider ID: 566401 Dr Gender: Male Land O Lakes, FL 34639 Access Healthcare LLC (813) 949-4224 7633 Cita Ln Fax: (813) 949-2809 New Port Richey, FL 34653 18 Yrs/130 Yrs (727) 372-1005 Languages: Spanish Fax: (727) 372-1009 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Bayfront Health Brooksville Bayfront Health Spring Hill Vana, Ted DO Oak Hill Hospital Provider ID: 1076799 Languages: Russian, Bulgarian Gender: Male M-F 9:00 AM - 5:00 PM Continuecare Medical Center PCMH: Yes, Level 3 Land O 21507 Vlg Lks Shopping Center Dr Land O Lakes, FL 34639 (813) 949-4224 Fax: (813) 949-2809 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 37

Last update 08/14/2017

Primary Care Physicians Pasco General Practice Guerrero Arias, Nestor MD Provider ID: 1160765 Gender: Male Fhz Internal Medicine of East Pasco 37924 Medical Arts Ct Zephyrhills, FL 33541 (813) 779-1900 Fax: (813) 779-8383 12 Yrs/130 Yrs Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No

Hanna, Maher MD Provider ID: 1324954 Gender: Male Sun Med Primary Care 7530 Congress St New Port Richey, FL 34653 (727) 842-9861 Fax: (727) 842-9759 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Hanna, Maher MD Provider ID: 612539 Gender: Male Sunmed Primary Care 1838 Health Care Dr Internal Medicine Trinity, FL 34655 (727) 375-8528 Choksi, Tarak MD Fax: (813) 909-4334 Provider ID: 1226382 12 Yrs/130 Yrs Gender: Male Florida Hospital Tampa Sunmed Primary Care M-F 8:00 AM - 5:00 PM 19409 Shumard Oak Dr Ste 101 PCMH: No Land O Lakes, FL 34638 Hasan, Syed MD (813) 909-1146 Provider ID: 161765 Fax: (813) 909-4334 Gender: Male 18 Yrs/130 Yrs West Coast Med Associates M-F 8:00 AM - 5:00 PM 5824 SR 54 Ste 101 PCMH: No New Port Richey, FL 34653 Choksi, Tarak MD (727) 845-1933 Provider ID: 295234 Fax: (727) 845-7307 Gender: Male 18 Yrs/130 Yrs Sunmed Primary Care CRMC At Bayonet Point Mease Hospital Dunedin 1838 Health Care Dr Bldg 2 Morton Plant North Bay Unit 2 Hospital New Port Richey, FL 34655 M-F 8:00 AM - 5:00 PM (727) 375-8528 PCMH: No Fax: (727) 372-7040 12 Yrs/130 Yrs Florida Hospital Carrollwood Kashlan, Ghiath MD Languages: Hindi, Gujarati Provider ID: 937313 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No 17921 Hunting Bow Cir Ste 101 Hanna, Maher MD Lutz, FL 33558 (813) 792-1900 Provider ID: 1257338 Fax: (855) 287-7006 Gender: Male 05 Yrs/130 Yrs Sun Med Primary Care 19409 Shumard Oak Dr Ste 101 M 8:00 AM - 5:00 PM T 2:00 AM - 6:00 PM Land O Lakes, FL 34639 PCMH: No (813) 909-1146 Fax: (913) 909-4334 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Khin, U MD Provider ID: 272342 Gender: Male Internal Medicine of East Pasco 37924 Medical Arts Ct Zephyrhills, FL 33541 (813) 779-1900 Fax: (813) 779-8383 18 Yrs/130 Yrs Florida Hospital Zephyrhills St Vincents Medical Center Riverside Languages: Burmese M-F 8:00 AM - 5:00 PM PCMH: No Kozhimala, John MD Provider ID: 224 Gender: Male Pasco Hernando Hma Physicians Manag 6340 Fort King Rd Zephyrhills, FL 33542 (813) 782-6116 Fax: (813) 780-1051 18 Yrs/110 Yrs Bayfront Health Dade City MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 4:00 PM PCMH: No Mehta, Shital DO Provider ID: 410850 Gender: Male 2800 Windguard Cir Ste 102 Wesley Chapel, FL 33543 (813) 345-8515 Fax: (813) 345-8517 21 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM PCMH: No

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Patel, Pritesh MD Provider ID: 244151 Gender: Male Sunmed Primary Care 1838 Health Care Dr Bldg 2 Unit 2 New Port Richey, FL 34655 (727) 375-8528 Fax: (727) 372-7040 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi, Gujarati M 9:00 AM - 12:30 PM T 8:00 AM - 5:00 PM PCMH: No Patel, Vibhaben MD Provider ID: 1124817 Gender: Female Baycare Medical Group Inc 6600 Madison St 2nd Fl New Port Richey, FL 34652 (727) 815-7207 Fax: (727) 266-4951 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Raj, Jayapriya MD Provider ID: 1257773 Gender: Female Fhpg Florida Hospital Prompt Care 12880 US Hwy 301 Dade City, FL 33525 (352) 567-3325 Fax: (352) 567-3385 18 Yrs/130 Yrs MTTH 8:00 AM - 5:00 PM W 8:00 AM - 3:00 PM F 8:00 AM - 1:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pasco Internal Medicine - cont. Aungst, Cary MD Shah, Manish MD Provider ID: 222320 Gender: Male Wesley Chapel Im and Pediatrics PA 2038 Ashley Oaks Cir Ste 102 Wesley Chapel, FL 33543 (813) 929-3622 Fax: (813) 929-3620 02 Yrs/12 Yrs Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Pediatrics Alvarez, Alfred MD Provider ID: 222765 Gender: Male N Pinellas Childrens Medical Center 10537 SR 54 New Port Richey, FL 34655 (727) 376-8404 Fax: (727) 674-2181 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Mease Hospital Dunedin M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3

Provider ID: 939645 Gender: Female East Lake Pediatrics 2137 Little Rd Trinity, FL 34655 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Awad, Reda MD Provider ID: 1202364 Gender: Male Premier Community Healthcare Group 11611 Denton Ave Hudson, FL 34667 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No Awad, Reda MD Provider ID: 950781 Gender: Male Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 00 Yrs/21 Yrs Florida Hospital Zephyrhills M-F 7:00 AM - 4:00 PM PCMH: No

Arroyo, Fernando MD Provider ID: 924294 Gender: Male Awad, Reda MD Pediatric Associates of Tampa Provider ID: 950782 Bay Gender: Male 10710 State Rd 54 Ste 108 Premier Community New Port Richey, FL 34655 Healthcare Group (727) 376-4040 37920 Medical Arts Ct Fax: (727) 376-8824 Zephyrhills, FL 33541 00 Yrs/18 Yrs (352) 518-2000 Mease Countryside Hospital 00 Yrs/21 Yrs Mease Hospital Dunedin Florida Hospital Zephyrhills M-TH 8:00 AM - 8:00 PM M-F 7:00 AM - 4:00 PM F 8:00 AM - 5:00 PM PCMH: No Sat 8:00 AM - 12:00 PM PCMH: No

Awad, Reda MD Provider ID: 950783 Gender: Male Premier Community Healthcare Group 2114 Seven Spgs Blvd Ste 300 New Port Richey, FL 34655 (352) 518-2000 00 Yrs/21 Yrs Florida Hospital Zephyrhills M-F 7:00 AM - 4:00 PM PCMH: Yes, Level 3 Booth, Christine MD Provider ID: 1095311 Gender: Female North Pinellas Childrens Medical CT 10537 SR 54 New Port Richey, FL 34655 (727) 376-8404 Fax: (727) 376-8552 00 Yrs/21 Yrs Mease Countryside Hospital Medical Center of Trinity M-F 7:00 AM - 8:00 PM Sat-Sun 8:00 AM - 12:00 PM PCMH: No

Dondero, Aldo MD Provider ID: 219194 Gender: Male Pediatrics At Rives Edge Inc 6352 River Rd New Prt Rchy, FL 34652 (727) 844-3551 Fax: (727) 547-0427 00 Yrs/21 Yrs Medical Center of Trinity Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Dubey, Rita MD Provider ID: 357890 Gender: Female 2236 Ashley Oaks Cir Ste 102 Wesley Chapel, FL 33544 (813) 973-2500 Fax: (813) 973-4438 00 Yrs/21 Yrs Florida Hospital Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Gajjela, Hemlata MD Provider ID: 1207673 Desai, Rupal MD Gender: Female Provider ID: 401354 Pediatric Partners of Gender: Male Zephyrhills A To Z Pediatrics 6712 Dairy Rd 4804 Rowan Rd Zephyrhills, FL 33542 New Port Richey, FL 34653 (813) 782-6064 (727) 375-5242 Fax: (813) 782-0984 Fax: (727) 375-5198 00 Yrs/18 Yrs 00 Yrs/21 Yrs M-F 8:00 AM - 10:00 PM Florida Hospital North Pinellas PCMH: No Johns Hopkins All Childrens Hospital Inc Gaud, Rosa MD Medical Center of Trinity Provider ID: 924301 Languages: Hindi, Gujarati Gender: Female M-F 8:00 AM - 6:00 PM Pediatric Associates of Tampa Sat 9:00 AM - 1:00 PM Bay PCMH: No 10710 State Rd 54 Ste 108 New Port Richey, FL 34655 (727) 376-4040 Fax: (727) 376-8824 00 Yrs/18 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

www.wellcare.com/Florida | 39

Last update 08/14/2017

Primary Care Physicians Pasco Pediatrics - cont.

Grover, Alpana MD

Hernandez, Sheridan MD

Jordan, Michael MD Provider ID: 413368 Gellady, Andrew MD Gender: Male Provider ID: 475034 Provider ID: 220078 East Lake Pediatrics PA Gender: Female Gender: Female Provider ID: 27122 N Pinellas Childrens Medical 2044 Trinity Oaks Blvd Ste 235 2137 Little Rd Center Trinity, FL 34655 Gender: Male New Port Richey, FL 34655 10537 SR 54 (727) 372-6760 4738 Grand Blvd Ste C (727) 375-5437 New Port Richey, FL 34655 00 Yrs/18 Yrs New Port Richey, FL 34652 Fax: (727) 375-0502 (727) 376-8404 Mease Countryside Hospital (727) 807-7800 00 Yrs/21 Yrs Fax: (727) 674-2181 Fax: (727) 807-7878 Florida Hospital North Pinellas Mease Hospital Dunedin Morton Plant Hospital 00 Yrs/21 Yrs Johns Hopkins All Childrens 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Hospital Inc Johns Hopkins All Childrens Medical Center of Trinity Medical Center of Trinity PCMH: No Hospital Inc M-F 9:00 AM - 5:00 PM Languages: Spanish M-F 8:00 AM 5:00 PM PCMH: No Lin, Kathryn MD MTH 9:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM Provider ID: 6852 Gomez-Luengas, Alexander T 9:00 AM 1:00 PM PCMH: Yes, Level 3 Gender: Female MD W 1:00 AM - 5:00 PM Hasell, Douglass MD Pediatric Partners of PCMH: Yes, Level 3 Provider ID: 925014 Zephyrhills P Gender: Male Hughes, Natasha MD 6712 Dairy Rd Pediatric Associates of Tampa Provider ID: 555790 Zephyrhills, FL 33542 Bay I Gender: Male (813) 782-6064 10710 State Rd 54 Ste 108 2044 Trinity Oaks Blvd Ste 235 Provider ID: 1097099 Fax: (813) 782-0984 New Port Richey, FL 34655 Gender: Female New Port Richey, FL 34655 00 Yrs/18 Yrs (727) 376-4040 North Pinellas Childrens (727) 375-5437 Bayfront Health Dade City Medical Center Fax: (727) 376-8824 Fax: (727) 375-0502 Florida Hospital Zephyrhills 10537 SR 54 00 Yrs/18 Yrs 00 Yrs/18 Yrs Languages: Spanish New Port Richey, FL 34655 Languages: Spanish Johns Hopkins All Childrens M-F 8:00 AM - 5:00 PM (727) 376-8404 M-F 8:00 AM - 5:00 PM Hospital Inc PCMH: No Mease Countryside Hospital Fax: (727) 674-2181 Sat 8:00 AM - 12:00 PM Medical Center of Trinity 00 Yrs/21 Yrs Sun 9:00 AM - 12:00 PM Lokesh, Haravu MD M-F 8:00 AM - 5:00 PM M-W 8:00 AM - 8:00 PM PCMH: No Provider ID: 26979 PCMH: Yes, Level 3 THF 8:00 AM - 5:00 PM Gender: Male Griffen, Michael DO Sat-Sun 8:00 AM - 12:00 PM Hayes, Lisa DO A To Z Pediatrics Provider ID: 1352163 PCMH: No 4804 Rowan Rd Provider ID: 971776 Gender: Male New Port Richey, FL 34653 Gender: Female Jara, Audrey MD Sun Country Pediatrics PLLC (727) 375-5242 Pediatric Associates of Tampa Provider ID: 225871 7040 Land O Lks Blvd Unit 101 Bay Fax: (727) 375-5198 Gender: Female Land O Lakes, FL 34638 10710 State Rd 54 Ste 108 00 Yrs/21 Yrs Caring Pediatrics PA (352) 678-5246 Trinity, FL 34655 Florida Hospital North Pinellas 7645 Cita Ln Ste 102 Fax: (352) 835-7900 Johns Hopkins All Childrens (727) 376-4040 New Port Richey, FL 34653 00 Yrs/21 Yrs Hospital Inc Fax: (727) 376-8824 (727) 853-2273 Bayfront Health Brooksville Medical Center of Trinity 16 Yrs/130 Yrs Bayfront Health Spring Hill Fax: (727) 853-2277 Languages: Hindi, Urdu, Arabic M-F 9:00 AM 5:00 PM M-F 8:00 AM - 5:00 PM 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Sat 8:00 AM - 12:00 PM Medical Center of Trinity Sat 9:00 AM - 1:00 PM PCMH: No Languages: Spanish, French PCMH: No MWTH 11:00 AM - 8:00 PM TF 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 40

Last update 08/14/2017

Primary Care Physicians Pasco Pediatrics - cont. Masterman, Wendy MD Provider ID: 1058334 Gender: Female Premier Community Healthcare Group 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs Languages: Spanish M-F 7:00 AM - 4:00 PM PCMH: No Masterman, Wendy MD Provider ID: 1100346 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs Languages: Spanish M-F 7:00 AM - 4:00 PM PCMH: Yes, Level 3 Masterman, Wendy MD Provider ID: 1108314 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs Languages: Spanish M-F 7:00 AM - 4:00 PM PCMH: Yes, Level 3

Mitchell, Paul MD Provider ID: 201338 Gender: Male N Pinellas Childrens Medical Center 10537 SR 54 New Port Richey, FL 34655 (727) 787-6335 Fax: (727) 674-2181 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Mula, Nicole DO Provider ID: 1234876 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Mula, Nicole DO Provider ID: 1234877 Gender: Female Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs M-F 7:00 AM - 4:00 PM PCMH: Yes, Level 3 Mula, Nicole DO Provider ID: 1234878 Gender: Female Premier Community Healthcare Group 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs M-F 7:00 AM - 4:00 PM PCMH: No

Mula, Nicole DO Provider ID: 1234879 Gender: Female Premier Community Healthcare Group 11611 Denton Ave Hudson, FL 34667 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/21 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Panicker, Usha MD Provider ID: 1179959 Gender: Female Dr Panicker and Associates LLC 5411 Grand Blvd Ste 102 New Port Richey, FL 34652 (727) 849-2535 Fax: (727) 849-7157 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc MTTHF 9:00 AM - 5:00 PM W 9:00 AM - 2:00 PM PCMH: No Perez, Maribelis MD Provider ID: 717619 Gender: Female Pediatric Partners of Zephyrhills P 6712 Dairy Rd Zephyrhills, FL 33542 (813) 782-6064 Fax: (813) 782-0984 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Pham, Thuy MD Provider ID: 13225 Gender: Female 2044 Trinity Oaks Blvd Ste 235 New Port Richey, FL 34655 (727) 375-5437 Fax: (727) 375-0502 00 Yrs/18 Yrs Florida Hospital North Pinellas Mease Countryside Hospital Languages: French, Vietnamese MWF 8:00 AM - 5:00 PM TTH 8:00 AM - 6:00 PM PCMH: Yes, Level 3 Pineiro, Alisha DO Provider ID: 971867 Gender: Female Pediatric Associates of Tampa Bay 10710 State Rd 54 Ste 108 Trinity, FL 34655 (727) 376-4040 Fax: (727) 376-8824 00 Yrs/18 Yrs M-TH 8:00 AM - 8:00 PM F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Porcelli, Monica MD Provider ID: 276207 Gender: Female G M Ramappa MD PA 12136 Cobblestone Dr Hudson, FL 34667 (727) 863-5474 Fax: (727) 868-0312 00 Yrs/21 Yrs Bayfront Health Spring Hill Medical Center of Trinity Languages: Hungarian, Romanian M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pasco Pediatrics - cont. Raguthu, Lalitha MD Provider ID: 1127093 Gender: Female Sveta Medical PLLC 27432 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 991-1457 Fax: (813) 907-2706 00 Yrs/18 Yrs Languages: Spanish, Hindi, Telugu M-F 9:00 AM - 4:00 PM PCMH: No Raguthu, Lalitha MD Provider ID: 624904 Gender: Female Tendercare Pediatrics 27432 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 973-9900 00 Yrs/18 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Ramappa, Gogi MD Provider ID: 27475 Gender: Male 12136 Cobblestone Dr Hudson, FL 34667 (727) 863-5474 Fax: (727) 868-0312 00 Yrs/21 Yrs Bayfront Health Spring Hill Medical Center of Trinity Morton Plant North Bay Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Sampang, Reginald MD

Siddiqi, Reshma MD

Provider ID: 783830 Provider ID: 1274182 Gender: Male Gender: Female A To Z Pediatrics Pediatric Partners of Zephyrhills P 4804 Rowan Rd 6712 Dairy Rd New Port Richey, FL 34653 Zephyrhills, FL 33542 (727) 375-5242 (813) 782-6064 Fax: (727) 375-5198 Fax: (813) 782-0984 00 Yrs/21 Yrs Florida Hospital North Pinellas 00 Yrs/18 Yrs Medical Center of Trinity M-F 8:00 AM - 10:00 PM M-F 8:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 1:00 PM Smith, Jessica MD PCMH: No Provider ID: 526297 Shah, Manish MD Gender: Female Provider ID: 222320 East Lake Pediatrics Gender: Male 2137 Little Rd Wesley Chapel Im and Trinity, FL 34655 Pediatrics PA (727) 372-6760 2038 Ashley Oaks Cir Ste 102 Fax: (727) 372-6808 Wesley Chapel, FL 33543 00 Yrs/18 Yrs (813) 929-3622 Mease Countryside Hospital Fax: (813) 929-3620 Morton Plant Hospital St Josephs Hospital 02 Yrs/12 Yrs Languages: German Florida Hospital Tampa M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Shah, Manish MD Provider ID: 324924 Gender: Male Wesley Chapel Im and Pediatrics PA 2038 Ashley Oaks Cir Ste 102 Wesley Chapel, FL 33544 (813) 929-3622 Fax: (813) 929-3620 00 Yrs/21 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No

Spagnolo-Hye, Carol DO Provider ID: 643886 Gender: Female Abrakidabra Kids Clinic 8736 US Hwy 19 Port Richey, FL 34668 (727) 478-8876 Fax: (727) 478-8868 00 Yrs/21 Yrs Bayfront Health Spring Hill Medical Center of Trinity M-F 8:30 AM - 5:00 PM PCMH: No Valencia, Diana MD Provider ID: 712522 Gender: Female Sun Country Pediatrics 7040 Land O Lks Blvd Unit 101 Land O Lakes, FL 34638 (813) 996-4932 Fax: (813) 996-9713 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

www.wellcare.com/Florida | 42

Vindhya, Naveena MD Provider ID: 1414934 Gender: Female G M Ramappa and Assoc 12136 Cobblestone Dr Hudson, FL 34667 (727) 863-5474 Fax: (727) 868-0312 00 Yrs/21 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Family Practice Anderson, Wayne MD Provider ID: 228913 Gender: Male Morton Plant Mease Primary Care Inc 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Armstrong, John DO Provider ID: 1097177 Gender: Male V.J. Dilella, DO, LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 738-5037 05 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Baab, Holly MD Provider ID: 541200 Gender: Female Bayfront Family Medicine Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 553-7342 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:30 AM - 5:00 PM PCMH: No

Barasch, Marc DO Provider ID: 197836 Gender: Male Marc S Barasch DO 1751 66th St N Saint Petersburg, FL 33710 (727) 302-9622 Fax: (727) 302-9711 00 Yrs/130 Yrs MW 8:30 AM - 6:00 PM TTH 7:30 AM - 2:00 PM F 8:30 AM - 4:30 PM Sat 7:30 AM - 11:00 PM PCMH: No Befeler, Carley MD Provider ID: 1419318 Gender: Female Bayfront Health St. Petersburg 700 6th St S Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 553-7340 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Bonaparte, Katina MD Provider ID: 1340859 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 Fax: (727) 736-1735 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Brownlee, Harrison MD

Burns, Craig DO Provider ID: 1354650 Gender: Male Fhpg North Pinellas Medical Center 4705 Alt 19 Ste B Palm Harbor, FL 34683 (727) 935-6477 Fax: (727) 935-6478 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Carlson, Timothy MD Provider ID: 1228770 Gender: Male Greater Tampa Bay Physician Network 1615 Pasadena Ave S Ste 430 Saint Petersburg, FL 33707 (727) 397-0606 Fax: (727) 397-6161 00 Yrs/130 Yrs Palms of Pasadena Hospital M-F 8:00 AM - 5:00 PM PCMH: No Chase, Stacy DO Provider ID: 711516 Gender: Female Largo Physcian Group LLC 6450 38th Ave N Ste 400 Saint Petersburg, FL 33710 (727) 545-4444 Fax: (727) 743-1504 00 Yrs/130 Yrs Languages: Vietnamese M-F 7:30 AM - 5:00 PM PCMH: No

Provider ID: 1214228 Gender: Male Bayfront Family Health Center 700 6th St S 3rd Fl Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 553-7340 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 43

Confident, Leonard MD Provider ID: 789284 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish, French, Creole M-F 8:00 AM - 5:00 PM PCMH: No Devries, Benjamin DO Provider ID: 798482 Gender: Male Largo Physician Group LLC 13540 Walsingham Rd Largo, FL 33774 (727) 593-5492 Fax: (727) 593-5440 00 Yrs/130 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Devries, Benjamin DO Provider ID: 798482 Gender: Male Largo Physician Group LLC 6450 38th Ave N Ste 400 Saint Petersburg, FL 33710 (727) 545-4444 Fax: (727) 545-5855 00 Yrs/130 Yrs Largo Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Family Practice - cont. Dilella, Vincent DO Provider ID: 203039 Gender: Male Vincent J Dilella 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 734-4454 05 Yrs/130 Yrs St Josephs Hospital MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 12:00 PM PCMH: No Eckstein, Daniel MD Provider ID: 1168793 Gender: Male Bayfront Hma Physician Managem 603 7th St S Ste 400 Saint Petersburg, FL 33701 (727) 553-7420 Fax: (727) 553-7419 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Farrar, Ted MD Provider ID: 366584 Gender: Male Morton Plant Mease Primary Care Inc 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Faulkner, Kim MD Provider ID: 1350230 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350231 Gender: Female Community Health Centers At Dunedin 1721 Main St Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 736-1735 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350237 Gender: Female Community Health Centers At Clearwa 707 Druid Rd E Clearwater, FL 33756 (727) 821-8181 Fax: (727) 443-7230 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350232 Gender: Female Community Health Centers At Tarpon 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350239 Gender: Female Community Health Centers At Largo 12420 130th Ave N Largo, FL 33774 (727) 821-8181 Fax: (727) 587-7739 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350234 Gender: Female Community Health Centers At St Pete 612 MLK St N Saint Petersburg, FL 33705 (727) 209-0394 Fax: (727) 209-0309 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350240 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 821-8181 Fax: (727) 893-6435 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350236 Gender: Female Community Health Centers At Suncoas 5523 Roosevelt Blvd Clearwater, FL 33760 (727) 821-8181 Fax: (727) 286-6225 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Faulkner, Kim MD Provider ID: 1350241 Gender: Female Community Health Centers Johnnie Ru 1344 22nd St S Saint Petersburg, FL 33712 (727) 821-8181 Fax: (727) 824-8150 18 Yrs/130 Yrs M-F 7:30 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 44

Fountain, Lorna MD Provider ID: 396732 Gender: Female Bayfront Family Medicine Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 553-7342 00 Yrs/130 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Gillespie, Olivia DO Provider ID: 1242869 Gender: Female All Care Medical Consultants 1115 Florida Ave Palm Harbor, FL 34683 (727) 259-2300 Fax: (727) 259-2305 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gillespie, Olivia DO Provider ID: 1242871 Gender: Female All Care Medical Consultants 1745 S Highland Ave Clearwater, FL 33756 (727) 587-0377 Fax: (727) 587-0527 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Greengold, Julian MD Provider ID: 168595 Gender: Male Turley Family Health Center 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Family Practice - cont. Gross, Andrew DO Provider ID: 524639 Gender: Male Vincent J Dilella DO LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 734-4454 05 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital M-TH 8:00 AM - 4:30 PM F 8:00 AM - 12:00 PM PCMH: No

Lawrence, Elizabeth MD Provider ID: 232818 Gender: Female Turley Family Health Center 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

Levine, Larry DO Provider ID: 205270 Gender: Male Vincent J Dilellia DO LLC Hashem, Tiffany MD 703 Virginia St Dunedin, FL 34698 Provider ID: 1238210 (727) 734-4000 Gender: Female Fax: (727) 734-4454 Community Health Centers of 12 Yrs/130 Yrs Pinella MTTH 8:00 AM - 4:30 PM 707 Druid Rd E WF 8:00 AM - 12:00 PM Clearwater, FL 33756 PCMH: No (727) 824-8181 Fax: (727) 443-7230 Levoy, Craig MD 16 Yrs/130 Yrs Provider ID: 1418109 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: Yes, Level 3 Bayfront Medical Center 700 6th St S 3rd Fl Kay, Walter DO Saint Petersburg, FL 33701 Provider ID: 548 (727) 893-6116 Gender: Male 00 Yrs/130 Yrs Florida Family Medical Bayfront Medical Center Centers M-F 8:00 AM - 5:00 PM 818 Chestnut St PCMH: No Clearwater, FL 33756 (727) 443-7478 Lewis, Paul MD Fax: (727) 446-0999 Provider ID: 175983 02 Yrs/130 Yrs Gender: Male Largo Medical Center Turley Family Health Center Mease Countryside Hospital 807 N Myrtle Ave Mease Hospital Dunedin Clearwater, FL 33755 M-F 9:00 AM - 5:00 PM (727) 467-2400 PCMH: No Fax: (727) 467-2477 00 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Lewis-Serag, Maha MD Malone, Donna DO Provider ID: 195167 Gender: Female Provider ID: 1043856 3190 N McMln Bth Rd Ste 203 Gender: Female Clearwater, FL 33761 Community Health Centers (727) 723-1910 At Tarpon Fax: (727) 723-1920 247 S Huey Ave 18 Yrs/130 Yrs Tarpon Springs, FL 34689 Florida Hospital North Pinellas (727) 824-8181 Mease Hospital Dunedin Fax: (727) 939-4679 Languages: Arabic 18 Yrs/130 Yrs MTTHF 8:30 AM - 5:00 PM M-F 8:00 AM - 5:00 PM W 8:30 AM - 2:00 PM PCMH: Yes, Level 3 PCMH: No Malone, Donna DO Lungren, Hillary DO Provider ID: 1046583 Provider ID: 1238124 Gender: Female Gender: Female Community Health Centers Community Health Centers At Tarpon At Pinella 707 Druid Rd E 7550 43rd St N Clearwater, FL 33756 Pinellas Park, FL 33781 (727) 824-8181 (727) 824-8181 Fax: (727) 443-7230 Fax: (727) 541-7984 18 Yrs/130 Yrs 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM MTHF 8:00 AM - 5:00 PM PCMH: No TW 8:00 AM - 8:00 PM Malone, Donna DO Sat 8:00 AM - 4:00 PM PCMH: Yes, Level 3 Provider ID: 1046680 Malone, Donna DO Gender: Female Community Health Centers Provider ID: 1028873 At Tarpon Gender: Female 7550 43rd St N Community Health Centers Pinellas Park, FL 33781 At Tarpon (727) 824-8181 701 6th St S Fax: (727) 939-4679 Saint Petersburg, FL 33701 18 Yrs/130 Yrs (727) 824-8181 M-F 8:00 AM - 5:00 PM Fax: (727) 209-5619 PCMH: No 18 Yrs/130 Yrs Malone, Donna DO M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 1135285 Gender: Female CHC At St. Petersburg 612 MLK St N Saint Petersburg, FL 33705 (727) 824-8181 18 Yrs/130 Yrs Languages: Sign M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Pinellas Family Practice - cont. Malone, Donna DO Provider ID: 1135305 Gender: Female Johnnie Ruth Clark 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 824-8150 18 Yrs/130 Yrs Languages: Sign M-F 8:00 AM - 5:00 PM PCMH: No Malone, Donna DO Provider ID: 1136243 Gender: Female CHC At Suncoast 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 18 Yrs/130 Yrs Languages: Sign M-F 8:00 AM - 5:00 PM PCMH: No

Murphy, William DO Provider ID: 163272 Gender: Male Largo Physician Group LLC 6450 38th Ave North Ste 400 Saint Petersburg, FL 33710 (727) 545-4444 Fax: (727) 545-5855 00 Yrs/130 Yrs Doctors Hospital Sarasota Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Patel-Elio, Bhiru MD

Murphy, William DO

Patel-Elio, Bhiru MD

Provider ID: 163272 Gender: Male Largo Physician Group, LLC 13540 Walsingham Rd Ste D Largo, FL 33774 (727) 593-5492 Fax: (727) 593-5440 00 Yrs/130 Yrs Doctors Hospital Sarasota Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: Yes, Level 2 Oyekoya, Adebola MD

Malone, Donna DO Provider ID: 1160713 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1172717 Gender: Female Getwell Medical Center 6613 49th St N Pinellas Park, FL 33781 (727) 527-6611 05 Yrs/130 Yrs M-F 10:00 AM - 6:00 PM PCMH: No Patel-Elio, Bhiru MD

Melichar, Jamie DO Provider ID: 1238038 Gender: Female Community Health Centers of Pinella 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1242864 Gender: Female All Care Medical Consultants PA 1115 Florida Ave Palm Harbor, FL 34683 (727) 259-2300 Fax: (727) 259-2305 21 Yrs/130 Yrs Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1242866 Gender: Female All Care Medical Consultants PA 8900 Park Blvd Seminole, FL 33777 (727) 545-4545 Fax: (727) 548-1360 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1242882 Gender: Female All Care Medical Consultants PA 1745 S Highland Ave Clearwater, FL 33756 (727) 587-0377 Fax: (727) 587-0527 21 Yrs/130 Yrs Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Pollan, Alina MD Provider ID: 586598 Gender: Female Alina Pollan MD Health Center LLC 1840 Mease Dr Ste 309 Safety Harbor, FL 34695 (727) 787-4383 Fax: (727) 787-4504 12 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin St Anthonys Hospital Languages: Spanish M 8:00 AM - 4:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 2:00 PM PCMH: No

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Rankin, Trevan MD Provider ID: 1129638 Gender: Female Community Health Centers At Johnnie 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 824-8150 18 Yrs/130 Yrs M 7:30 AM - 8:00 PM T 8:00 AM - 8:00 PM WTHF 7:30 AM - 5:00 PM PCMH: Yes, Level 3 Rankin Jr, George MD Provider ID: 613097 Gender: Male Turley Family Health Center 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Renelus, Deborah MD Provider ID: 1354747 Gender: Female Fhpg North Pinellas Medical Center 4705 Alt 19 Ste B Palm Harbor, FL 34683 (727) 935-6477 Fax: (727) 935-6478 05 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Renelus, Deborah MD Provider ID: 1354755 Gender: Female Fhnp East Lake 4140 Woodlands Pkwy Palm Harbor, FL 34685 (727) 953-9041 Fax: (727) 953-9043 05 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Family Practice - cont. Rodriguez, Carlos MD Provider ID: 613074 Gender: Male Bayfront Family Medicine Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 553-7340 00 Yrs/130 Yrs St Anthonys Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Sardo, Margo DO Provider ID: 1421721 Gender: Female Palms Primary Care 1615 Pasadena Ave S Ste 430 South Pasadena, FL 33707 (727) 397-0606 Fax: (727) 397-6161 18 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No Serag, Sherif MD Provider ID: 22761 Gender: Male St Mary's Family Practice Center 1152 62nd Ave S Saint Petersburg, FL 33705 (727) 866-6306 Fax: (727) 864-9614 12 Yrs/130 Yrs Mease Hospital Dunedin Northside Hospital St Anthonys Hospital Languages: Arabic M-F 8:30 AM - 5:00 PM PCMH: No

Sochet, Kristin MD Provider ID: 1299143 Gender: Female Bayfront Medical Center 700 6th St S 3 Fl Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 893-6978 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 4:30 PM PCMH: No Sourbeer, Jeffrey MD Provider ID: 174182 Gender: Male Turley Family Health Center 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Steinberg, Brandon MD Provider ID: 1310190 Gender: Male Professional Healthcare Of Pinellas 5500 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Steinberg, Brandon MD Provider ID: 1310193 Gender: Male Professional Healthcare Of Pinellas 8133 54th Ave N Saint Petersburg, FL 33709 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Steinberg, Brandon MD Provider ID: 1310196 Gender: Male Professional Healthcare Of Pinellas 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Vu, Tan MD Provider ID: 1331274 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs Languages: Vietnamese M-F 8:30 AM - 5:00 PM PCMH: No Wallace, Robert MD Provider ID: 1108108 Gender: Male Love The Golden Rule Inc 721 Dr M L King Jr St S Saint Petersburg, FL 33705 (727) 826-0700 Fax: (727) 954-6994 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Williams, Natalie MD Provider ID: 1335703 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Wojnowich, Katherine MD Provider ID: 1125728 Gender: Female Bayfront Health Medical Group 603 7th St S Ste 440 Saint Petersburg, FL 33701 (727) 893-6333 Fax: (727) 553-7787 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

General Practice Ducker, Stephen MD Provider ID: 1324887 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Santiago Perez, Jose MD Provider ID: 1094802 Gender: Male Live Better Health Center, LLC 4423 Park Blvd N Pinellas Park, FL 33781 (727) 827-2825 Fax: (727) 827-2809 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Sat 8:30 AM - 3:00 PM PCMH: No

Internal Medicine Afzal, Ahsan MD Provider ID: 1331280 Gender: Male Professional Healthcare Of Pinellas 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Internal Medicine - cont. Al-Andary, Hazem MD Afzal, Ahsan MD Provider ID: 1331281 Gender: Male Professional Healthcare Of Pinellas 5500 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Afzal, Ahsan MD Provider ID: 1331284 Gender: Male Professional Healthcare Of Pinellas 8133 54th Ave N Saint Petersburg, FL 33709 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Al-Andary, Hazem MD Provider ID: 587880 Gender: Male Physicians Group Alliance of South 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 12 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 587881 Gender: Male Physicians Group Alliance of South 5500 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 322-1054 Fax: (727) 727-2574 12 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Arkhipenko, Tatiana MD Provider ID: 655568 Gender: Female Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 12 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No Azzi, Nadine MD Provider ID: 1308792 Gender: Female Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Brea, Carlos MD Provider ID: 918138 Gender: Male Your Care Clinics LLC 5985 49th St N Saint Petersburg, FL 33709 (727) 528-8997 Fax: (727) 521-4949 18 Yrs/130 Yrs Northside Hospital St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Brea, Carlos MD Provider ID: 918139 Gender: Male Your Care Clinics LLC 10225 Ulmerton Rd Ste 9A Largo, FL 33771 (727) 528-8997 Fax: (727) 521-4949 18 Yrs/130 Yrs Northside Hospital St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Choe, Leo DO Provider ID: 1121674 Gender: Male Suncoast Internal Medicine Consulta 13644 Walsingham Rd Largo, FL 33774 (727) 595-2519 Fax: (727) 479-0485 18 Yrs/130 Yrs Largo Medical Center Languages: Spanish, Bengali M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

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Karkare, Rajendra MD Provider ID: 224694 Gender: Male Rajendra A Karkare MD PA 10700 Johnson Blvd Ste C Seminole, FL 33772 (727) 392-8500 Fax: (727) 392-8204 18 Yrs/130 Yrs Bayfront Medical Center Largo Medical Center Northside Hospital Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM PCMH: No Kaszuba, Robert MD Provider ID: 801738 Gender: Male Robert Kazsuba 1803 Briar Creek Blvd Safety Harbor, FL 34695 (727) 216-0505 Fax: (727) 789-8261 18 Yrs/130 Yrs Mease Hospital Dunedin Medical Center of Trinity Morton Plant North Bay Hospital Languages: Polish M 8:00 AM - 4:30 PM TTH 8:30 AM - 6:00 PM W 8:30 AM - 4:30 PM F 8:00 AM - 4:00 PM PCMH: No King, Kelly MD Provider ID: 1053252 Gender: Female Help US Help U 1700 22nd St S Saint Petersburg, FL 33712 (727) 223-1070 Fax: (727) 290-4176 05 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Internal Medicine - cont. McCoy, Brenton DO Korbaj, Rabee MD Provider ID: 409036 Gender: Male Professional Health Care Of Pinellas 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 12 Yrs/130 Yrs Largo Medical Center St Anthonys Hospital St Petersburg General Hospital Languages: Spanish, French, Chinese, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Kurtsikidze, Nino MD Provider ID: 518658 Gender: Female Professional Health Care Of Pinella 5500 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 525-5500 Fax: (727) 522-2574 12 Yrs/130 Yrs Bayfront Medical Center Northside Hospital St Anthonys Hospital Languages: Russian M-F 8:00 AM - 6:00 PM PCMH: No Kurtsikidze, Nino MD Provider ID: 518807 Gender: Female Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 932-2105 Fax: (727) 471-0557 12 Yrs/130 Yrs Bayfront Medical Center Northside Hospital St Anthonys Hospital Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1160824 Gender: Male Suncoast Internal Medicine Consulta 13644 Walsingham Rd Largo, FL 33774 (727) 595-2519 Fax: (727) 595-9856 18 Yrs/130 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Minnix, William MD

Muthalakuzhy, George MD Provider ID: 1149214 Gender: Male V.J. Dilella, DO, LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 738-5037 18 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-F 8:00 AM - 4:30 PM PCMH: No Narayan, Aurindom MD

Provider ID: 525092 Gender: Male Palms Internal Medicine 1615 Pasadena Ave S Ste 430 Saint Petersburg, FL 33707 (727) 397-0606 Fax: (727) 397-6161 12 Yrs/130 Yrs Palms of Pasadena Hospital M-F 8:00 AM - 5:00 PM PCMH: No Morgan, Robert DO Provider ID: 1169163 Gender: Male Family Care At Walsingham 13540 Walsingham Rd Ste D Largo, FL 33774 (727) 593-5492 Fax: (727) 593-5440 05 Yrs/130 Yrs MTWTHFSat 8:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM PCMH: No Munoz, Lorenzo MD Provider ID: 1214222 Gender: Male Live Better Health Center LLC 4423 Park Blvd N Pinellas Park, FL 33781 (727) 827-2825 Fax: (727) 827-2809 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Sat 8:30 AM - 3:00 PM PCMH: No

Provider ID: 521331 Gender: Male Aurindom Narayan MD PA 4820 5th Ave N Saint Petersburg, FL 33713 (727) 321-6768 Fax: (727) 327-8741 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Hindi M-F 8:00 AM - 4:30 PM PCMH: No Nirmalan, Nadarajah MD Provider ID: 1094871 Gender: Male Sai Medical Center LLC 8999 US Hwy 19 N Pinellas Park, FL 33781 (727) 527-2139 Fax: (727) 576-5606 12 Yrs/130 Yrs Languages: Tamil M 2:00 AM - 5:00 PM PCMH: No

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Nowacki, Mark MD Provider ID: 8201 Gender: Male Mark Nowacki MD 7011 1st Ave S Saint Petersburg, FL 33707 (727) 347-4158 Fax: (813) 345-2260 12 Yrs/130 Yrs Bayfront Medical Center Palms of Pasadena Hospital St Petersburg General Hospital Languages: Polish M-F 9:00 AM - 5:00 PM PCMH: No Paganini, Cynthia MD Provider ID: 1137745 Gender: Female 1840 Mease Dr Ste 302 Safety Harbor, FL 34695 (727) 725-6463 Fax: (727) 635-2186 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Perez-Arce, Jose MD Provider ID: 194240 Gender: Male Jose A Perez Arce MD 12685 Starkey Rd Ste 1 Largo, FL 33773 (727) 535-9901 Fax: (727) 535-8760 12 Yrs/130 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Rao, Kavita MD Provider ID: 1211535 Gender: Female Gulf Coast Internist, LLC 4957 38th Ave N Ste C Saint Petersburg, FL 33710 (727) 525-0900 Fax: (727) 525-9500 18 Yrs/130 Yrs Languages: Hindi, Indonesian, Tamil, Malayalam M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Internal Medicine - cont. Shah, Apurva MD Saba, Fadi MD Provider ID: 199819 Gender: Male Professional Health Care Of Pinellas 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 16 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Anthonys Hospital Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Saberi, Ali MD Provider ID: 1137756 Gender: Male 1201 5th Ave N Ste 408 Saint Petersburg, FL 33705 (727) 894-3733 Fax: (727) 825-1482 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Schell, Gina DO Provider ID: 1137760 Gender: Female 560 Jackson St N Ste 302 Saint Petersburg, FL 33705 (727) 895-9640 Fax: (727) 895-9692 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Scutaru, Irina MD Provider ID: 716810 Gender: Female Bayfront Physician Speciality Services 461 7th Ave S Saint Petersburg, FL 33701 (727) 823-0402 Fax: (727) 823-4153 18 Yrs/130 Yrs Bayfront Medical Center MW 1:00 AM - 4:45 PM T 9:30 AM - 11:45 PM PCMH: No

Provider ID: 495397 Gender: Male 13220 Belcher Rd S Ste 11 Largo, FL 33773 (727) 533-2242 Fax: (727) 533-2252 18 Yrs/130 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 2 Shah, Nilamben MD Provider ID: 1336075 Gender: Female Sunrise Medical Clinic 5750 5th Ave N Saint Petersburg, FL 33710 (727) 388-2625 Fax: (727) 828-9233 18 Yrs/130 Yrs Bayfront Medical Center Palms of Pasadena Hospital St Anthonys Hospital Languages: Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Shastri, Milind MD Provider ID: 28550 Gender: Male Your Care Clinics LLC 5985 49th St N Saint Petersburg, FL 33709 (727) 528-8997 Fax: (727) 521-4949 12 Yrs/130 Yrs Northside Hospital St Petersburg General Hospital Languages: Hindi, Gujarati M-F 8:30 AM - 5:00 PM PCMH: No

Shastri, Milind MD Provider ID: 917560 Gender: Male Your Care Clinics LLC 10225 Ulmerton Rd Ste 9A Largo, FL 33771 (727) 528-8997 Fax: (727) 521-4949 18 Yrs/130 Yrs Northside Hospital St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Tirupathi, Sreelatha MD Provider ID: 225046 Gender: Female All Florida Family Care Inc 3301 66th St N Ste A Saint Petersburg, FL 33710 (727) 344-6200 Fax: (727) 344-6222 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Trevino, Miguel MD Provider ID: 316765 Gender: Male 1573 S Fort Harrison Ave Clearwater, FL 33756 (727) 584-8777 Fax: (727) 584-8772 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Languages: Spanish, French M-F 8:30 AM - 5:00 PM PCMH: No Williams, Oswald MD Provider ID: 199053 Gender: Male Maturity Medical PA 502 Pasadena Ave S Saint Petersburg, FL 33707 (727) 381-9500 Fax: (727) 347-0893 12 Yrs/130 Yrs Bartow Regional Medical Center Lake Wales Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

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Yamani, Mohammad MD Provider ID: 1242875 Gender: Male All Care Medical Consultants PA 8900 Park Blvd Seminole, FL 33777 (727) 545-4545 Fax: (727) 548-1360 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Yamani, Mohammad MD Provider ID: 1242877 Gender: Male All Care Medical Consultants 1745 S Highland Ave Clearwater, FL 33756 (727) 587-0377 Fax: (727) 587-0527 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Yamani, Mohammad MD Provider ID: 1242881 Gender: Male All Care Medical Consultants 1115 Florida Ave Palm Harbor, FL 34683 (727) 259-2300 Fax: (727) 259-2305 21 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Acker Lense, Beverly MD Provider ID: 1009138 Gender: Female St Petersburg Pediatrics 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 526-4346 00 Yrs/18 Yrs Bayfront Medical Center M-F 8:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Arango, Jan MD Provider ID: 25401 Gender: Female St Petersburg Pediatrics Southside 1012 4th St S Saint Petersburg, FL 33701 (727) 894-2231 Fax: (727) 895-8602 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Arango, Jan MD Provider ID: 816274 Gender: Female St Petersburg Pediatrics Northside 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 821-0932 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Arango, Jan MD Provider ID: 816276 Gender: Female 3475 E Bay Dr Largo, FL 33771 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM PCMH: No

Arango, Jan MD Provider ID: 816277 Gender: Female St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Arango, Jan MD Provider ID: 816279 Gender: Female St Petersburg Pediatrics Seville 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Arango, Jan MD Provider ID: 816280 Gender: Female St Petersburg Pediatrics Disston 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Arango, Jan MD Provider ID: 816281 Gender: Female St Petersburg Pediatrics Largo 3475 E Bay Dr Largo, FL 33771 (727) 535-9700 Fax: (727) 539-7301 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Aungst, Cary MD Provider ID: 940804 Gender: Female East Lake Pediatrics 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs MT 9:00 AM - 6:00 PM WTHF 8:00 AM - 5:00 PM PCMH: No Banks, Elizabeth MD Provider ID: 1226373 Gender: Female Stephen G Nelson MD PA 7855 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Arroyo, Fernando MD Provider ID: 923982 Gender: Male Pediatric Associates of Tampa Bay 2595 Tampa Rd Ste W Palm Harbor, FL 34684 (727) 785-3092 Fax: (727) 786-1714 Banks, Elizabeth MD 00 Yrs/18 Yrs Mease Hospital Dunedin Provider ID: 1226377 M-F 8:00 AM - 5:00 PM Gender: Female PCMH: No Stephen G Nelson MD PA 5601 MLK St N Arvelo-Velez, Beatriz MD Saint Petersburg, FL 33703 (727) 525-2161 Provider ID: 609938 Fax: (727) 527-1968 Gender: Female 00 Yrs/21 Yrs North Pinellas Children's Bayfront Medical Center Medical C MWTH 8:00 AM - 6:00 PM 31860 US Hwy 19 N T 8:00 AM - 5:30 PM Palm Harbor, FL 34684 F 8:00 AM - 5:00 PM (727) 787-6335 PCMH: No Fax: (727) 489-2519 00 Yrs/18 Yrs Banks, Elizabeth MD Languages: Spanish MTWSatSun 7:00 AM - 9:00 Provider ID: 1226379 PM Gender: Female THF 7:00 AM - 5:00 PM Stephen G Nelson MD PA PCMH: No 8787 Bryan Dairy Rd Ste 350 Seminole, FL 33777 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/21 Yrs MWTH 8:00 AM - 6:00 PM T 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Beetler, June DO Provider ID: 1087255 Gender: Female St Petersburg Pediatrics 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 392-9578 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Bender, Jan MD Provider ID: 251 Gender: Male Sunshine Pediatric Center 6449 38th Ave N Ste G4 Saint Petersburg, FL 33710 (727) 347-2557 Fax: (727) 345-8972 00 Yrs/21 Yrs St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Berio Alvarez, Marta MD Provider ID: 163219 Gender: Female St Petersburg Pediatrics 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 939-9578 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM PCMH: No

Berio Alvarez, Marta MD Provider ID: 163231 Gender: Female 12170 Seminole Blvd Largo, FL 33778 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM PCMH: No Berio Alvarez, Marta MD Provider ID: 163235 Gender: Female St Petersburg Pediatrics 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Berio Alvarez, Marta MD Provider ID: 163244 Gender: Female 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Berio Alvarez, Marta MD Provider ID: 163246 Gender: Female St Petersburg Pediatrics 12170 Seminole Blvd Largo, FL 33778 (813) 871-5437 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM PCMH: No Berio Alvarez, Marta MD Provider ID: 189668 Gender: Female St Petersburg Pediatrics 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Berio Alvarez, Marta MD Provider ID: 199773 Gender: Female St Petersburg Pediatrics 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

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Berio Alvarez, Marta MD Provider ID: 817466 Gender: Female St Petersburg Pediatrics Largo 3475 E Bay Dr Largo, FL 33771 (727) 535-9700 Fax: (727) 539-7301 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Bharucha, Corrie MD Provider ID: 1218002 Gender: Female Stephen G Nelson MD PA 8787 Bryan Dairy Rd Ste 350 Seminole, FL 33777 (727) 525-2161 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM Sat-Sun 9:00 AM - 12:00 PM PCMH: No Bharucha, Corrie MD Provider ID: 681566 Gender: Female Stephen G Nelson MD PA 5601 MLK St N Saint Petersburg, FL 33703 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/21 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM Sat-Sun 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Bharucha, Corrie MD Provider ID: 716997 Gender: Female Stephen G Nelson MD PA 7855 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 525-2161 00 Yrs/21 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Black, Janet MD Provider ID: 222677 Gender: Female N Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 787-7691 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Mease Hospital Dunedin M-F 7:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Sun 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Booth, Christine MD Provider ID: 1095308 Gender: Female North Pinellas Childrens Medical CT 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 489-2519 00 Yrs/21 Yrs M-F 7:00 AM - 8:00 PM Sat-Sun 8:00 AM - 12:00 PM PCMH: No

Brown, William MD Provider ID: 13131 Gender: Male Bayfront Family Medicine Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 893-6966 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No Cano, Carlos MD Provider ID: 14591 Gender: Male Suncoast Pediatric 1395 W. Bay Dr Largo, FL 33770 (727) 584-6802 Fax: (727) 586-6278 00 Yrs/18 Yrs Morton Plant Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:30 PM Sat 8:00 AM - 11:00 PM PCMH: No Cibran, Mariano MD Provider ID: 452 Gender: Male St Pete Pediatrics 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 821-0932 00 Yrs/18 Yrs St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM PCMH: No

Cibran, Mariano MD Provider ID: 453 Gender: Male St Petersburg Pediatrics 1012 4th St S Saint Petersburg, FL 33701 (727) 894-2231 Fax: (727) 895-8602 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 8:30 AM - 5:30 PM PCMH: No Cibran, Mariano MD Provider ID: 816927 Gender: Male St Petersburg Pediatrics Seminole 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 392-9578 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM PCMH: No Cibran, Mariano MD Provider ID: 817006 Gender: Male St Petersburg Pediatrics Pinellas P 7500 Park Blvd N Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

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Cibran, Mariano MD Provider ID: 817028 Gender: Male St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Cibran, Mariano MD Provider ID: 817054 Gender: Male St Petersburg Pediatrics Seville 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM PCMH: No Cibran, Mariano MD Provider ID: 817063 Gender: Male St Petersburg Pediatrics Disston 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Colon, Yaritza MD Provider ID: 1076559 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Colon, Yaritza MD Provider ID: 1076819 Gender: Female CHC At St. Petersburg 612 Dr MLK Jr St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/18 Yrs MWTH 8:00 AM - 7:00 PM TF 8:00 AM - 5:00 PM PCMH: No Colon, Yaritza MD Provider ID: 1077547 Gender: Female CHC At Suncoast 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Colon, Yaritza MD Provider ID: 1160698 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Colon, Yaritza MD Provider ID: 187621 Gender: Female Community Health Ctrs of Pinellas 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Colon, Yaritza MD Provider ID: 225285 Gender: Female Community Health Ctrs of Pinellas 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish MWTH 8:00 AM - 7:00 PM TF 8:00 AM - 5:00 PM PCMH: No Colon, Yaritza MD Provider ID: 382499 Gender: Female Community Health Ctrs of Pinellas 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Colon, Yaritza MD Provider ID: 382506 Gender: Female 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 895-3762 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Colon, Yaritza MD Provider ID: 382568 Gender: Female Community Health Ctrs of Pinellas 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Conde, Nicole DO Provider ID: 1354377 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs MF 8:00 AM - 6:00 PM TWTH 8:00 AM - 8:00 PM Sat 8:00 AM - 4:30 PM PCMH: No Ellis, Lynne MD Provider ID: 232469 Gender: Female Lynne M Ellis MD PA 1111 7th Ave N Ste 103 Saint Petersburg, FL 33705 (727) 822-5393 Fax: (727) 895-3313 00 Yrs/21 Yrs Bayfront Medical Center St Petersburg General Hospital M-F 7:00 AM - 5:00 PM PCMH: No Garsva, Allison DO Provider ID: 1214342 Gender: Female Community Health Centers At Johnnie 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Gaud, Rosa MD Provider ID: 924305 Gender: Female Pediatric Associates of Tampa Bay 2595 Tampa Rd Ste W Palm Harbor, FL 34684 (727) 785-3092 Fax: (727) 786-1714 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gayahan, Glivery Mary MD Provider ID: 1135290 Gender: Female CHC At St. Petersburg 612 MLK St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gayahan, Glivery Mary MD Provider ID: 1135292 Gender: Female Community Health Centers of Pinella 247 S Huey Ave Tarpon Springs, FL 34689 (727) 944-7729 Fax: (727) 939-4679 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gayahan, Glivery Mary MD Provider ID: 1135293 Gender: Female Community Health Centers of Pinella 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Gayahan, Glivery Mary MD

Gayahan, Glivery Mary MD Provider ID: 1160700 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Hagan, Teri MD Provider ID: 1335670 Gender: Female Community Health Centers At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1135294 Gender: Female Community Health Centers of Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 Gayahan, Glivery Mary MD 00 Yrs/21 Yrs Hagan, Teri MD M-F 8:00 AM - 5:00 PM Provider ID: 1335672 PCMH: No Provider ID: 990586 Gender: Female Gender: Female Gayahan, Glivery Mary MD Community Health Centers of Community Health Centers At Pinella Pinella 7550 43rd St N Provider ID: 1135295 707 Druid Rd E Pinellas Park, FL 33781 Gender: Female Clearwater, FL 33756 (727) 824-8181 Community Health Centers of (727) 824-8181 Fax: (727) 541-7984 Pinella Fax: (727) 443-7230 00 Yrs/18 Yrs 1344 22nd St S 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Saint Petersburg, FL 33712 M-F 8:00 AM - 5:00 PM PCMH: No (727) 821-6701 PCMH: Yes, Level 3 Fax: (727) 824-8150 Hagan, Teri MD Geddes, Carol MD 00 Yrs/21 Yrs Provider ID: 1335674 M-F 8:00 AM - 5:00 PM Provider ID: 1099100 Gender: Female PCMH: No Gender: Female Community Health Centers St Petersburg Pediatrics At Clearwa Gayahan, Glivery Mary MD 4105 49th St N 707 Druid Rd E Saint Petersburg, FL 33709 Clearwater, FL 33756 Provider ID: 1135297 (727) 528-6900 (727) 824-8181 Gender: Female Fax: (727) 526-0753 Fax: (727) 443-7230 Community Health Centers of 00 Yrs/18 Yrs 00 Yrs/18 Yrs Pinella M-F 8:00 AM - 7:00 PM M-F 9:00 AM - 5:00 PM 701 6th St S Sat-Sun 9:00 AM - 12:00 PM PCMH: No Saint Petersburg, FL 33701 PCMH: No (727) 824-8181 Hagan, Teri MD Hagan, Teri MD Fax: (727) 209-5619 Provider ID: 1335676 00 Yrs/21 Yrs Provider ID: 1335667 Gender: Female M-F 8:00 AM - 5:00 PM Gender: Female Community Health Centers PCMH: No Community Health Centers At Suncoas At Bayfron 5523 Roosevelt Blvd Gayahan, Glivery Mary MD 701 6th St S Clearwater, FL 33760 Saint Petersburg, FL 33701 (727) 824-8181 (727) 824-8181 Provider ID: 1136238 Fax: (727) 286-6225 Fax: (727) 893-6435 Gender: Female 00 Yrs/18 Yrs 00 Yrs/18 Yrs CHC At Suncoast M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM 707 Druid Rd E PCMH: No PCMH: No Clearwater, FL 33760 (727) 824-8181 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3

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Hagan, Teri MD Provider ID: 1335677 Gender: Female Community Health Centers At St Pete 612 MLK St N Saint Petersburg, FL 33705 (727) 209-0394 Fax: (727) 209-0309 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hagan, Teri MD Provider ID: 1335679 Gender: Female Community Health Centers At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 Fax: (727) 736-1735 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hagan, Teri MD Provider ID: 1335681 Gender: Female Johnnie Ruth Clark 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hagan, Teri MD Provider ID: 1335685 Gender: Female Community Health Centers of Pinella 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Hartlage, Kiersten MD Provider ID: 1074136 Gender: Female CHC At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hartlage, Kiersten MD Provider ID: 1076557 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hartlage, Kiersten MD Provider ID: 1076816 Gender: Female CHC At St. Petersburg 612 Dr MLK Jr St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hartlage, Kiersten MD Provider ID: 1077561 Gender: Female CHC At Suncoast 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Hartlage, Kiersten MD Provider ID: 608598 Gender: Female Community Health Centers of Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Hartlage, Kiersten MD Provider ID: 673003 Gender: Female CHC of Pinellas Inc 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Hartlage, Kiersten MD Provider ID: 673004 Gender: Female CHC At Tarpon Spring 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Hartlage, Kiersten MD Provider ID: 673005 Gender: Female Community Health Cntrs At Pinellas Pk 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Herrero, Vivian MD Provider ID: 710798 Gender: Female Dunedin Pediatrics LLC 424 Douglas Ave Dunedin, FL 34698 (727) 734-7337 Fax: (727) 734-4422 00 Yrs/21 Yrs Languages: Spanish, French MTWF 9:00 AM - 5:00 PM TH 10:00 AM - 7:00 PM PCMH: No Hicks, Mary MD Provider ID: 950440 Gender: Female Raj K Pai MD PA 2370 Drew St Ste B Clearwater, FL 33765 (727) 461-1543 Fax: (727) 449-0594 00 Yrs/21 Yrs Morton Plant Hospital Languages: Hindi M-F 8:30 AM - 5:00 PM Sat 9:00 AM - 11:30 PM PCMH: No

Hughes, Natasha MD Provider ID: 1097101 Gender: Female North Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 489-2519 00 Yrs/21 Yrs M-W 8:00 AM - 8:00 PM THF 8:00 AM - 5:00 PM Sat-Sun 8:00 AM - 12:00 PM PCMH: No Jackson-Curtis, Danuta MD Provider ID: 202336 Gender: Female Better Health Medical & Rehab 28960 US Hwy 19 N Ste 115 Clearwater, FL 33761 (727) 771-8282 Fax: (727) 771-8788 00 Yrs/21 Yrs Florida Hospital North Pinellas Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Languages: Polish MW 11:30 AM - 7:00 PM T 12:00 AM - 4:00 PM THF 9:00 AM - 4:00 PM PCMH: No

Hidalgo, Carlos MD Provider ID: 192391 Gender: Male Tarpon Springs Pediatrics LLC 1007 E Boyer St Tarpon Springs, FL 34689 (727) 772-5982 Jindal, Mayuri MD Fax: (727) 772-0693 Provider ID: 1129634 00 Yrs/18 Yrs Florida Hospital North Pinellas Gender: Female Community Health Centers Mease Countryside Hospital At Johnnie Languages: Spanish 1344 22nd St S M-F 9:00 AM - 6:00 PM Saint Petersburg, FL 33712 PCMH: No (727) 824-8181 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3

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Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Johnson-Milas, Audrey DO Provider ID: 14593 Gender: Female Suncoast Pediatrics 1395 W. Bay Dr Largo, FL 33770 (727) 584-6802 Fax: (727) 586-6278 00 Yrs/18 Yrs Largo Medical Center M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:30 PM Sat 8:00 AM - 11:00 PM PCMH: No Jordan, Michael MD Provider ID: 267061 Gender: Male East Lake Pediatrics PA 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital MT 9:00 AM - 6:00 PM WTHF 8:00 AM - 5:00 PM PCMH: No Kelley, Sarah MD Provider ID: 1076560 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/21 Yrs MTTH 8:00 AM - 8:00 PM WF 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Kelley, Sarah MD Provider ID: 1076822 Gender: Female CHC At St. Petersburg 612 Dr MLK Jr St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/21 Yrs MTTH 8:00 AM - 8:00 PM WF 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Kelley, Sarah MD Provider ID: 727405 Gender: Female 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/21 Yrs MTTH 8:00 AM - 8:00 PM WF 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Kelley, Sarah MD Provider ID: 1077560 Gender: Female CHC At Suncoast 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 00 Yrs/21 Yrs MTTH 8:00 AM - 8:00 PM WF 8:00 AM - 5:00 PM PCMH: No

Kelley, Sarah MD Provider ID: 727412 Gender: Female 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 944-3828 00 Yrs/21 Yrs MTTH 8:00 AM - 8:00 PM WF 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Kelley, Sarah MD Provider ID: 1160703 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Kelley, Sarah MD Provider ID: 727414 Gender: Female 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs MTTH 8:00 AM - 8:00 PM WF 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM PCMH: No

Kelley, Sarah MD Provider ID: 712794 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs M-W 8:00 AM - 8:00 PM THF 8:00 AM - 5:00 PM Sat 8:00 AM - 4:00 PM PCMH: Yes, Level 3

Keshishian, Jessica MD Provider ID: 1268335 Gender: Female Peninsula Pediatrics of West Florid 13131 66th St Largo, FL 33773 (727) 228-7000 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Kharbanda, Monica MD Provider ID: 302646 Gender: Female Countryside Pediatric Care PA 1840 Mease Dr Ste 405 Safety Harbor, FL 34695 (727) 599-0893 Fax: (727) 674-2965 00 Yrs/21 Yrs Mease Countryside Hospital St Josephs Hospital Languages: Hindi, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No Kilbride, Pamela MD Provider ID: 954115 Gender: Female Raj K Pai MD PA 2370 Drew St Ste B Clearwater, FL 33765 (727) 461-1543 Fax: (727) 449-0594 00 Yrs/21 Yrs Morton Plant Hospital M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:00 PM PCMH: No Kim, Jennifer MD Provider ID: 1218003 Gender: Female Stephen G Nelson MD PA 8787 Bryan Dairy Rd Ste 350 Seminole, FL 33777 (727) 525-2161 00 Yrs/18 Yrs M-F 8:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Kim, Jennifer MD Provider ID: 799757 Gender: Female Stephen G Nelson MD PA 5601 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital MTH 8:30 AM - 6:00 PM T 8:30 AM - 5:30 PM W 8:30 AM - 6:30 PM F 8:30 AM - 4:30 PM Sat 9:30 AM - 11:30 PM PCMH: No Kim, Jennifer MD Provider ID: 799765 Gender: Female Stephen G Nelson MD PA 7855 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital M 8:00 AM - 4:00 PM TW 8:30 AM - 12:00 PM TH 9:00 AM - 4:00 PM F 8:30 AM - 4:00 PM PCMH: No Kitterman, Christopher DO Provider ID: 1335079 Gender: Male Community Health Centers At Pinella 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Kitterman, Christopher DO

Kitterman, Christopher DO

Provider ID: 1335089 Gender: Male Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Provider ID: 1335126 Gender: Male Community Health Centers At Pinella 612 MLK St N Saint Petersburg, FL 33705 (727) 209-0394 Fax: (727) 209-0309 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Kitterman, Christopher DO

Kitterman, Christopher DO

Provider ID: 1335096 Gender: Male Community Health Centers At Pinella 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Provider ID: 1335128 Gender: Male Community Health Centers At Pinella 1721 Main St Dunedin, FL 34698 (727) 824-8181 Fax: (727) 736-1735 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Kitterman, Christopher DO Provider ID: 1335110 Gender: Male Community Health Centers At Pinella 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No Kitterman, Christopher DO Provider ID: 1335121 Gender: Male Community Health Centers At Pinella 5523 Roosevelt Blvd Clearwater, FL 33760 (727) 824-8181 Fax: (727) 286-6225 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Klein, Jay MD Provider ID: 475077 Gender: Male N Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 787-7691 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital M-F 7:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Sun 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Lam, Yim MD Provider ID: 1073738 Gender: Male Johnnie Ruth Clark 1344 22nd St S Saint Petersburg, FL 33712 (727) 821-6701 Fax: (727) 541-7984 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Lam, Yim MD Provider ID: 1073739 Gender: Male CHC At Clearwater 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Lam, Yim MD Provider ID: 1073740 Gender: Male Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/18 Yrs M 8:00 AM - 4:00 PM PCMH: No Lam, Yim MD Provider ID: 1073742 Gender: Male Community Health Centers At Suncoas 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6224 Fax: (727) 286-6225 00 Yrs/18 Yrs M 8:00 AM - 4:00 PM PCMH: No Lam, Yim MD Provider ID: 1073743 Gender: Male CHC At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Lam, Yim MD Provider ID: 1073744 Gender: Male Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lam, Yim MD Provider ID: 1135282 Gender: Male CHC At St. Petersburg 612 MLK St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lam, Yim MD Provider ID: 1135301 Gender: Male CHC At Tarpon Springs 247 S Huey Ave Tarpon Springs, FL 34689 (727) 944-7729 Fax: (727) 939-4679 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lam, Yim MD Provider ID: 1160705 Gender: Male CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Lopez Dominguez, Maria MD Provider ID: 975991 Gender: Female 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Lopez Molina, Norma MD

Lopez-Mccormack, Celia MD

Provider ID: 1077549 Gender: Female CHC At Suncoast 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 717001 Gender: Female Stephen G Nelson MD PA 7855 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 525-2161 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Lopez Molina, Norma MD

Lopez Molina, Norma MD Provider ID: 1074137 Gender: Female CHC At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lopez Molina, Norma MD Provider ID: 1076563 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lopez Molina, Norma MD Provider ID: 1076829 Gender: Female CHC At St. Petersburg 612 Dr MLK Jr St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1160706 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lopez-Mccormack, Celia MD Provider ID: 1218004 Gender: Female Stephen G Nelson MD PA 8787 Bryan Dairy Rd Ste 350 Seminole, FL 33777 (727) 525-2161 00 Yrs/21 Yrs Languages: Spanish M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Lopez-Mccormack, Celia MD Provider ID: 18027 Gender: Female Stephen G Nelson MD PA 5601 Dr MLK Jr St North Saint Petersburg, FL 33703 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Lopez-Molina, Norma MD Provider ID: 809074 Gender: Female CHC At Tarpon Springs 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Lopez-Molina, Norma MD Provider ID: 809076 Gender: Female CHC At Pinellas Park 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Lopez-Molina, Norma MD Provider ID: 809079 Gender: Female Johnnie Ruth Clarke 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 895-3762 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Luna, Juan MD Provider ID: 1123029 Gender: Male Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs Bayfront Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 4:00 PM PCMH: Yes, Level 3 Meyer, Ernesto MD Provider ID: 19037 Gender: Male Partners In Pediatrics 401 Corbett St Ste 210 Belleair, FL 33756 (727) 446-1161 Fax: (727) 446-8212 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Morton Plant Hospital St Petersburg General Hospital Languages: Spanish, German, Portuguese M-F 8:30 AM - 5:00 PM PCMH: No

Meyer, Laura MD Provider ID: 925434 Gender: Female Partners In Pediatrics 401 Corbett St Ste 210 Belleair, FL 33756 (727) 446-1161 Fax: (727) 446-8212 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Morton Plant Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Miranda, Elinor MD Provider ID: 21586 Gender: Female St Petersburg Pediatrics 3801 34th St S Saint Petersburg, FL 33711 (727) 865-0515 Fax: (727) 865-0250 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-F 10:00 AM - 11:30 PM PCMH: No Miranda, Elinor MD Provider ID: 576883 Gender: Female St. Petersburg Pediatrics 6675 38th Ave N Ste 101 Saint Petersburg, FL 33710 (727) 384-1217 Fax: (727) 384-3240 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 1:00 AM - 4:30 PM PCMH: No

Montgomery, Kelly MD Provider ID: 1093484 Gender: Female Community Health Centers At Clearwa 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Moore, Steven MD Provider ID: 1212749 Gender: Male Peninsula Pediatrics of West Florid 13131 66th St Largo, FL 33773 (727) 228-7000 Fax: (727) 223-3614 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Morton Plant Hospital M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Nelson, Stephen MD Provider ID: 1218007 Gender: Male Stephen G Nelson MD PA 8787 Bryan Dairy Rd Ste 350 Seminole, FL 33777 (727) 525-2161 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM Sat-Sun 9:00 AM - 12:00 PM PCMH: No

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Nelson, Stephen MD Provider ID: 18026 Gender: Male Stephen G Nelson MD PA 5601 Dr MLK Jr. St North Saint Petersburg, FL 33703 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Petersburg General Hospital Languages: Spanish M-TH 8:00 AM - 6:30 PM F 8:00 AM - 5:00 PM PCMH: No Pai, Rajendra MD Provider ID: 151521 Gender: Male Clearwater Pediatric Care 2370 Drew St Unit B Clearwater, FL 33765 (727) 461-1543 Fax: (727) 449-0594 00 Yrs/21 Yrs Bayfront Health Dade City Mease Hospital Dunedin Morton Plant Hospital Languages: Hindi, Urdu, Kannada M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:00 PM PCMH: No Pantages, Efstratios MD Provider ID: 475039 Gender: Male N Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 787-7691 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Hospital Dunedin M-F 7:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Sun 8:00 AM - 12:00 PM PCMH: Yes, Level 3

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Petitfils, Lisa MD Provider ID: 1043418 Gender: Female Lynne M Ellis MD PA 1111 7th Ave N Ste 103 Saint Petersburg, FL 33705 (727) 822-5393 Fax: (727) 895-3313 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital MTF 8:00 AM - 5:00 PM W 8:30 AM - 12:00 PM TH 8:30 AM - 5:00 PM Sat 8:00 AM - 12:30 PM PCMH: No Razman, Dolores MD Provider ID: 475044 Gender: Female N Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 209-1177 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Reilly Hays, Elizabeth MD Provider ID: 816842 Gender: Female St Petersburg Pediatrics Northside 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 821-0932 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Reilly Hays, Elizabeth MD Provider ID: 816847 Gender: Female 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Reilly Hays, Elizabeth MD Provider ID: 816849 Gender: Female St Petersburg Pediatrics Pinellas P 7500 Park Blvd N Ste A Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Reilly Hays, Elizabeth MD Provider ID: 816853 Gender: Female St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Reilly Hays, Elizabeth MD Provider ID: 816861 Gender: Female St Petersburg Pediatrics Seville 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Reilly Hays, Elizabeth MD Provider ID: 816866 Gender: Female St Petersburg Pediatrics Disston 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Rommel, Duane MD Provider ID: 475065 Gender: Male N Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 787-7691 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Mease Hospital Dunedin Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 3 Salib, Magda MD Provider ID: 1057628 Gender: Female St Mary Florida Pediatric Care PLLC 2626 Tampa Rd Ste 101 Palm Harbor, FL 34684 (727) 754-1984 Fax: (727) 754-2868 00 Yrs/21 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital Languages: Arabic MTH 9:00 AM - 5:00 PM TW 10:00 AM - 7:00 PM PCMH: No

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Sawka, Jennifer MD Provider ID: 475067 Gender: Female N Pinellas Childrens Medical Center 31860 US Hwy 19 N Palm Harbor, FL 34684 (727) 787-6335 Fax: (727) 489-2519 00 Yrs/21 Yrs Mease Countryside Hospital M-F 7:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Sun 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Schey, Nicholas MD Provider ID: 1335687 Gender: Male Community Health Centers At Johnnie 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Schey, Nicholas MD Provider ID: 1335689 Gender: Male Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Schey, Nicholas MD Provider ID: 1335691 Gender: Male Community Health Centers At Suncoas 5523 Roosevelt Blvd Clearwater, FL 33760 (727) 824-8181 Fax: (727) 286-6225 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Schey, Nicholas MD Provider ID: 1335693 Gender: Male Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Schey, Nicholas MD Provider ID: 1335694 Gender: Male Community Health Centers At Clearwa 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No

Schey, Nicholas MD Provider ID: 1335695 Gender: Male Community Health Centers At St Pete 612 MLK Jr St N Saint Petersburg, FL 33705 (727) 824-8181 Fax: (727) 209-0309 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Schey, Nicholas MD Provider ID: 1335698 Gender: Male Community Health Centers At Tarpon 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Schey, Nicholas MD

Smith, Jessica MD Provider ID: 526433 Gender: Female East Lake Pediatrics 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs Mease Countryside Hospital Morton Plant Hospital St Josephs Hospital Languages: German MT 9:00 AM - 6:00 PM WTHF 8:00 AM - 5:00 PM PCMH: No Sterling, Fran DO Provider ID: 14595 Gender: Female Suncoast Pediatrics 1395 W. Bay Dr Largo, FL 33770 (727) 584-6802 Fax: (727) 586-6278 00 Yrs/18 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:30 PM Sat 8:00 AM - 11:00 PM PCMH: No Szafranski, Christy MD

Provider ID: 1335701 Gender: Male Community Health Centers At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 Fax: (727) 736-1735 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No

Provider ID: 816749 Gender: Female St Petersburg Pediatrics Northside 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 821-0932 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

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Szafranski, Christy MD Provider ID: 816759 Gender: Female St Petersburg Pediatrics Seminole 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 939-9578 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM PCMH: No Szafranski, Christy MD Provider ID: 816771 Gender: Female St Petersburg Pediatrics Pinellas P 7500 Park Blvd N Ste A Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Szafranski, Christy MD Provider ID: 816778 Gender: Female St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Szafranski, Christy MD Provider ID: 816791 Gender: Female St Petersburg Pediatrics 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs Bayfront Medical Center St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Szafranski, Christy MD Provider ID: 816795 Gender: Female St Petersburg Pediatrics Disston 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Szafranski, Christy MD Provider ID: 816800 Gender: Female St Petersburg Pediatrics Largo 3475 E Bay Dr Largo, FL 33771 (727) 535-9700 Fax: (727) 539-7301 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Tabassum, Rana MD Provider ID: 955763 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 00 Yrs/18 Yrs Languages: Spanish, Hindi, Urdu, Punjabi M-F 9:00 AM - 5:00 PM PCMH: No Threadgill, Nichelle MD Provider ID: 1076555 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/21 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Threadgill, Nichelle MD Provider ID: 1076842 Gender: Female CHC At St. Petersburg 612 Dr MLK Jr St N Saint Petersburg, FL 33705 (727) 824-8181 00 Yrs/21 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: Yes, Level 3 Threadgill, Nichelle MD Provider ID: 1077566 Gender: Female CHC At Suncoast 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Threadgill, Nichelle MD Provider ID: 1160714 Gender: Female CHC At Dunedin 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/21 Yrs St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Threadgill, Nichelle MD Provider ID: 192467 Gender: Female Community Health Ctrs of Pinellas 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/21 Yrs St Petersburg General Hospital MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Threadgill, Nichelle MD Provider ID: 192468 Gender: Female Community Health Ctrs of Pinellas 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/21 Yrs St Petersburg General Hospital MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

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Threadgill, Nichelle MD Provider ID: 192469 Gender: Female Community Health Ctrs of Pinellas 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 824-8165 00 Yrs/21 Yrs St Petersburg General Hospital MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Threadgill, Nichelle MD Provider ID: 192470 Gender: Female Community Health Centers At Tarpon 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/21 Yrs St Petersburg General Hospital MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Threadgill, Nichelle MD Provider ID: 192471 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/21 Yrs St Petersburg General Hospital MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Tran, Thein MD Provider ID: 213546 Gender: Female St Petersburg Pediatrics Seville 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Tran, Thein MD Provider ID: 231987 Gender: Female St Petersburg Pediatrics Pinellas P 7500 Park Blvd N Ste A Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Tran, Thein MD Provider ID: 546313 Gender: Female St Petersburg Pediatrics Northside 2701 154th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 821-0932 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Tran, Thein MD Provider ID: 598423 Gender: Female St Petersburg Pediatrics Southside 1012 4th St S Saint Petersburg, FL 33701 (727) 894-2231 Fax: (727) 895-8602 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Tran, Thein MD Provider ID: 857469 Gender: Female St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Tran, Thein MD Provider ID: 874527 Gender: Female St Petersburg Pediatrics Seminole 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 939-9578 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM PCMH: No

Weinberger, Alyssa MD Provider ID: 1218006 Gender: Female Stephen G Nelson MD PA 8787 Bryan Dairy Rd Ste 350 Seminole, FL 33777 (727) 525-2161 00 Yrs/18 Yrs M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Weinberger, Alyssa MD Provider ID: 240906 Gender: Female Stephen G Nelson MD PA 5601 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 525-2161 Fax: (727) 527-1968 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Languages: Spanish, French, German, Portuguese M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:30 PM PCMH: No Weinberger, Alyssa MD Provider ID: 717025 Gender: Female Stephen G Nelson MD PA 7855 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 525-2161 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Tran, Thein MD Provider ID: 879546 Gender: Female St Petersburg Pediatrics Disston 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

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Zhao, Wenying MD Provider ID: 189671 Gender: Female St Petersburg Pediatrics 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Languages: Chinese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Zhao, Wenying MD Provider ID: 199776 Gender: Female St Petersburg Pediatrics 3475 E Bay Dr Largo, FL 33771 (727) 535-9700 Fax: (727) 539-7301 00 Yrs/18 Yrs Languages: Chinese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Zhao, Wenying MD Provider ID: 199778 Gender: Female St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs Languages: Chinese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Pinellas Pediatrics - cont. Zhao, Wenying MD Provider ID: 25304 Gender: Female St Petersburg Pediatrics 7500 Park Blvd N Ste A Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Languages: Chinese M-F 8:00 AM - 7:00 PM PCMH: No

Zhao, Wenying MD Provider ID: 816781 Gender: Female St Petersburg Pediatrics 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Zhao, Wenying MD Provider ID: 25305 Gender: Female St Petersburg Pediatrics 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 821-0932 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Languages: Chinese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Zhao, Wenying MD Provider ID: 25306 Gender: Female St Petersburg Pediatrics 1012 4th St S Saint Petersburg, FL 33701 (727) 894-2231 Fax: (727) 895-8602 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Languages: Chinese M-F 8:30 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Polk Family Practice Amin, Sapnalaxmi MD Provider ID: 1272048 Gender: Female Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Amin, Sapnalaxmi MD Provider ID: 1272051 Gender: Female Central Florida Health Care 916 Old Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Amin, Sapnalaxmi MD Provider ID: 1272055 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Concepcion, Maria MD Provider ID: 1176086 Gender: Female Maria Nina Concepcion MD PA 339 Cypress Pkwy Ste 180 Poinciana, FL 34759 (863) 422-1400 Fax: (893) 422-4616 02 Yrs/130 Yrs Languages: Tagalog M-F 9:30 AM - 5:00 PM PCMH: No Concepcion, Maria MD

Amin, Sapnalaxmi MD Provider ID: 1272053 Gender: Female Central Florida Health Care 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Amin, Sapnalaxmi MD Provider ID: 1272054 Gender: Female Central Florida Health Care 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Provider ID: 989572 Gender: Female Maria Nina Concepcion MD PA 2302 North Blvd W Davenport, FL 33837 (863) 422-1400 Fax: (893) 422-4616 02 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Tagalog M-F 9:30 AM - 5:00 PM PCMH: No

Dean, Byron DO Provider ID: 354953 Gender: Male Dean Medical Inc 1129 Lakeland Hills Blvd Lakeland, FL 33805 (863) 648-5846 Fax: (863) 937-6354 00 Yrs/130 Yrs Bartow Regional Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Gandhi, Drashti MD Provider ID: 1276744 Gender: Female Haines City Hma Physician Mgmnt LLC 410 Lionel Way Davenport, FL 33837 (863) 419-2420 Fax: (863) 547-9756 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gondi, Avantica MD Provider ID: 1192648 Gender: Female Lakeland Physicians And Associates 1818 Harden Blvd Ste 120 Lakeland, FL 33803 (863) 210-5640 Fax: (863) 210-5716 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Khan, Kashan MD Provider ID: 480442 Gender: Male Chamber of Medicine PA 2231 North Blvd W Ste B Davenport, FL 33837 (863) 422-1890 Fax: (863) 422-1893 18 Yrs/110 Yrs Heart of Florida Reg Med Center Languages: Hindi, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

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Louisville, Tommy MD Provider ID: 1132957 Gender: Male First Family Practice Inc 1801 Crystal Lake Dr Lakeland, FL 33801 (863) 937-8886 Fax: (863) 937-8892 00 Yrs/130 Yrs M-F 8:00 AM - 6:30 PM PCMH: No Louisville, Tommy MD Provider ID: 1132963 Gender: Male First Family Practice Inc 235 N Commonwealth Ave Polk City, FL 33868 (863) 984-8000 Fax: (863) 984-8009 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Louisville, Tommy MD Provider ID: 1132969 Gender: Male First Family Practice Inc 320 1st St S Winter Haven, FL 33880 (863) 299-8485 Fax: (863) 293-8450 00 Yrs/130 Yrs MWFSatSun 8:00 AM - 6:30 PM TTH 8:00 AM - 7:00 PM PCMH: No Nelson James, Cara DO Provider ID: 1160863 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk Family Practice - cont. Nelson- James, Cara DO Provider ID: 715645 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Nelson- James, Cara DO Provider ID: 715668 Gender: Female Central Florida Health Care Inc 916 SR 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3258 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Nelson-James, Cara DO Provider ID: 360815 Gender: Female Central Florida Health Care Inc 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Patrick, Brian MD Provider ID: 799357 Gender: Male Trinity Medical Center 3240 S Florida Ave Lakeland, FL 33803 (863) 646-4000 Fax: (863) 904-0398 00 Yrs/130 Yrs Bartow Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Shoba, Sama MD Provider ID: 790336 Gender: Female Good Health Physicians LLC 217 E Central Ave Winter Haven, FL 33880 (863) 229-2540 Fax: (863) 229-1230 00 Yrs/130 Yrs Winter Haven Hospital Languages: Hindi M-F 8:30 AM - 5:30 PM Sat 10:00 AM - 12:00 PM PCMH: No Soni, Ambica MD Provider ID: 848603 Gender: Female Soni Family Practice PLLC 106 Park Place Blvd Ste C Davenport, FL 33837 (863) 588-4775 Fax: (863) 422-7664 00 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Spanish, Hindi, Urdu MW 9:00 AM - 7:00 PM T 9:00 AM - 5:00 PM F 9:00 AM - 2:00 PM PCMH: No

Sookdeo, Trishanna MD Provider ID: 1281292 Gender: Female Haines City Hma Physician Mgmnt LLC 410 Lionel Way 3rd Fl Davenport, FL 33837 (863) 419-2420 Fax: (863) 419-2429 00 Yrs/130 Yrs M-TH 8:00 AM - 4:00 PM PCMH: No Velez, Giovanni MD Provider ID: 933322 Gender: Male Jay Care Medical Center 950 1st St S Winter Haven, FL 33880 (863) 295-5604 Fax: (863) 295-5398 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

General Practice Alvarez, Edel MD Provider ID: 1174556 Gender: Male Downtown Haines City Medical Center 502 E Hinson Ave Haines City, FL 33844 (863) 438-7911 Fax: (863) 638-5035 02 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Blanco, Adolfo MD Provider ID: 273425 Gender: Male American Care of Tampa 2600 Industrial Park Dr Ste C Lakeland, FL 33801 (863) 666-6100 Fax: (863) 248-4395 02 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Cruz Diaz, Ana MD Provider ID: 1269767 Gender: Female Jay Care Medical Center 950 1st St S Winter Haven, FL 33880 (863) 295-5604 Fax: (863) 295-5398 16 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Cruz Diaz, Ana MD Provider ID: 1269768 Gender: Female Jay Care Medical Center 135 E 1st St Lakeland, FL 33805 (863) 875-7928 Fax: (863) 686-6737 16 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM PCMH: No De Vera, Melva MD Provider ID: 25016 Gender: Female Seen At Polk County Health Dept 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2620 Fax: (863) 499-2612 02 Yrs/18 Yrs Languages: Spanish, Filipino M-F 8:00 AM - 5:00 PM PCMH: No Del Toro Rivera, Eliud MD Provider ID: 1209889 Gender: Male American Care of Tampa Inc 1005 N Lake Parker Ave Lakeland, FL 33805 (863) 583-4053 Fax: (863) 248-8288 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk General Practice - cont. Del Toro Rivera, Eliud MD Provider ID: 1209892 Gender: Male American Care 2791 Lake Alfred Rd Winter Haven, FL 33881 (863) 291-4590 Fax: (863) 508-6503 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fersobe, Saadia MD Provider ID: 1243387 Gender: Female Kidsville Pediatrics I, PA 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 9:30 AM - 12:00 PM PCMH: No Garcia, Nestor MD Provider ID: 1162085 Gender: Male Jay Care Medical Center 135 E 1st St Lakeland, FL 33805 (863) 686-2728 Fax: (863) 686-6737 12 Yrs/130 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Garcia, Nestor MD Provider ID: 1203240 Gender: Male Jay Care Medical Center 950 1st St S Winter Haven, FL 33880 (863) 295-5604 Fax: (863) 295-5398 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ham Ying, John MD Provider ID: 1196157 Gender: Male Central Florida Health Care, Inc. 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No Herrera, Cesar MD Provider ID: 1170023 Gender: Male American Care of Tampa 502 E Hinson Ave Haines City, FL 33844 (863) 438-7911 Fax: (863) 638-5035 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Herrera, Cesar MD Provider ID: 1170024 Gender: Male American Care of Tampa Inc 2600 Industrial Park Dr Ste C Lakeland, FL 33801 (863) 666-6100 Fax: (863) 248-4395 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Herrera, Cesar MD Provider ID: 1170025 Gender: Male American Care 2791 Lake Alfred Rd Winter Haven, FL 33881 (863) 291-4590 Fax: (863) 508-6503 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Jean Francois Benoit, Gladys MD Provider ID: 1205018 Gender: Female American Care of Tampa 502 E Hinson Ave Haines City, FL 33844 (863) 438-7911 Fax: (863) 638-5035 02 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lafontant, Anne MD Provider ID: 1223027 Gender: Female Jay Care Medical Ceter 135 E 1st St Lakeland, FL 33805 (863) 686-2728 Fax: (863) 686-6737 00 Yrs/130 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Jean Francois Benoit, Gladys MD Provider ID: 1205020 Gender: Female American Care of Tampa Inc 2600 Industrial Park Dr Ste C Lakeland, FL 33801 (863) 666-6100 Fax: (863) 248-4395 02 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1220780 Gender: Male Jay Care Medical Center 135 E 1st St Lakeland, FL 33805 (863) 686-2728 Fax: (863) 686-6737 00 Yrs/130 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Jean Francois Benoit, Gladys MD Provider ID: 1205023 Gender: Female American Care 2791 Lake Alfred Rd Winter Haven, FL 33881 (863) 291-4590 Fax: (863) 508-6503 02 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jimenez Arocho, Emilio MD Provider ID: 1242823 Gender: Female Orlando Family Medical Inc 900 Towne Center Dr Kissimmee, FL 34759 (407) 931-0444 Fax: (407) 978-6639 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Maduagwu, Okoroafor MD

Naseer, Saira MD Provider ID: 1356325 Gender: Female Doctor Today TLC LLC 1429 Lakeland Hills Blvd Lakeland, FL 33805 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs M-F 8:30 AM - 5:30 PM PCMH: Yes, Level 2 Nelson James, Cara DO Provider ID: 523312 Gender: Female Central Florida Health Care Inc 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk General Practice - cont. Ortiz Guzman, Enrique MD Provider ID: 1356324 Gender: Female Doctor Today TLC LLC 602 US Hwy 17 92 W Haines City, FL 33844 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs M-F 8:30 AM - 5:30 PM PCMH: Yes, Level 2 Pierre, Jean MD Provider ID: 1356323 Gender: Male Doctor Today TLC LLC 101 Magnolia Ave Auburndale, FL 33823 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-F 10:00 AM - 7:00 PM PCMH: Yes, Level 2 Rodriguez Marin, Yomayra MD Provider ID: 1335720 Gender: Female Kidsville Pediatrics I, PA 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 9:30 AM - 12:00 PM PCMH: No Ton, Liem MD Provider ID: 1111108 Gender: Male First Family Practice Inc 1801 Crystal Lake Dr Lakeland, FL 33801 (863) 937-8886 Fax: (863) 937-8892 00 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No

Ton, Liem MD Provider ID: 1111110 Gender: Male First Family Practice Inc 235 N Commonwealth Ave Polk City, FL 33868 (863) 984-8000 Fax: (863) 984-8009 00 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Ton, Liem MD Provider ID: 1111112 Gender: Male First Family Practice Inc 320 1st St S Winter Haven, FL 33880 (863) 294-6132 Fax: (863) 293-8450 00 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Vasquez, Kimber MD Provider ID: 658568 Gender: Male Central Florida Health Care Winter 1514 1st St N Winter Haven, FL 33881 (866) 234-8534 Fax: (863) 292-4293 00 Yrs/130 Yrs Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Virella Guzman, Vivian MD Provider ID: 1054334 Gender: Female Internal Medicine Spec Medical Grou 5425 S Florida Ave Lakeland, FL 33813 (863) 644-3585 Fax: (863) 644-3171 18 Yrs/130 Yrs Languages: Spanish MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

Virella Guzman, Vivian MD Provider ID: 1054335 Gender: Female Internal Medicine Spec Medical Grou 1045 E County Rd 540A Lakeland, FL 33813 (863) 644-3585 Fax: (863) 644-3171 18 Yrs/130 Yrs Languages: Spanish MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

Internal Medicine Acuna, Jose MD Provider ID: 1251406 Gender: Male Angel Primary Care Clinic 1500 Lakeland Hills Blvd Ste 3 Lakeland, FL 33805 (863) 333-0200 Fax: (863) 937-7398 18 Yrs/130 Yrs Bartow Regional Medical Center Lakeland Reg Medical Center Languages: Spanish M-F 5:00 AM - 7:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Bhatia, Gitashree MD Provider ID: 1159457 Gender: Female Central Florida Health Care Inc Win 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Bhatia, Gitashree MD Provider ID: 202714 Gender: Female Central Florida Health Care Inc Dun 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 12 Yrs/130 Yrs Languages: Hindi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Fernandez, Rodolfo MD Provider ID: 1054565 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 18 Yrs/130 Yrs Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Garcia Jr, Jose MD Provider ID: 1170916 Gender: Male American Care of Tampa 502 E Hinson Ave Haines City, FL 33844 (863) 438-7911 Fax: (863) 638-5601 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Garcia Jr, Jose MD Provider ID: 1170917 Gender: Male American Care of Tampa Inc 2791 Lake Alfred Rd Winter Haven, FL 33881 (863) 291-4590 Fax: (863) 508-6503 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk Internal Medicine - cont. Issar, Jeetendra MD Garcia Jr, Jose MD Provider ID: 377524 Gender: Male American Care of Tampa 2600 Industrial Park Dr Ste C Lakeland, FL 33801 (863) 666-6100 Fax: (863) 248-4395 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Issar, Jeetendra MD Provider ID: 221864 Gender: Male Tampa Bay IPA LLC 3810 S Florida Ave Lakeland, FL 33813 (863) 619-5100 Fax: (863) 619-5102 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No Issar, Jeetendra MD Provider ID: 231806 Gender: Male Tampa Bay IPA LLC 700 1st St S Winter Haven, FL 33880 (863) 858-8000 Fax: (863) 619-5102 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No Issar, Jeetendra MD Provider ID: 314458 Gender: Male Tampa Bay IPA LLC 1429 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-0200 Fax: (863) 687-0222 00 Yrs/130 Yrs Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No

Provider ID: 684276 Gender: Male Doctor Today TLC LLC 4435 US Hwy 98 N Ste B Lakeland, FL 33809 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 2 Issar, Jeetendra MD Provider ID: 724773 Gender: Male Doctor Today TLC LLC 101 Magnolia Ave Auburndale, FL 33823 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Issar, Rekha MD Provider ID: 1126059 Gender: Female Tampa Bay IPA LLC 1045 US Hwy 17 S Bartow, FL 33830 (863) 619-5100 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:30 AM - 5:30 PM PCMH: No Issar, Rekha MD Provider ID: 216136 Gender: Female Tampa Bay IPA LLC 3810 S Florida Ave Lakeland, FL 33813 (863) 858-8000 Fax: (863) 619-5102 00 Yrs/130 Yrs Languages: Hindi MTWTHFSat 8:30 AM - 5:30 PM PCMH: Yes, Level 2

Issar, Rekha MD Provider ID: 231808 Gender: Female Tampa Bay IPA LLC 4435 US Hwy 98 N Lakeland, FL 33809 (863) 619-5100 Fax: (863) 619-5102 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No Issar, Rekha MD Provider ID: 315120 Gender: Female Tampa Bay IPA LLC 1429 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-0200 Fax: (863) 687-0222 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi MTWTHFSat 8:30 AM - 5:30 PM PCMH: No Issar, Rekha MD Provider ID: 500399 Gender: Female Doctor Today TLC LLC 101 Magnolia Ave Auburndale, FL 33823 (863) 858-8000 Fax: (863) 858-8005 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Issar, Rekha MD Provider ID: 704984 Gender: Female Tampa Bay IPA LLC 700 1st St S Winter Haven, FL 33880 (863) 858-8000 Fax: (863) 619-5102 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No

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Jacob, Nirmala MD Provider ID: 27395 Gender: Female Verimed Health Group Lakeland 1417 Lakelnd Hls Blvd Ste 204 Lakeland, FL 33805 (863) 688-5811 Fax: (863) 688-5866 18 Yrs/130 Yrs Baptist Medical Center of The Beaches Bethesda Memorial Hospital University Hospital Languages: Spanish, French, Italian, Malayalam M-F 9:00 AM - 5:00 PM PCMH: No Jacob, Viola MD Provider ID: 1238946 Gender: Female Lakeland Physician Group LC 517 Buena Vista St Lakeland, FL 33805 (863) 688-3674 Fax: (863) 616-9902 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kattan, Halide MD Provider ID: 245585 Gender: Female Jay Care Medical 5985 S Florida Ave Lakeland, FL 33813 (863) 644-8459 16 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk Internal Medicine - cont. Latt, Khin MD Kattan, Halide MD Provider ID: 26913 Gender: Female Jay Care Medical Center 175 US Hwy 17 N Lakeland, FL 33830 (863) 533-8215 16 Yrs/130 Yrs Lakeland Florida Endodba Surgery Center of Lake Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Kundlas, Kulmeet MD Provider ID: 17651 Gender: Male Davita Medical Group Haines City 35600 Hwy 27 Haines City, FL 33844 (863) 679-8815 Fax: (863) 679-8335 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Winter Haven Hospital Languages: Punjabi M-F 9:00 AM - 5:00 PM PCMH: No Kundlas, Kulmeet MD Provider ID: 27536 Gender: Male Davita Medical Group Cypress Garden 6800 Cypress Gardens Blvd Winter Haven, FL 33884 (863) 679-8815 Fax: (863) 679-8335 18 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Punjabi M-F 8:30 AM - 5:00 PM PCMH: No

Mathan, Sukumar MD

Provider ID: 378866 Gender: Male Jaycare Medical Center 135 E 1st St Lakeland, FL 33805 (863) 686-2728 Fax: (863) 686-6737 18 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Burmese M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Lopez, Raphael MD Provider ID: 273231 Gender: Male Cypress Medical Center 131 Webb Dr Ste C Davenport, FL 33837 (863) 421-4400 Fax: (863) 421-4402 16 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Mathan, Sukumar MD Provider ID: 178730 Gender: Male Davita Medical Group Lake Wales 1143 SR 60 E Lake Wales, FL 33853 (863) 679-8815 Fax: (863) 679-8335 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Winter Haven Hospital Languages: Hindi, Tamil, Telugu M-F 8:30 AM - 5:30 PM PCMH: No

Provider ID: 192339 Gender: Male Davita Medical Group Haines City 35600 Hwy 27 Haines City, FL 33844 (863) 679-8815 Fax: (863) 679-8335 18 Yrs/130 Yrs Lake Wales Medical Center Winter Haven Hospital Languages: Hindi, Tamil, Telugu M-F 8:30 AM - 5:30 PM PCMH: No

Mena Perez, Raysa MD Provider ID: 1014599 Gender: Female Jay Care Medical Center 175 US Hwy 17 N Bartow, FL 33830 (863) 533-8215 Fax: (863) 533-8221 12 Yrs/130 Yrs Bartow Regional Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Min, Zaw MD Provider ID: 232471 Mathan, Sukumar MD Gender: Male Provider ID: 288494 Jaycare Medical Center Gender: Male 135 E 1st St Davita Medical Group Cypress Lakeland, FL 33805 Garden (863) 686-2728 6800 Cypress Gardens Blvd Fax: (863) 686-6737 Winter Haven, FL 33884 16 Yrs/130 Yrs (863) 679-8815 Lakeland Reg Medical Center Fax: (863) 679-8335 M-F 8:00 AM - 9:00 PM 18 Yrs/130 Yrs Sat 9:00 AM - 5:00 PM Heart of Florida Reg Med PCMH: No Center Lake Wales Medical Center Palazzolo, Arlene MD Winter Haven Hospital Provider ID: 473482 Languages: Hindi, Tamil, Gender: Female Telugu Central Florida Healthcare M-F 8:30 AM - 5:00 PM Partners PCMH: No 1485 Legends Blvd Champions Gate, FL 33896 Mbakwem, Alexander MD (407) 390-6480 Fax: (407) 390-6483 Provider ID: 204466 12 Yrs/130 Yrs Gender: Male Florida Hospital Orlando Alexander C Mbakwem MD Orlando Regional Medical PA Center 1629 Lakeland Hills Blvd Languages: Italian Lakeland, FL 33805 M-F 9:00 AM - 5:00 PM (863) 687-9333 PCMH: No Fax: (863) 686-0160 18 Yrs/130 Yrs Brandon Regional Hospital Lakeland Reg Medical Center Languages: Ibo/Igbo M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Polk Internal Medicine - cont. Singh, Japinder MD Ranon, Eric MD Provider ID: 300746 Gender: Male Jay Care Medical Center 950 1st St S Winter Haven, FL 33880 (863) 295-5604 Fax: (863) 295-5398 00 Yrs/130 Yrs Languages: Tagalog M-F 8:00 AM - 5:00 PM PCMH: No Reddy, Ashok MD Provider ID: 163303 Gender: Male Florida Medical Center Pl 308 Ave C NE Winter Haven, FL 33881 (863) 294-7959 Fax: (863) 294-9338 16 Yrs/130 Yrs Winter Haven Hospital Languages: Hindi MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Rivera, Miriam MD Provider ID: 512089 Gender: Female Nuestra Sra Del Carmen 306 S 10th St Haines City, FL 33844 (407) 201-7918 Fax: (407) 201-7945 05 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Singh, Japinder MD Provider ID: 19988 Gender: Male Jaycare Medical Center 175 US Hwy 17th N Bartow, FL 33830 (863) 533-8215 Fax: (863) 533-8221 18 Yrs/130 Yrs Brandon Regional Hospital Lakeland Reg Medical Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Pediatrics Youngtan, Alison MD Provider ID: 1202832 Anchundia, Maria MD Gender: Female Florida Department of Health Provider ID: 1159456 Polk C Gender: Female 1700 Baker Ave Central Florida Health Care Haines City, FL 33844 Inc Avo (863) 421-3204 106 NW 9th Ave Fax: (863) 842-3210 Mulberry, FL 33860 00 Yrs/130 Yrs (863) 452-6200 M-F 8:00 AM - 5:00 PM Fax: (863) 452-6219 PCMH: No 00 Yrs/18 Yrs M-TH 7:30 AM - 6:00 PM Youngtan, Alison MD F 7:30 AM - 5:30 PM Provider ID: 1202833 PCMH: No Singh, Japinder MD Gender: Female Provider ID: 240205 Florida Department of Health Anchundia, Maria MD Gender: Male Polk C Provider ID: 1247646 Jaycare Medical Center 835 W Central Ave Gender: Female 135 E 1st St Lake Wales, FL 33853 Central Florida Health Care Lakeland, FL 33805 (863) 413-2620 Inc (863) 686-2728 Fax: (863) 678-4000 601 S Florida Ave Fax: (863) 686-6737 00 Yrs/130 Yrs Lakeland, FL 33801 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM (863) 688-0841 Brandon Regional Hospital PCMH: No Fax: (863) 616-9709 Lakeland Reg Medical Center 00 Yrs/18 Yrs Languages: Hindi Youngtan, Alison MD M-TH 7:30 AM - 6:00 PM M-F 8:00 AM - 9:00 PM Provider ID: 1202834 F 7:30 AM - 5:30 PM Sat 9:00 AM - 5:00 PM Gender: Female Sat 8:00 AM - 5:00 PM PCMH: No Florida Department of Health PCMH: No Polk C Smith, Owen MD 3241 Lakeland Hills Blvd Anchundia, Maria MD Provider ID: 1204975 Lakeland, FL 33805 Provider ID: 413284 Gender: Male (863) 413-2620 Gender: Female Verimed Health Group Fax: (863) 499-2612 Central Florida Health Care Lakeland 00 Yrs/130 Yrs Inc Dun 1417 Lakelnd Hls Blvd Ste 204 M-F 8:00 AM - 5:00 PM 916 Hwy 542 Lakeland, FL 33805 PCMH: No Dundee, FL 33838 (863) 688-5811 (863) 419-3330 Fax: (863) 688-5866 Zaffar, Nauman MD Fax: (863) 419-3249 18 Yrs/130 Yrs 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Provider ID: 1198204 Languages: Spanish PCMH: No Gender: Male M-TH 7:30 AM - 6:00 PM Z Medical Center Inc F 7:30 AM - 5:30 PM Youngtan, Alison MD 7810 Lake Wilson Rd PCMH: No Provider ID: 1202831 Davenport, FL 33896 Gender: Female (863) 420-7617 Florida Department of Health Fax: (863) 420-7619 Polk C 05 Yrs/130 Yrs 1805 Hobbs Rd Orlando Regional Medical Auburndale, FL 33823 Center (863) 519-7910 Raulerson Hospital Fax: (863) 965-3739 St Lucie Medical Center 00 Yrs/130 Yrs Languages: Hindi, Urdu, M-F 8:00 AM - 5:00 PM Punjabi PCMH: No M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Provider ID: 19990 Gender: Male Jay Care Medical Center 950 1st St S Winter Haven, FL 33880 (863) 295-5604 Fax: (863) 295-5398 18 Yrs/130 Yrs Brandon Regional Hospital Lakeland Reg Medical Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Polk Pediatrics - cont. Anchundia, Maria MD Provider ID: 523496 Gender: Female Central Florida Health Care Inc 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No Brar, Sardul MD Provider ID: 1159459 Gender: Male Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Brar, Sardul MD Provider ID: 1187325 Gender: Male Polk County Public Health Departmen 3421 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2620 Fax: (863) 499-2612 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Brar, Sardul MD Provider ID: 331110 Gender: Male Central Florida Health Care Inc Fro 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/18 Yrs Languages: Hindi, Punjabi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Brar, Sardul MD Provider ID: 909029 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/18 Yrs Lakeland Reg Medical Center M-F 7:30 AM - 5:30 PM Sat 8:00 AM - 12:00 PM PCMH: No

Brar, Sardul MD Provider ID: 331113 Gender: Male Central Florida Health Care Inc Dun 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/18 Yrs Languages: Hindi, Punjabi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Cannon, Cara MD Provider ID: 1120067 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 688-8969 00 Yrs/18 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3

Brar, Sardul MD Provider ID: 509382 Gender: Male Central Florida Health Care Inc Lak 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs Languages: Hindi, Punjabi M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No

Cannon, Cara MD Provider ID: 1120068 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 688-8969 00 Yrs/18 Yrs M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM Sun 11:00 AM - 2:00 PM PCMH: Yes, Level 3 Cano Montoya, Angelica MD Provider ID: 1216883 Gender: Female Kidville Pediatrics I, PA 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Sat 9:30 AM - 12:00 PM PCMH: No

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Chachad, Sairah MD Provider ID: 310988 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3 Cory, Matthew MD Provider ID: 4827 Gender: Male Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3 Cory, Matthew MD Provider ID: 26862 Gender: Male Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3

Last update 08/14/2017

Primary Care Physicians Polk Pediatrics - cont. Cosic, Sanja MD Provider ID: 1163673 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/18 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Cosic, Sanja MD Provider ID: 25001 Gender: Female Central Florida Health Care Inc Fro 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Spanish, French M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Cosic, Sanja MD Provider ID: 473748 Gender: Female Central Florida Health Care Inc Dun 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/18 Yrs Languages: Spanish, French M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Cosic, Sanja MD Provider ID: 715627 Gender: Female Central Florida Health Care Inc Lak 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/18 Yrs Languages: Spanish, French M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No Cosic, Sanja MD Provider ID: 715631 Gender: Female Central Florida Health Care Inc Win 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/18 Yrs Languages: Spanish, French M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No D'Aunoy, Mary MD Provider ID: 1320103 Gender: Female Central Florida Healthcare Lakeland 601 S Florida Ave Lakeland, FL 33801 (863) 688-0841 Fax: (863) 616-9709 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

D'Aunoy, Mary MD Provider ID: 1320106 Gender: Female Central Florida Healthcare Frostpro 109 W Wall St Frostproof, FL 33843 (863) 365-4891 Fax: (863) 635-7613 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

D'Aunoy, Mary MD Provider ID: 1320113 Gender: Female Central Florida Healthcare Lakeland 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

D'Aunoy, Mary MD Provider ID: 1320108 Gender: Female Central Florida Healthcare Lake Wal 225 Lincoln Ave Lake Wales, FL 33853 (863) 678-4360 Fax: (863) 678-4399 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

D'Aunoy, Mary MD Provider ID: 1320114 Gender: Female Central Florida Healthcare Mulberry 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

D'Aunoy, Mary MD Provider ID: 1320109 Gender: Female Central Florida Healthcare Dundee 916 HIGHWAY542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Depadua, Maria MD

D'Aunoy, Mary MD Provider ID: 1320111 Gender: Female Central Florida Healthcare Lakeland 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No

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Provider ID: 1160862 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Depadua, Maria MD Provider ID: 179563 Gender: Female Central Florida Health Care Inc Dun 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Spanish, Filipino M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk Pediatrics - cont. Depadua, Maria MD Provider ID: 19977 Gender: Female Central Florida Health Care Inc Fro 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/18 Yrs Florida Hospital Heartland Languages: Filipino M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Depadua, Maria MD Provider ID: 715695 Gender: Female Central Florida Health Care Inc Win 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 299-7999 00 Yrs/18 Yrs Languages: Filipino M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No El Sayed, Eiman MD Provider ID: 1073151 Gender: Female Pediatric Care of Four Corners PLLC 2506 Sand Mine Rd Davenport, FL 33897 (863) 232-5527 Fax: (863) 438-2776 00 Yrs/18 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No

Estrella Gonzalez, Carlos MD Provider ID: 1314496 Gender: Male Kidsville Pediatrics I, PA 2201 North Blvd W Ste C Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Gill, Parmjit MD Provider ID: 519360 Gender: Female Happy Kidz Pediatrics Pl 4304 Highland Park Blvd Lakeland, FL 33813 (863) 644-9398 Fax: (863) 644-9354 00 Yrs/21 Yrs Highlands Regional Medical M 9:00 AM - 5:00 PM TWTHF 8:30 AM - 5:00 PM PCMH: No Gonzalez, Francelis MD Provider ID: 173192 Gender: Female Kidsville Pediatrics I PA 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/21 Yrs Florida Hospital Orlando Heart of Florida Reg Med Center Lakeland Reg Medical Center Languages: Spanish M-F 8:30 AM - 5:00 PM Sat 9:30 AM - 12:00 PM PCMH: No

Grant, Stewart MD Provider ID: 901286 Gender: Male Total Pediatric Healthcare 930 Marcum Rd Ste 12 Lakeland, FL 33809 (863) 815-3775 Fax: (863) 815-3765 00 Yrs/18 Yrs Brandon Regional Hospital Languages: Spanish MTH 9:00 AM - 5:00 PM TWF 9:00 AM - 3:30 PM PCMH: No Harrison, Krystin MD Provider ID: 1119097 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3 Harrison, Krystin MD Provider ID: 1119099 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM Sun 11:00 AM - 2:00 PM PCMH: Yes, Level 3

Issar, Jeetendra MD Provider ID: 221864 Gender: Male Tampa Bay IPA LLC 3810 S Florida Ave Lakeland, FL 33813 (863) 619-5100 Fax: (863) 619-5102 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No Issar, Jeetendra MD Provider ID: 314458 Gender: Male Tampa Bay IPA LLC 1429 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-0200 Fax: (863) 687-0222 00 Yrs/130 Yrs Languages: Hindi M-F 8:30 AM - 5:30 PM PCMH: No Issar, Jeetendra MD Provider ID: 724773 Gender: Male Doctor Today TLC LLC 101 Magnolia Ave Auburndale, FL 33823 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Kahlon, Harpreet MD Provider ID: 175559 Gender: Female Rainbow Pediatrics PA 101 Park Place Blvd Ste A Davenport, FL 33837 (863) 421-2799 Fax: (863) 421-2791 00 Yrs/18 Yrs Languages: Hindi, Urdu, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Primary Care Physicians Polk Pediatrics - cont. Kazmi, Ishrat MD Provider ID: 1328289 Gender: Male Total Pediatric Healthcare PA 930 Marcum Rd Ste 12 Lakeland, FL 33809 (863) 815-3775 Fax: (863) 815-3765 00 Yrs/18 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Khan, Maria MD Provider ID: 166454 Gender: Female Davenport Pediatrics PA 40124 Hwy 27 Ste 207 Davenport, FL 33837 (863) 421-1855 Fax: (863) 421-2624 00 Yrs/21 Yrs Florida Hospital Orlando Heart of Florida Reg Med Center Osceola Regional Medical Center Languages: Spanish, Filipino M-F 9:00 AM - 5:00 PM PCMH: No Khodr, Bilal MD Provider ID: 950101 Gender: Male Pediatrics and Family Medicine of B 519 Buena Vista St Lakeland, FL 33805 (863) 337-4994 Fax: (863) 937-8943 00 Yrs/18 Yrs Doctors Memorial Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Kleine, Josef MD Provider ID: 1095737 Gender: Male Nemours Children Primary Care Kinde 435 2nd St NE Winter Haven, FL 33881 (863) 299-4567 Fax: (863) 297-9750 00 Yrs/18 Yrs Winter Haven Hospital M-F 9:00 AM - 5:00 PM PCMH: No Krishnadas, Praveen MD Provider ID: 685433 Gender: Male Heartland Pediatrics of Lake Wales 1356 State Rd 60 E Lake Wales, FL 33853 (863) 679-8888 Fax: (863) 676-2851 00 Yrs/21 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 8:30 AM - 5:00 PM PCMH: No Leviten, Daniel MD Provider ID: 4825 Gender: Male Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3

Leviten, Daniel MD Provider ID: 26864 Gender: Male Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3

Nguyen, Kenny MD Provider ID: 958298 Gender: Male Bond Clinic PA 45 Lake Elbert Dr SE Winter Haven, FL 33880 (863) 293-1191 Fax: (863) 293-3635 00 Yrs/18 Yrs Winter Haven Hospital Languages: Vietnamese M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 1 Nimbargi, Stephen MD

Nguyen, Kenny MD Provider ID: 1036254 Gender: Male Bond Clinic PA 500 E Central Ave Winter Haven, FL 33880 (863) 293-1191 Fax: (863) 293-3635 00 Yrs/18 Yrs Winter Haven Hospital Languages: Vietnamese M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Kenny MD Provider ID: 437958 Gender: Male Bond Clinic PA 45 Lake Elbert Dr SE Winter Haven, FL 33880 (863) 293-1191 Fax: (863) 293-3635 00 Yrs/18 Yrs Winter Haven Hospital Languages: Vietnamese M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 1

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Provider ID: 349403 Gender: Male Lakeland Physicians Group 517 Buena Vista St Lakeland, FL 33805 (863) 648-4275 Fax: (863) 616-9902 00 Yrs/21 Yrs Orlando Regional Medical Center South Seminole Hospital Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Palta, Anoop MD Provider ID: 958239 Gender: Male Happy Kidz Pediatrics 4304 Highland Park Blvd Lakeland, FL 33813 (863) 644-9398 Fax: (863) 644-9354 00 Yrs/21 Yrs Highlands Regional Medical Nemours Childrens Hospital Languages: Hindi, Punjabi, Marathi M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk Pediatrics - cont. Pillai, Anantha MD Provider ID: 28209 Gender: Male 1265 E Main St Bartow, FL 33830 (863) 534-3737 Fax: (863) 533-6323 00 Yrs/18 Yrs Bartow Regional Medical Center Lakeland Reg Medical Center Languages: Spanish, Hindi M-F 8:30 AM - 5:00 PM PCMH: No Polk, Sara MD Provider ID: 1087817 Gender: Female Central Florida Health Care, Inc. 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/21 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Premkanth, Phimagham MD Provider ID: 277164 Gender: Male Polk Pediatrics 1265 E Main St Bartow, FL 33830 (863) 534-3737 Fax: (863) 533-6323 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Pruthi, Jagdeep MD Provider ID: 520879 Gender: Male Sunrise Pediatrics LLC 25103 US Hwy 27 Lake Wales, FL 33859 (863) 734-0344 Fax: (863) 439-1540 00 Yrs/21 Yrs Lake Wales Medical Center Languages: Hindi, Urdu, Punjabi M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Ramos-Collazo, Yesenia MD Provider ID: 685335 Gender: Female Lakeside Pediatrics South 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3 Ramos-Collazo, Yesenia MD Provider ID: 692958 Gender: Female Lakeside Pediatrics North 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3

Ray, Dorothy MD Provider ID: 1179865 Gender: Female Pediatric Associates 2140 E Edgewood Dr Lakeland, FL 33803 (863) 669-1212 Fax: (863) 666-6089 00 Yrs/18 Yrs Lakeland Reg Medical Center MTTHF 9:00 AM - 5:00 PM W 9:00 AM - 12:00 PM PCMH: No Ray, Dorothy MD Provider ID: 1179867 Gender: Female Raypar, Inc D/B/A Pediatric Assoc 1920 Lakeland Hills Blvd Lakeland, FL 33805 (863) 683-4661 Fax: (863) 683-2579 00 Yrs/18 Yrs Lakeland Reg Medical Center M-TH 8:30 AM - 5:00 PM F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Ray, Rachel MD Provider ID: 1189386 Gender: Female Pediatric Associates of Lakeland 1920 Lakeland Hills Blvd Lakeland, FL 33805 (863) 683-4661 Fax: (863) 683-2579 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Rolette, Ayanna MD Provider ID: 4831 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 3

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Rolette, Ayanna MD Provider ID: 26865 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM PCMH: Yes, Level 3 Sia, Edwin Michael MD Provider ID: 330150 Gender: Male Davenport Pediatrics PA 40124 Hwy 27 Ste 207 Davenport, FL 33837 (863) 421-1855 Fax: (863) 421-2624 00 Yrs/21 Yrs Heart of Florida Reg Med Center Languages: Tagalog M-F 9:00 AM - 5:00 PM PCMH: No Tucker, Michele DO Provider ID: 1168720 Gender: Female Raypar, Inc. 1920 Lakeland Hills Blvd Lakeland, FL 33805 (863) 683-4661 Fax: (863) 683-2579 00 Yrs/21 Yrs Lakeland Reg Medical Center M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Polk Pediatrics - cont. Tucker, Michele DO Provider ID: 1168723 Gender: Female Raypar, Inc. 2140 E Edgewood Dr Lakeland, FL 33803 (863) 669-1212 Fax: (863) 666-6089 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Umeh, Ifeyinwa MD Provider ID: 1151464 Gender: Female Pediatrics of Central Florida PA 820 Cypress Pkwy Ste A Kissimmee, FL 34759 (407) 846-3455 Fax: (407) 933-8696 00 Yrs/21 Yrs Osceola Regional Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Vazquez Maldonado, Lilliam MD Provider ID: 1246334 Gender: Female Kidsville Pediatrics I P A 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Sat 9:30 AM - 12:00 PM PCMH: No Whitworth, Heather MD Provider ID: 1087211 Gender: Female Children's Health Alliance, LLC 435 2nd St NE Winter Haven, FL 33881 (863) 299-4567 Fax: (863) 297-9750 00 Yrs/18 Yrs Winter Haven Hospital M-F 7:30 AM - 5:00 PM Sat 8:30 AM - 12:00 PM PCMH: No

Umeh, Ifeyinwa MD Provider ID: 531503 Gender: Female Pediatrics of Central Florida PA 820 Cypress Pkwy Ste A Kissimmee, FL 34759 (407) 846-3455 Fax: (407) 933-8696 00 Yrs/21 Yrs Florida Hospital Orlando Osceola Regional Medical Center St Cloud Reg Medical Center Languages: Spanish, Hindi, Gujarati, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 78

Last update 08/14/2017

Primary Care Physicians Sarasota Family Practice Bayindiryan, Teodora MD Provider ID: 1157672 Gender: Female Manateee County Rural Health 1949 Northgate Blvd Sarasota, FL 34234 (941) 373-7844 Fax: (941) 373-7856 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM PCMH: No Brand, Andrea MD Provider ID: 331634 Gender: Female Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 00 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 2 Fleener, Carola MD Provider ID: 22675 Gender: Female Sarasota Childrens Clinic 3920 Bee Ridge Rd Bldg A Ste C Sarasota, FL 34233 (941) 923-3667 Fax: (941) 684-0194 00 Yrs/130 Yrs Languages: Spanish, German M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Garruto, Anthony MD Provider ID: 1196142 Gender: Female Senior Friendship Centers 2350 Scenic Dr Venice, FL 34293 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Reddy, Dheeraj MD

Gero, Michele MD Provider ID: 1246351 Gender: Female Gulf Coast Hma Physician Management 14575 Tamiami Trl North Port, FL 34287 (844) 366-9362 Fax: (941) 429-3430 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: Yes, Level 2

Reddy, Dheeraj MD

Provider ID: 1308361 Gender: Male Sarasota Primary Care 8383 S Tamiami Trl Ste 115 Sarasota, FL 34238 (941) 244-9430 Fax: (941) 244-9437 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1308365 Gender: Male Gulf Coast Hma Physician Management 1720 E Venice Ave Venice, FL 34292 (941) 483-9730 Fax: (941) 483-9745 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sauder, Deborah MD Provider ID: 446409 Gender: Female Sarasota Co Health Dept Fiscal 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stuart, Lorna MD Provider ID: 1406326 Gender: Female Senior Friendship Centers Inc 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 40 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Varney, Ella MD Provider ID: 1051332 Gender: Female Reeder, Robert MD North Tuttle Family Healthcare Provider ID: 1258891 220 N Tuttle Ave Gender: Male Florida Department of Health Sarasota, FL 34237 (941) 366-0800 In Sar Fax: (941) 328-3582 2200 Ringling Blvd 00 Yrs/130 Yrs Sarasota, FL 34237 M-F 8:00 AM - 5:00 PM (941) 861-2900 PCMH: No Fax: (941) 861-2719 00 Yrs/130 Yrs Zagata, Mateusz MD M-F 7:30 AM - 6:00 PM Juricic, Marilyn MD PCMH: No Provider ID: 1246365 Provider ID: 1270880 Gender: Male San Tun, Sabine MD Gender: Female Gulf Coast Hma Physician Management South County Medical Center Provider ID: 1198723 8431 Pointe Loop Dr 579 S Indiana Ave Gender: Female Englewood, FL 34223 Florida Department of Health Venice, FL 34293 (941) 207-5350 (941) 497-4303 In Sar Fax: (941) 207-5321 Fax: (941) 460-1345 2200 Ringling Blvd 00 Yrs/130 Yrs 00 Yrs/130 Yrs Sarasota, FL 34237 M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM (941) 861-2900 PCMH: No PCMH: No Fax: (941) 861-2719 00 Yrs/130 Yrs M-F 7:00 AM - 5:30 PM PCMH: No Jacob, John MD Provider ID: 1297778 Gender: Male Gulf Coast Hma Physician Management 8383 S Tamiami Trl Ste 115 Sarasota, FL 34238 (844) 366-9362 Fax: (941) 244-9437 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 79

Last update 08/14/2017

Primary Care Physicians Sarasota General Practice Fisher, Ronald MD Provider ID: 1169437 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No Griffith, James MD Provider ID: 1185568 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Snyder, Donald MD Heymann, William MD Provider ID: 1187327 Provider ID: 343411 Gender: Male Gender: Male Senior Friendship Centers, Inc. Sarasota County Health Department 1900 Brother Geenen Way 2200 Ringling Blvd Sarasota, FL 34236 Sarasota, FL 34237 (941) 556-3220 (941) 861-2900 Fax: (941) 955-8214 Fax: (941) 861-2828 50 Yrs/110 Yrs 00 Yrs/130 Yrs Languages: Spanish, Bulgarian, Czech, Slovak M-F 7:00 AM - 6:00 PM M-TH 8:00 AM - 4:00 PM Sat 8:00 AM - 12:00 PM PCMH: No PCMH: No

Internal Medicine Bhamber, Davinder MD Provider ID: 905140 Gender: Male Ishpaul Medical Inc 5250 17th St Ste 7 Sarasota, FL 34235 (941) 378-3843 Fax: (941) 378-7864 18 Yrs/130 Yrs Blake Medical Center Doctors Hospital Sarasota Manatee Memorial Hospital MW 9:00 AM - 5:00 PM TF 9:00 AM - 11:30 PM TH 1:30 AM - 5:00 PM PCMH: No

Heinrichs, Richard MD Provider ID: 1196153 Gender: Male Senior Friendship Centers, Inc. 1900 Brother Geenen Way Sarasota, FL 34236 Farhangi, Vida MD (941) 556-3220 Provider ID: 1276717 Fax: (941) 955-8214 Gender: Female 50 Yrs/110 Yrs Gulf Coast Hma Physician Languages: Spanish, Italian, Management German, Bulgarian 8383 S Tamiami Trl Ste 115 M-TH 8:00 AM - 4:00 PM Sarasota, FL 34238 PCMH: No (941) 244-9430 Nusbaum, Lana MD Fax: (941) 244-9437 18 Yrs/130 Yrs Provider ID: 1183779 Venice Regional Medical Gender: Female Center Senior Friendship Centers M-F 9:00 AM - 5:00 PM 1900 Brother Geenen Way PCMH: No Sarasota, FL 34236 (614) 234-6168 50 Yrs/110 Yrs Languages: Spanish, German, Bulgarian, Czech M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Heymann, William MD Provider ID: 354767 Gender: Male Sarasota County Health Dept 6950 Outreach Way North Port, FL 34287 (941) 861-3820 Fax: (941) 861-3829 12 Yrs/130 Yrs M-F 7:00 AM - 6:00 PM PCMH: No Maliot, Jerry MD Provider ID: 1027789 Gender: Male Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 18 Yrs/130 Yrs M-F 7:30 AM - 6:30 PM PCMH: No Nevins, David MD Provider ID: 1182423 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

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Nguyen, Thieu MD Provider ID: 28860 Gender: Male Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 2 Paredes, Augusto MD Provider ID: 344604 Gender: Male Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2640 Fax: (941) 861-2553 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Portnow, Arthur MD Provider ID: 18880 Gender: Male 5537 Marquesas Cir Sarasota, FL 34233 (941) 929-0444 Fax: (941) 929-0636 18 Yrs/130 Yrs Languages: Italian M-F 8:15 AM - 5:00 PM PCMH: No Shah, Avani MD Provider ID: 574917 Gender: Female 1949 Northgate Blvd Sarasota, FL 34234 (941) 373-7844 Fax: (941) 373-7856 12 Yrs/130 Yrs Manatee Memorial Hospital Languages: Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Sarasota Internal Medicine - cont. Soscia, John MD Provider ID: 346600 Gender: Male Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 12 Yrs/130 Yrs M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Tripodi, Amedeo MD Provider ID: 1162503 Gender: Male Senior Friendship Centers Inc 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 40 Yrs/130 Yrs M-TH 8:00 AM - 4:00 PM F 8:30 AM - 4:30 PM PCMH: No Tripodi, Amedeo MD Provider ID: 1162505 Gender: Male Senior Friendship Centers Inc 2350 Scenic Dr Venice, FL 34293 (941) 584-0041 Fax: (941) 496-8627 50 Yrs/110 Yrs M-W 8:30 AM - 4:30 PM PCMH: No Zoher, Mina MD Provider ID: 1367598 Gender: Male Florida Dept of Health In Sarasota 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/21 Yrs M-F 7:30 AM - 6:00 PM PCMH: No

Obstetrics/Gynecology Singer, Joseph MD Provider ID: 531251 Gender: Male Seen At Sarasota County Health Dept 1750 17th St Sarasota, FL 34234 (941) 861-1400 Fax: (941) 373-7676 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Fatmi, Ashfaq MD Provider ID: 28056 Gender: Male Pediatrics of Sarasota Inc 1951 Northgate Blvd Sarasota, FL 34234 (941) 355-0687 Fax: (941) 358-0417 00 Yrs/18 Yrs Blake Medical Center Manatee Memorial Hospital MTWF 9:00 AM - 5:00 PM TH 9:00 AM - 12:00 PM PCMH: No Fleener, Barbara MD Provider ID: 684571 Gender: Female Sarasota Childrens Clinic 3920 Bee Ridge Rd Bldg A Ste C Sarasota, FL 34233 (941) 923-3667 Fax: (941) 684-0194 00 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM PCMH: No

Fleener, Carola MD Provider ID: 22675 Gender: Female Sarasota Childrens Clinic 3920 Bee Ridge Rd Bldg A Ste C Sarasota, FL 34233 (941) 923-3667 Fax: (941) 684-0194 00 Yrs/130 Yrs Languages: Spanish, German M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Gonzalez Abello, Lisa MD Provider ID: 1160761 Gender: Female Sunshine Pediatric Care 145 Miami Ave E Venice, FL 34285 (941) 480-0088 Fax: (941) 480-0006 00 Yrs/21 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Gonzalez-Abello, Lisa MD Provider ID: 165379 Gender: Female Childrens Health Center 1750 17th St Ste E Sarasota, FL 34234 (941) 861-1400 Fax: (941) 373-7676 00 Yrs/21 Yrs Sarasota Memorial Hospital Languages: Spanish M-TH 7:30 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

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Gonzalez-Abello, Lisa MD Provider ID: 927255 Gender: Female Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-3820 Fax: (941) 861-3820 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Sarasota Memorial Hospital Languages: Spanish M-F 7:00 AM - 6:00 PM PCMH: No Gross, Francine MD Provider ID: 193104 Gender: Female Sarasota County Health Dept 1750 17th St Ste E Sarasota, FL 34234 (941) 861-1400 Fax: (941) 373-7676 00 Yrs/21 Yrs Sarasota Memorial Hospital Winter Haven Hospital M-TH 7:30 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: Yes, Level 2 Guastavino, Ella MD Provider ID: 27449 Gender: Female Englewood Pediatrics PA 900 Pine St Unit 216-217 Englewood, FL 34223 (941) 474-5093 Fax: (941) 474-9049 00 Yrs/21 Yrs Englewood Community Hospital (MP) Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Primary Care Physicians Sarasota Pediatrics - cont. Gulati, Rachna MD Provider ID: 523962 Gender: Female North Port Health Center 6950 Outreach Way North Port, FL 34287 (941) 861-3820 Fax: (941) 861-3829 00 Yrs/21 Yrs Mease Countryside Hospital Morton Plant Hospital Sarasota Memorial Hospital Languages: Spanish M-F 7:00 AM - 6:00 PM PCMH: Yes, Level 2 Horvat, Nevenka MD Provider ID: 10587 Gender: Female Nevenka Horvat 3333 Clark Rd Ste 160 Sarasota, FL 34231 (941) 923-1809 Fax: (941) 927-9645 00 Yrs/21 Yrs Sarasota Memorial Hospital M 9:00 AM - 6:00 PM TW 9:00 AM - 4:30 PM TH 10:00 AM - 6:00 PM F 9:00 AM - 4:00 PM PCMH: No Khan, Azima MD Provider ID: 220828 Gender: Female Sunshine Pediatric Care 145 Miami Ave E Venice, FL 34285 (941) 480-0088 Fax: (941) 480-0006 00 Yrs/18 Yrs M-F 9:00 AM - 4:00 PM PCMH: No

Lyons, David MD Provider ID: 1289576 Gender: Male Florida Dept of Health Sarasota County 6950 Outreach Way North Port, FL 34287 (941) 861-2900 Fax: (941) 526-1533 00 Yrs/18 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Lyons, David MD Provider ID: 1289577 Gender: Male Florida Dept of Health Sarasota County 1750 17th St Bldg 3 Sarasota, FL 34234 (941) 861-2900 Fax: (941) 526-1533 00 Yrs/18 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Mihm, Susan MD Provider ID: 222083 Gender: Female Sunshine Pediatric Care 145 Miami Ave E Venice, FL 34285 (941) 480-0088 Fax: (941) 480-0006 00 Yrs/18 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Patrusky, Eric DO Provider ID: 211144 Gender: Male Eric Patrosky D O P A 3920 Bee Ridge Rd Bldg B Ste C Sarasota, FL 34233 (941) 377-8684 Fax: (941) 378-3498 00 Yrs/18 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Perez, Richard MD Provider ID: 3066 Gender: Male Gulf Coast Pediatrics 5664 Bee Ridge Rd Ste 202 Sarasota, FL 34233 (941) 377-6406 Fax: (941) 377-6407 00 Yrs/21 Yrs Sarasota Memorial Hospital Languages: Spanish MTHF 8:30 AM - 5:00 PM T 8:30 AM - 7:00 PM W 8:30 AM - 12:00 PM PCMH: No Perez, Richard MD Provider ID: 146787 Gender: Male Gulf Coast Pediatrics 405 Commercial Ct Ste D Venice, FL 34292 (941) 412-1515 Fax: (941) 412-1525 00 Yrs/21 Yrs Sarasota Memorial Hospital Languages: Spanish MTHF 8:30 AM - 5:00 PM T 8:30 AM - 7:00 PM W 8:30 AM - 12:00 PM PCMH: No Rizkallah, Munir MD Provider ID: 522163 Gender: Male Sarasota County Health Dept 6950 Outreach Way North Port, FL 34287 (941) 861-3820 Fax: (941) 861-3829 00 Yrs/130 Yrs Sarasota Memorial Hospital Tampa General Hospital Languages: French, Arabic M-F 7:00 AM - 6:00 PM PCMH: No

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Wittmann, Lisa MD Provider ID: 995431 Gender: Female Florida Department of Health In Sar 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2920 Fax: (941) 861-2719 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Last update 08/14/2017

Specialty Physicians De Soto Chiropractic Sweat, Steven DC Provider ID: TPV10869-03 Gender: Male Manatee County Rural Health Services Inc 1110 E Gibson St Arcadia, FL 34266 (863) 993-0100 Fax: (863) 993-1127 10 Yrs/99 Yrs M 10:00 AM - 6:00 PM TW 8:00 AM - 5:00 PM PCMH: No

General Dentistry

Snyder, Kirk DMD Provider ID: TPVP103556-01 Gender: Male Doh - Desoto County Health Department 34 S Baldwin Ave Arcadia, FL 34266 (863) 993-4601 Fax: (863) 993-4574 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

General Surgery

Internal Medicine Beal, Jeffrey MD Provider ID: 1026340 Gender: Male Desoto County Dept of Health 34 S Baldwin Ave Arcadia, FL 34266 (863) 993-4601 Fax: (863) 993-4574 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Nephrology

Arniella, Alvaro MD Liquete, Egbert MD

Cook, Patricia DDS Provider ID: TPVP44445-01 Gender: Female Doh - Desoto County Health Department 34 S Baldwin Ave Arcadia, FL 34266 (863) 993-4601 Fax: (863) 993-4574 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Smith, David DDS Provider ID: TPVP44444-01 Gender: Male Doh - Desoto County Health Department 34 S Baldwin Ave Arcadia, FL 34266 (863) 993-4601 Fax: (863) 993-4574 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1032805 Gender: Male Desoto Memorial Center For Family H 888 N Robert Ave Arcadia, FL 34266 (863) 494-8401 Fax: (863) 491-4328 18 Yrs/130 Yrs Bayfront Health Punta Gorda Fawcett Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Bada Arniella, Alvaro MD Provider ID: 1032293 Gender: Male Dchd Healthcare Professionals 900 N Robert Ave Arcadia, FL 34266 (863) 494-3535 Fax: (863) 491-4328 18 Yrs/130 Yrs Bayfront Health Punta Gorda Fawcett Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1176270 Gender: Male Renal Hypertension Center 810 N Mills Ave Arcadia, FL 34266 (863) 491-8349 Fax: (863) 491-8355 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Obstetrics/Gynecology Rivera-Ortiz, Wilfredo MD Provider ID: 14920 Gender: Male 1110 E Gibson St Arcadia, FL 34266 (863) 494-1915 Fax: (863) 993-2116 12 Yrs/80 Yrs Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Teodorescu, Dumitru-Dan MD Provider ID: 293807 Gender: Male Manatee County Rural Health Services 1110 E Gibson St Arcadia, FL 34266 (863) 494-1915 Fax: (863) 993-2116 12 Yrs/130 Yrs Desoto Memorial Hospital Languages: Romanian MWTHF 8:00 AM - 5:00 PM T 11:00 AM - 8:00 PM PCMH: No Vazquez, Carlos MD Provider ID: 226011 Gender: Male 1110 E Gibson St Arcadia, FL 34266 (863) 494-1915 Fax: (863) 993-2116 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Wolford, Dale DO Provider ID: 12187 Gender: Male Community Care Family Healthcare Center 1110 E Gibson St Arcadia, FL 34266 (863) 494-1918 Fax: (863) 993-2116 12 Yrs/130 Yrs Desoto Memorial Hospital M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Optometry Radish, Douglas OD Provider ID: 208300 Gender: Male 122 N Brevard Ave Arcadia, FL 34266 (941) 494-5161 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians De Soto Orthopaedic Surgery Connolly, Brendon MD Provider ID: 1319555 Gender: Male Brendon Connolly MD Pl Arcadia 936 N Mills Ave Arcadia, FL 34266 (941) 757-3521 Fax: (941) 714-0869 18 Yrs/110 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Podiatry Chi, Andy DPM Provider ID: 1093026 Gender: Male Community Care Family Clinic 1148 E Gibson St Arcadia, FL 34266 (863) 494-6222 Fax: (863) 494-3227 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No Hulbert, Nelson DPM Provider ID: 1235184 Gender: Male Arcadia Medical Associates, PA 425 Nursing Home Dr Arcadia, FL 34266 (863) 494-0921 Fax: (863) 494-5491 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Pulmonary Disease Wei, Michael MD Provider ID: 1123656 Gender: Male Pulmonary Associates of Charlotte C 900 N Robert Ave 3F Arcadia, FL 34266 (941) 205-5864 Fax: (941) 205-5864 02 Yrs/130 Yrs Bayfront Health Punta Gorda Fawcett Memorial Hospital M 12:30 AM - 5:00 PM PCMH: No

Radiation Oncology Rice, David MD Provider ID: 294696 Gender: Male 21st Century Oncology LLC 920 N Mills Ave Arcadia, FL 34266 (863) 494-1400 Fax: (863) 494-1113 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 920 N Mills Ave Arcadia, FL 34266 (863) 494-9991 Fax: (863) 494-6777 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Williams, Thomas MD Provider ID: 1193531 Gender: Not Available 920 N Mills Ave Arcadia, FL 34266 (863) 494-9991 Fax: (863) 494-6777 18 Yrs/110 Yrs Sarasota Memorial Hospital M 8:00 AM - 12:00 PM T 11:00 AM - 7:00 PM W 8:00 AM - 5:30 PM PCMH: No

Urology Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 920 N Mills Ave Arcadia, FL 34266 (863) 494-9991 Fax: (863) 494-6777 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M 7:30 AM - 7:00 PM T 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hardee Cardiology Cook, William MD Provider ID: 477971 Gender: Male Florida Hospital Heartland Medical 533 Carlton St Wauchula, FL 33873 (863) 382-6182 Fax: (863) 382-1433 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Mumma, Michael MD Provider ID: 25662 Gender: Male Florida Cardiac Consultants Inc 463 Carlton St Wauchula, FL 33873 (863) 767-0660 Fax: (863) 767-0560 16 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Chiropractic Altman, James DC Provider ID: TPV10838-01 Gender: Male Altman Chiropractic PA 431 Carlton St Wauchula, FL 33873 (863) 767-1019 Fax: (863) 767-1023 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 6:00 PM W 10:00 AM - 4:00 PM TH 8:00 AM - 5:00 PM PCMH: No

General Dentistry Antony, Archana DDS Provider ID: TPVP93467-01 Gender: Female Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Antony, Archana DDS Provider ID: TPVP93467-04 Gender: Female Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No Cardenas, Carlos DDS Provider ID: TPV12871-07 Gender: Male Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No Cardenas, Carlos DDS Provider ID: TPV12871-08 Gender: Male Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Cocchieri, Richard DDS Provider ID: TPVP36034-01 Gender: Male Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Franceschi, Marisa DDS Provider ID: TPV13763-02 Gender: Female Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Cocchieri, Richard DDS Provider ID: TPVP36034-04 Gender: Male Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No

Franceschi, Marisa DDS Provider ID: TPV13763-04 Gender: Female Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No

Cooper, Angela DDS Provider ID: TPV13255-01 Gender: Female Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No

Gomara, Denise DDS Provider ID: TPVP42496-01 Gender: Female Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No

Cooper, Angela DDS Provider ID: TPV13255-13 Gender: Female Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

Gomara, Denise DDS Provider ID: TPVP42496-05 Gender: Female Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hardee General Dentistry - cont. Seifert, Thomas DDS McKenzie, Karen DDS Provider ID: TPV18154-07 Gender: Female Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No McKenzie, Karen DDS Provider ID: TPV18154-08 Gender: Female Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Rumbel, Richard DDS Provider ID: TPV11518-07 Gender: Male Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No Rumbel, Richard DDS Provider ID: TPV11518-08 Gender: Male Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Provider ID: TPV6990-02 Gender: Male Central Florida Health CareWachula 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3278 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-06 Gender: Male Central Florida Health Care Inc 121 Kd Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 448-4517 00 Yrs/99 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

General Practice Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc Wa 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-6946 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

General Surgery Medalle, Gregorio MD Provider ID: 3274 Gender: Male Gregorio N Medalle MD 1052 Downing Cir Wauchula, FL 33873 (863) 773-3773 Fax: (863) 773-0358 05 Yrs/130 Yrs Bartow Regional Medical Center Languages: Filipino M-TH 8:30 AM - 5:00 PM PCMH: No

Internal Medicine Cook, William MD Provider ID: 477971 Gender: Male Florida Hospital Heartland Medical 533 Carlton St Wauchula, FL 33873 (863) 382-6182 Fax: (863) 382-1433 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Obstetrics/Gynecology Best, Erin MD Provider ID: 795193 Gender: Female 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 767-0697 05 Yrs/130 Yrs Languages: Hindi, Arabic M-F 9:00 AM - 5:00 PM PCMH: No

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Bullard, Guinevere MD Provider ID: 435404 Gender: Female Florida Hospital Wauchula Womens We 522 Carlton St Wauchula, FL 33873 (863) 773-0975 Fax: (863) 773-4383 00 Yrs/130 Yrs Florida Hospital Heartland M-F 9:00 AM - 5:00 PM PCMH: No Qadri, Syed MD Provider ID: 532026 Gender: Male Central Florida Health Care Inc 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 00 Yrs/130 Yrs Languages: Hindi, Urdu M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Turnquest, Merse MD Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 767-0697 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hardee Obstetrics/Gynecology - Black, Daniel OD cont. Provider ID: TPV1033581236-0 Turnquest, Merse MD Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-6946 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Ophthalmology

Gender: Male Sevigny Associates Eye Care PA 735 N 6th Ave Wauchula, FL 33873 (863) 773-3322 Fax: (863) 773-6458 00 Yrs/99 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No Peltzer, Bradley OD Provider ID: TPV1396776340-0 Gender: Male Sevigny Associates Eye Care PA 735 N 6th Ave Wauchula, FL 33873 (863) 773-3322 Fax: (863) 773-6458 05 Yrs/99 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No

Moscoso, Walter MD Provider ID: TPV1992703854-0 Gender: Male Sevigny Associates Eye Care PA 735 N 6th Ave Wauchula, FL 33873 (863) 773-3322 Russell, Robyn OD Fax: (863) 773-6458 Provider ID: TPV1356678155-0 18 Yrs/99 Yrs Manatee Memorial Hospital & Gender: Female Sevigny Associates Eye Care Health Syste PA Languages: French 735 N 6th Ave M-F 8:00 AM - 5:00 PM Wauchula, FL 33873 PCMH: No (863) 773-3322 Fax: (863) 773-6458 Optometry 05 Yrs/99 Yrs Languages: French Anderson, Angela OD M-F 8:00 AM - 5:00 PM Provider ID: TPV1265426977-0 PCMH: No Gender: Female Sevigny Associates Eye Care Sevigny, Mark OD PA Provider ID: TPV1205028461-0 735 N 6th Ave Gender: Male Wauchula, FL 33873 Sevigny Associates Eye Care (863) 773-3322 PA Fax: (863) 773-6458 735 N 6th Ave 04 Yrs/99 Yrs Wauchula, FL 33873 Languages: French (863) 773-3322 M-F 8:00 AM - 5:00 PM Fax: (863) 773-6458 PCMH: No 00 Yrs/99 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No

Sevigny, Ronald OD Provider ID: TPV1558445635-0 Gender: Male Sevigny Associates Eye Care PA 735 N 6th Ave Wauchula, FL 33873 (863) 773-3322 Fax: (863) 773-6458 05 Yrs/99 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Wac 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-6946 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Podiatry Hulbert, Nelson DPM Provider ID: 1235184 Gender: Male Arcadia Medical Associates, PA 324 S 6th Ave Wauchula, FL 33873 (863) 473-4733 Fax: (863) 222-3177 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Preventive Medicine Senatorov, Vladimir MD Provider ID: 1272021 Gender: Male Central Florida Health Care, Inc. 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Urology Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 115 W Bay St Wauchula, FL 33873 (863) 773-3785 Fax: (863) 773-3996 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 115 W Bay St Wauchula, FL 33873 (863) 773-3785 Fax: (863) 773-3996 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hardee Urology - cont. Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 115 W Bay St Hardee Wauchula, FL 33873 (863) 773-3785 Fax: (863) 773-3996 00 Yrs/130 Yrs Languages: Spanish M 9:00 AM - 3:00 PM PCMH: No Tingle, William MD Provider ID: 1193488 Gender: Not Available 115 W Bay St Wauchula, FL 33873 (863) 773-3785 Fax: (863) 773-3996 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No Williams, Thomas MD Provider ID: 1193531 Gender: Not Available 115 W Bay St Wauchula, FL 33873 (863) 773-3785 Fax: (863) 773-9960 18 Yrs/110 Yrs Sarasota Memorial Hospital M 8:00 AM - 12:00 PM T 11:00 AM - 7:00 PM W 8:00 AM - 5:30 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Highlands Cardiology Arcenas, Rey MD Provider ID: 1432231 Gender: Male Fhhmc Cardiology Associates 4638 Sun N Lake Blvd Sebring, FL 33872 (863) 386-0055 Fax: (863) 386-0118 18 Yrs/130 Yrs Florida Hospital Heartland M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Bhandare, Deepti MD Provider ID: 845671 Gender: Female Fhhmc Cardiology Associates 4638 Sun N Lake Blvd Sebring, FL 33872 (863) 386-0055 Fax: (863) 386-0118 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No Bhandare, Deepti MD Provider ID: 845671 Gender: Female Fhhmc Cardiology Associates Lake Pl 1352 US Hwy 27 N Lake Placid, FL 33852 (863) 386-0055 Fax: (863) 386-0118 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Languages: Spanish, Hindi MT 8:00 AM - 5:00 PM W 8:00 AM - 4:00 PM PCMH: No

Doud, Debra MD Provider ID: 778100 Gender: Female Florida Hospital Heartland Medical 4638 Sun N Lake Blvd Sebring, FL 33872 (863) 386-0055 Fax: (863) 386-0118 18 Yrs/130 Yrs Florida Hospital Heartland Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jones, Phillip MD Provider ID: 590386 Gender: Male Fh Heartland Medical Center Interve 4240 Sun N Lake Blvd Ste 202 Sebring, FL 33872 (863) 471-3926 Fax: (863) 385-3093 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 2:00 PM PCMH: No Patel, Chandrakant MD Provider ID: 609580 Gender: Male Heartland Cardiology Group PA 4639 Sun N Lake Blvd Sebring, FL 33872 (863) 471-1010 Fax: (863) 382-3398 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Patel, Roshankumar MD Provider ID: 1314996 Gender: Male Heart Vascular Institute of Florid 7 Ryant Blvd Ste 7 Sebring, FL 33870 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sankar, Deo MD Provider ID: 217403 Gender: Male 519 W Interlake Blvd Lake Placid, FL 33852 (863) 471-1010 18 Yrs/130 Yrs Florida Hospital Heartland M-F 9:00 AM - 5:00 PM PCMH: No Sankar, Deo MD Provider ID: 217403 Gender: Male Heartland Cardiology Group PA 4639 Sun N Lake Blvd Sebring, FL 33872 (863) 471-1010 Fax: (863) 382-3398 18 Yrs/130 Yrs Florida Hospital Heartland M-TH 8:00 AM - 3:00 PM PCMH: No Shimshak, Thomas MD Provider ID: 1169157 Gender: Male Florida Hospital Heartland Medical 4240 Sun N Lake Blvd Ste 202 Sebring, FL 33872 (863) 471-3926 Fax: (863) 385-3093 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 2:00 PM PCMH: No

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Siddiqui, Irfan DO Provider ID: 584117 Gender: Female Heart and Vascular Plc 7 Ryant Blvd Ste 7 Sebring, FL 33870 (863) 424-3278 Fax: (863) 420-9701 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Torres, Ramon MD Provider ID: 486258 Gender: Male Fh Heartland Medical Center Cardiol 1352 US Hwy 27 N Lake Placid, FL 33852 (863) 386-0055 Fax: (863) 386-0118 18 Yrs/130 Yrs Florida Hospital Heartland Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Torres, Ramon MD Provider ID: 486258 Gender: Male Florida Hospital Heartland Division 4638 Sun N Lake Blvd Sebring, FL 33872 (863) 386-0055 Fax: (863) 386-0118 18 Yrs/130 Yrs Florida Hospital Heartland Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands Cardiology - cont. Torres, Ramon MD Provider ID: 486258 Gender: Male Florida Hospital Heartland Medical 1210 US 27 N Lake Placid, FL 33852 (863) 386-0055 Fax: (863) 386-0118 18 Yrs/130 Yrs Florida Hospital Heartland Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Wittum, Roger MD Provider ID: 472974 Gender: Male Fh Heartland Medical Center Interve 4240 Sun N Lake Blvd Ste 202 Sebring, FL 33872 (863) 471-3926 Fax: (863) 385-3093 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 2:00 PM PCMH: No

Chiropractic Boersma, David DC Provider ID: TPV11448-01 Gender: Male Avon Park Chiropractic Clinic 1590 US 27 N Avon Park, FL 32825 (863) 453-5777 Fax: (863) 453-9737 00 Yrs/99 Yrs MTF 7:45 AM - 5:00 PM W 7:45 AM - 7:00 PM TH 7:45 AM - 12:00 PM PCMH: No

Danzey, Patrick DC Provider ID: TPV10129-01 Gender: Male Avon Park Chiropractic Clinic 1590 US Hwy 27 N Avon Park, FL 33825 (863) 453-5777 Fax: (863) 453-9737 00 Yrs/99 Yrs MTF 7:45 AM - 5:00 PM W 7:45 AM - 7:00 PM TH 7:45 AM - 12:00 PM PCMH: No Marinock, David DC Provider ID: TPV11447-01 Gender: Male Avon Park Chiropractic Clinic 1590 US 27 N Avon Park, FL 32825 (863) 453-5777 Fax: (863) 453-9737 00 Yrs/99 Yrs MTF 7:45 AM - 5:00 PM W 7:45 AM - 7:00 PM TH 7:45 AM - 12:00 PM PCMH: No

Robinson, Kevin MD Provider ID: 186563 Gender: Male Highlands Medical Group 3435 S Highlands Ave Sebring, FL 33870 (863) 402-1970 Fax: (863) 402-1979 00 Yrs/18 Yrs Highlands Regional Medical Jackson South Community Hospit Nicklaus Children's Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Gastroenterology Ekici, Sedat MD Provider ID: 429273 Gender: Male Sedat T Edici PA 2950 Alt US Hwy 27 S Ste A Sebring, FL 33870 (863) 471-1300 Fax: (863) 638-5065 18 Yrs/130 Yrs Florida Hospital Heartland Languages: Spanish, French, Turkish M-W 10:00 AM - 5:00 PM PCMH: No

Trax, David DC Provider ID: TPV11387-02 Gender: Male Hawthorne Chiropractic Clinic 1200 W Avon Blvd Ste 200 Avon Park, FL 33825 (863) 368-0526 Fax: (352) 481-9954 Ferretti, Francesco MD 00 Yrs/99 Yrs Provider ID: 1129131 M 9:00 AM - 5:00 PM Gender: Male PCMH: No Sebring Hma Physician Managment, LL Ear, Nose & Throat 103 Medical Center Ave Sebring, FL 33870 Merritt, Robert MD (863) 385-8777 Fax: (863) 385-6585 Provider ID: 176476 18 Yrs/110 Yrs Gender: Male Florida Hospital Heartland The Barranco Clinic Highlands Regional Medical 1397 Whisper Cir M-TH 10:00 AM - 4:00 PM Sebring, FL 33870 PCMH: No (863) 382-4800 Fax: (863) 382-0761 00 Yrs/130 Yrs Heart of Florida Reg Med Center M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:30 PM PCMH: No

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Thakkar, Vinod MD Provider ID: 210060 Gender: Male 3581 S Highlands Ave Sebring, FL 33870 (863) 385-5129 Fax: (863) 385-7162 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

General Dentistry Antony, Archana DDS Provider ID: TPVP93467-06 Gender: Female Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Cardenas, Carlos DDS Provider ID: TPV12871-03 Gender: Male Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Cocchieri, Richard DDS Provider ID: TPVP36034-06 Gender: Male Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands General Dentistry - cont. Rumbel, Richard DDS Cooper, Angela DDS Provider ID: TPV13255-05 Gender: Female Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Franceschi, Marisa DDS Provider ID: TPV13763-06 Gender: Female Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Gomara, Denise DDS Provider ID: TPVP42496-03 Gender: Female Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No McKenzie, Karen DDS Provider ID: TPV18154-03 Gender: Female Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Provider ID: TPV11518-03 Gender: Male Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Smith, David DDS Provider ID: TPVP44444-02 Gender: Male Doh - Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 382-7257 Fax: (863) 382-9482 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Sander, Marc DDS Provider ID: TPVP45553-01 Gender: Male Affordable Dentures - Avon Park PA 1036 US 27 South Avon Park, FL 33825 (863) 784-0463 Fax: (863) 784-0465 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Snyder, Kirk DMD Provider ID: TPVP103556-02 Gender: Male Doh - Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 382-7257 Fax: (863) 382-9482 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Santos, Luis DMD Provider ID: TPVP127430-08 Gender: Male Doh - Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 382-7257 Fax: (863) 382-9482 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Tutay, John DMD Provider ID: TPVP137170-01 Gender: Male Doh - Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 382-7257 Fax: (863) 382-9482 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-04 Gender: Male Central Florida Health Care 950 County Rd 17-A W. Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Ward, Tasha DDS Provider ID: TPVP44296-08 Gender: Female Doh - Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 382-7257 Fax: (863) 382-9482 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Zapert, Edward DDS Provider ID: TPVP127236-02 Gender: Male Doh - Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 382-7257 Fax: (863) 382-9482 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

General Practice Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc Av 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

General Surgery Atalla, Sameh MD Provider ID: 13621 Gender: Male Florida Hospital Heartland Med Cntr Higlands 4301 Sun N Lake Blvd Ste 103 Sebring, FL 33872 (863) 385-1900 Fax: (863) 385-9229 00 Yrs/130 Yrs Languages: Arabic M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands General Surgery - cont. Brown, Russell MD Provider ID: 1418162 Gender: Male Highlands Medical Group 3435 S Highlands Ave Sebring, FL 33870 (863) 314-8665 Fax: (863) 314-8663 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Descalso, Reynaldo MD Provider ID: 210070 Gender: Male 1221 W Stratford Rd Avon Park, FL 33825 (863) 453-7579 Fax: (863) 453-8390 02 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No Ismail, Sajid DO Provider ID: 1355809 Gender: Male Heart and Vascular Institute of Flo 7 Ryant Blvd Ste 7 Sebring, FL 33870 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Lackey II, Thomas DO Provider ID: 434803 Gender: Male Florida Lakes Surgical 4759 Lakeview Dr Sebring, FL 33870 (863) 402-5600 Fax: (863) 402-5602 18 Yrs/130 Yrs Highlands Regional Medical M-F 9:00 AM - 4:00 PM PCMH: No

Vanterpool, Clyde MD Provider ID: 189760 Gender: Male 4151 Sun N Lake Blvd Sebring, FL 33872 (863) 402-0881 Fax: (863) 866-0266 00 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Hand Surgery Carr, Diana MD Provider ID: 665071 Gender: Female Diana D. Carr MD 131 US Hwy 27 N Sebring, FL 33870 (863) 382-7777 Fax: (863) 382-2195 00 Yrs/130 Yrs Florida Hospital Heartland M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Hematology & Oncology Riaz, Wasif MD Provider ID: 1043590 Gender: Male Florida Cancer Specialists Pl 4420 Sun N Lake Blvd Sebring, FL 33872 (863) 385-1244 Fax: (863) 385-6086 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Urdu M-TH 8:00 AM - 4:30 PM F 8:00 AM - 4:00 PM PCMH: No

Infectious Disease Duharte Vidaurre, Luis MD Provider ID: 1161051 Gender: Male Luis Duharte and Associates, MD, LL 5825 US Hwy 27 N Sebring, FL 33870 (863) 314-0004 Fax: (863) 314-0944 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lacson, J Agustin MD Provider ID: 188936 Gender: Male J Agustin Lacson MD Inc 3300 US Hwy 27 S Avon Park, FL 33825 (863) 385-6700 Fax: (863) 385-6703 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish, Filipino M-F 9:00 AM - 5:00 PM PCMH: No

Internal Medicine Bhandare, Deepti MD Provider ID: 845671 Gender: Female Fhhmc Cardiology Associates 4638 Sun N Lake Blvd Sebring, FL 33872 (863) 386-0055 Fax: (863) 386-0118 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No

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Bhandare, Deepti MD Provider ID: 845671 Gender: Female Fhhmc Cardiology Associates Lake Pl 1352 US Hwy 27 N Lake Placid, FL 33852 (863) 386-0055 Fax: (863) 386-0118 00 Yrs/130 Yrs Florida Hospital Heartland Florida Hospital Wauchula Languages: Spanish, Hindi MT 8:00 AM - 5:00 PM W 8:00 AM - 4:00 PM PCMH: No Heart, Rami DO Provider ID: 1297790 Gender: Male Heart and Vascular Plc 7 Ryant Blvd Ste 7 Sebring, FL 33870 (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Saint Fleur, Guilda MD Provider ID: 1418193 Gender: Female Highlands Medical Group 3319 Medical Hill Rd Sebring, FL 33870 (863) 402-0431 Fax: (863) 402-1471 18 Yrs/130 Yrs Highlands Regional Medical M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands Internal Medicine - cont. Interventional Cardiology Shah, Amit MD Saint Fleur, Guilda MD Provider ID: 1418193 Gender: Female Highlands Regional Medical Center 3600 South Highlands Ave Sebring, FL 33870 (863) 314-9308 Fax: (863) 314-0601 18 Yrs/130 Yrs Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No

Massaro, Joseph DO Provider ID: 1355885 Gender: Male Florida Hospital Heartland Medical 4240 Sun N Lake Blvd Ste 202 Sebring, FL 33872 (863) 471-3926 Fax: (863) 385-3093 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Medical Oncology

Saint Fleur, Paul MD Provider ID: 1418191 Gender: Male Highlands Medical Group 3319 Medical Hill Rd Sebring, FL 33870 (863) 402-0431 Fax: (863) 402-1471 18 Yrs/130 Yrs Highlands Regional Medical M-F 8:00 AM - 5:00 PM PCMH: No Shimshak, Thomas MD Provider ID: 1169157 Gender: Male Florida Hospital Heartland Medical 4240 Sun N Lake Blvd Ste 202 Sebring, FL 33872 (863) 471-3926 Fax: (863) 385-3093 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 2:00 PM PCMH: No

Ahmed, Syed MD Provider ID: 505791 Gender: Male Florida Cancer Specialists Pl 4420 Sun N Lake Blvd Sebring, FL 33872 (863) 385-1244 Fax: (863) 385-6086 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No Shah, Amit MD Provider ID: 273540 Gender: Male Florida Cancer Specialists, Pl 4200 Sun N Lake Blvd Sebring, FL 33872 (863) 385-1244 Fax: (863) 385-6086 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 273540 Gender: Male Florida Cancer Specialists, Pl 4420 Sun N Lake Blvd Sebring, FL 33872 (863) 385-1244 Fax: (863) 385-6086 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No

Nephrology Oliveros, Fabio MD Provider ID: 173960 Gender: Male Fabio Oliveros Associates PA 130 Medical Center Ave Sebring, FL 33870 (863) 385-2606 Fax: (863) 385-7723 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Pinzon, Ernesto MD Provider ID: 291662 Gender: Male Florida Physicians Medical Group 2950 Alt US 27 S Ste A Sebring, FL 33870 (863) 471-1300 Fax: (863) 471-1315 18 Yrs/100 Yrs Florida Hospital Heartland Florida Hospital Lake Placid Highlands Regional Medical Languages: Spanish M-TH 8:00 AM - 6:00 PM F 8:00 AM - 2:00 PM PCMH: No

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Zeledon, Jorge MD Provider ID: 588038 Gender: Male Fabio Oliveros Associates PA 130 Medical Center Ave Sebring, FL 33870 (863) 385-2606 Fax: (863) 385-7723 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Obstetrics/Gynecology Best, Erin MD Provider ID: 795193 Gender: Female 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 05 Yrs/130 Yrs Languages: Hindi, Arabic M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Cooper Mercado, Rachel MD Provider ID: 187711 Gender: Female Florida Hospital Heartland Womens H 37 Ryant Blvd Sebring, FL 33870 (863) 402-7555 Fax: (863) 402-4625 00 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-TH 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands Obstetrics/Gynecology - Turnquest, Merse MD cont. Guerra, David MD Provider ID: 561898 Gender: Male Florida Woman Care LLC 919 Mall Ring Rd Sebring, FL 33872 (863) 471-1236 Fax: (863) 304-8157 12 Yrs/130 Yrs Highlands Regional Medical Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Khan, Nasim MD Provider ID: 309929 Gender: Female Florida Woman Care LLC 3425 S Highlands Ave Sebring, FL 33870 (863) 471-1703 Fax: (863) 471-6229 12 Yrs/130 Yrs Highlands Regional Medical Sacred Heart Hospital Languages: Spanish, Urdu M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Khan, Nasim MD Provider ID: 309929 Gender: Female Florida Woman Care LLC 915 Mall Ring Rd Sebring, FL 33870 (863) 471-1703 Fax: (863) 471-6229 12 Yrs/130 Yrs Highlands Regional Medical Sacred Heart Hospital Languages: Spanish, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Upadhyaya, Dipakkumar MD Provider ID: 3076 Gender: Male 6801 US 27 N Ste A1 Sebring, FL 33870 (863) 382-1144 Fax: (863) 382-1779 12 Yrs/130 Yrs Highlands Regional Medical Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Ophthalmology Berger, Adam MD Provider ID: TPV1972574408-0 Gender: Male Vitreous and Retina Consultants 5233 US 27 N Sebring, FL 33870 (863) 385-4220 Fax: (863) 385-5635 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

El-Jabali, Fayssal DO Misch, David MD Provider ID: TPV1629199096-0 Provider ID: TPV1992775571-0 Gender: Male Gender: Male Newsom Eye Laser Center Inc Vitreous and Retina Consultants 4211 US Hwy 27 N 5233 US 27 N Sebring, FL 33870 Sebring, FL 33870 (863) 381-1544 (863) 385-4220 Fax: (863) 381-1233 Fax: (863) 385-5635 18 Yrs/99 Yrs 18 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Winter Haven Hospital Languages: Spanish, Arabic Languages: Korean M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Fischer, III, Frank MD Provider ID: TPV1497752687-0 Gender: Male Fischer Schemmer and Silbiger 3600 US Hwy 27 N Sebring, FL 33870 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs Winter Haven Hospital M 8:30 AM - 11:30 PM PCMH: No

Moon, Suk MD Provider ID: TPV1477524130-0 Gender: Male Vitreous and Retina Consultants 5233 US 27 N Sebring, FL 33870 (863) 385-4220 Fax: (863) 385-5635 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Garruto, Bryan MD Newsom, Thomas MD Provider ID: TPV1710902911-0 Gender: Male Provider ID: TPV1851386395-0 Newsom Eye Laser Center Inc Gender: Male 4211 US Hwy 27 N Newsom Eye Laser Center Inc Sebring, FL 33870 4211 US Hwy 27 N (863) 381-1544 Sebring, FL 33870 Fax: (863) 381-1233 (863) 381-1544 00 Yrs/99 Yrs Fax: (863) 381-1233 Languages: Spanish, Arabic 06 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Florida Hospital No Hospital PrivilegesPCMH: No Covering Arrangem Hamilton, Richard MD Languages: Spanish, Arabic M-F 9:00 AM - 5:00 PM Provider ID: TPV1568412823-0 PCMH: No Gender: Male Vitreous and Retina Consultants 5233 US 27 N Sebring, FL 33870 (863) 385-4220 Fax: (863) 385-5635 18 Yrs/99 Yrs South Lake Hospital Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Highlands Ophthalmology - cont.

Black, Daniel OD Provider ID: TPV1033581236-0 Gender: Male Sevigny Associates Eye Care PA 363 US Hwy 27 S Sebring, FL 33870 (863) 385-7070 Fax: (863) 385-7080 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fazio, Eric OD Parrish, Gregory OD Provider ID: TPV1447245246-0 Provider ID: TPV1598759458-1 Gender: Male Gender: Male Newsom Eye Laser Center Inc Myeyedr Optometry of Florida LLC 4211 US Hwy 27 N 3600 US Hwy 27 N Sebring, FL 33870 Sebring, FL 33870 (863) 381-1544 (863) 382-2020 Fax: (863) 381-1233 Fax: (863) 382-1410 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish, Arabic M-F 8:30 AM - 6:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No

Black, Daniel OD Provider ID: TPV1033581236-0 Gender: Male Srivastava, Vinita MD Sevigny Associates Eye Care PA Provider ID: TPV1720370034-0 27 US 27 S Gender: Female Newsom Eye Laser Center Inc Lake Placid, FL 33852 (863) 773-3322 4211 US Hwy 27 N Fax: (863) 773-6458 Sebring, FL 33870 00 Yrs/99 Yrs (863) 381-1544 M-F 8:00 AM - 5:00 PM Fax: (863) 381-1233 PCMH: No 15 Yrs/99 Yrs Eskenazi Hospital Buffano, Roxanne OD Indiana University Med Center Provider ID: TPV1275765265-1 Languages: Spanish, Arabic Gender: Female M-F 9:00 AM - 5:00 PM Myeyedr Optometry of Florida LLC PCMH: No 3600 US Hwy 27 N Optometry Sebring, FL 33870 (863) 382-2020 Anderson, Angela OD Fax: (863) 382-1410 Provider ID: TPV1265426977-0 05 Yrs/99 Yrs Gender: Female M-F 8:30 AM - 6:00 PM Sevigny Associates Eye Care PCMH: No PA Dixon, Dustin OD 363 US Hwy 27 S Sebring, FL 33870 Provider ID: TPV1245578491-1 (863) 385-7070 Gender: Male Fax: (863) 385-7080 Myeyedr Optometry of Florida LLC 04 Yrs/99 Yrs 3600 US Hwy 27 N M-F 8:00 AM - 5:00 PM Sebring, FL 33870 PCMH: No (863) 382-2020 Fax: (863) 382-1410 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Patel, Binal OD Forde, Jessica OD Provider ID: TPV1790036325-2 Provider ID: TPV1699223974-0 Gender: Female Gender: Female Newsom Eye Laser Center Inc Myeyedr Optometry of Florida LLC 4211 US Hwy 27 N 3600 US Hwy 27 N Sebring, FL 33870 Sebring, FL 33870 (863) 381-1544 (863) 382-2020 Fax: (863) 381-1233 Fax: (863) 382-1410 00 Yrs/99 Yrs 06 Yrs/99 Yrs Languages: Spanish, Arabic M-F 8:30 AM - 6:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No

Randolph, John MD Provider ID: TPV1164621330-0 Gender: Male Vitreous and Retina Consultants 5233 US 27 N Sebring, FL 33870 (863) 385-4220 Fax: (863) 385-5635 06 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Lopez, Viviana OD Provider ID: TPV1447583950-1 Gender: Female Myeyedr Optometry of Florida LLC 3600 US Hwy 27 N Sebring, FL 33870 (863) 382-2020 Fax: (863) 382-1410 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Peltzer, Bradley OD Provider ID: TPV1396776340-0 Gender: Male Sevigny Associates Eye Care PA 363 US Hwy 27 S Sebring, FL 33870 (863) 385-7070 Fax: (863) 385-7080 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Naqvi, Zarrin OD Provider ID: TPV1942436993-0 Gender: Male Myeyedr Optometry of Florida LLC 3600 US Hwy 27 N Sebring, FL 33870 (863) 382-2020 Fax: (863) 382-1410 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Peltzer, Bradley OD Provider ID: TPV1396776340-0 Gender: Male Sevigny Associates Eye Care PA 27 US 27 S Lake Placid, FL 33852 (863) 773-3322 Fax: (863) 773-6458 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Highlands Optometry - cont.

Roberts, Elizabeth OD Provider ID: TPV1295722908-1 Petit, Mitchell OD Gender: Female Provider ID: TPV1184628547-0 Myeyedr Optometry of Florida LLC Gender: Male Newsom Eye Laser Center Inc 3600 US Hwy 27 N Sebring, FL 33870 4211 US Hwy 27 N (863) 382-2020 Sebring, FL 33870 Fax: (863) 382-1410 (863) 381-1544 05 Yrs/99 Yrs Fax: (863) 381-1233 M-F 8:30 AM - 6:00 PM 05 Yrs/99 Yrs PCMH: No Languages: Spanish, Arabic M-F 9:00 AM - 5:00 PM Russell, Robyn OD PCMH: No Provider ID: TPV1356678155-0 Phillips, Stephen OD Gender: Female Sevigny Associates Eye Care Provider ID: TPV1871587592-1 PA Gender: Male 363 US Hwy 27 S Myeyedr Optometry of Sebring, FL 33870 Florida LLC (863) 385-7070 3600 US Hwy 27 N Fax: (863) 385-7080 Sebring, FL 33870 05 Yrs/99 Yrs (863) 382-2020 M-F 8:00 AM - 5:00 PM Fax: (863) 382-1410 PCMH: No 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM Russell, Robyn OD PCMH: No Provider ID: TPV1356678155-0 Puzzo, Melissa OD Gender: Female Sevigny Associates Eye Care Provider ID: TPV1669760799-1 PA Gender: Female 27 US 27 S Myeyedr Optometry of Lake Placid, FL 33852 Florida LLC (863) 773-3322 3600 US Hwy 27 N Fax: (863) 773-6458 Sebring, FL 33870 05 Yrs/99 Yrs (863) 382-2020 M-F 8:00 AM - 5:00 PM Fax: (863) 382-1410 PCMH: No 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM Salomon, Brad OD PCMH: No Provider ID: TPV1851385710-1 Roberts, David OD Gender: Male Myeyedr Optometry of Provider ID: TPV1972665883-0 Florida LLC Gender: Male 3600 US Hwy 27 N Myeyedr Optometry of Sebring, FL 33870 Florida LLC (863) 382-2020 3600 US Hwy 27 N Fax: (863) 382-1410 Sebring, FL 33870 05 Yrs/99 Yrs (863) 382-2020 M-F 8:30 AM - 6:00 PM Fax: (863) 382-1410 PCMH: No 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-1 Gender: Female Myeyedr Optometry of Florida LLC 3600 US Hwy 27 N Sebring, FL 33870 (863) 382-2020 Fax: (863) 382-1410 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Sevigny, Ronald OD Provider ID: TPV1558445635-0 Gender: Male Sevigny Associates Eye Care PA 363 US Hwy 27 S Sebring, FL 33870 (863) 385-7070 Fax: (863) 385-7080 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Salomon, Teresa OD Provider ID: TPV1891789517-1 Gender: Female Myeyedr Optometry of Florida LLC 3600 US Hwy 27 N Sebring, FL 33870 (863) 382-2020 Fax: (863) 382-1410 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Thai, Pauline OD Provider ID: TPV1871808097-1 Gender: Female Myeyedr Optometry of Florida LLC 3600 US Hwy 27 N Sebring, FL 33870 (863) 382-2020 Fax: (863) 382-1410 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Sevigny, Mark OD Provider ID: TPV1205028461-0 Gender: Male Sevigny Associates Eye Care PA 363 US Hwy 27 S Sebring, FL 33870 (863) 385-7070 Fax: (863) 385-7080 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Orthopaedic Surgery

Sevigny, Mark OD Provider ID: TPV1205028461-0 Gender: Male Sevigny Associates Eye Care PA 27 US 27 S Lake Placid, FL 33852 (863) 773-3322 Fax: (863) 773-6458 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Arango, David MD Provider ID: 470918 Gender: Male Royal Palm Orthopedics 133 US Hwy 27 N Sebring, FL 33870 (863) 324-6100 Fax: (863) 679-9182 00 Yrs/130 Yrs Winter Haven Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Carr, Diana MD Provider ID: 665071 Gender: Female Diana D. Carr MD 131 US Hwy 27 N Sebring, FL 33870 (863) 382-7777 Fax: (863) 382-2195 00 Yrs/130 Yrs Florida Hospital Heartland M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands Orthopaedic Surgery cont. Chaudhri, Tahir MD Provider ID: 587251 Gender: Male Highlands Medical Group 3427 S Highlands Ave Sebring, FL 33870 (863) 314-9308 Fax: (863) 382-2064 00 Yrs/130 Yrs Highlands Regional Medical Languages: Urdu, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Cardiology Garcia, Jorge MD Provider ID: 611723 Gender: Male Pediatric Cardiology Consultants PA 4421 Sun N Lake Blvd Sebring, FL 33872 (407) 303-2001 Fax: (407) 203-2450 18 Yrs/130 Yrs Central Florida Regional Hospital Florida Hospital Waterman Orlando Regional Medical Center Languages: Spanish, French, Italian M-F 8:00 AM - 5:00 PM PCMH: No

Ramos, Agustin MD Provider ID: 5155 Gender: Male Pediatric Cardiology Consultants PA 4421 Sun N Lake Blvd Sebring, FL 33872 (407) 303-2001 Fax: (407) 203-2450 00 Yrs/21 Yrs Arnold Palmer Hospital For Children Florida Hospital Waterman Orlando Regional Medical Center Languages: Spanish, French, Italian, German M-F 8:00 AM - 5:00 PM PCMH: No Trivedi, Bhavya MD Provider ID: 724439 Gender: Male Pediatric Cardiology Consultants PA 4421 Sun N Lake Blvd Sebring, FL 33872 (407) 303-2001 Fax: (407) 203-2450 12 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital Languages: Gujarati M-F 9:00 AM - 5:00 PM PCMH: No Zussman, Matthew MD Provider ID: 688932 Gender: Male Pediatric Cardiology Consultants PA 4421 Sun N Lake Blvd Sebring, FL 33872 (407) 303-2001 Fax: (407) 203-2450 18 Yrs/130 Yrs Florida Hospital Orlando Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Avo 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3002 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Podiatry Dolber, Pamela DPM Provider ID: 331196 Gender: Female 3 S Main Ave Lake Placid, FL 33852 (863) 699-0710 Fax: (863) 659-1071 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Jones, Joni DPM Provider ID: 216570 Gender: Female Sebring Footcare PA 206 W Center Ave Sebring, FL 33870 (863) 382-3228 Fax: (863) 382-8011 00 Yrs/130 Yrs M-W 9:30 AM - 4:30 PM PCMH: No Lewis, Richard DPM Provider ID: 758203 Gender: Male 316 W Interlake Blvd Lake Placid, FL 33852 (863) 465-7650 Fax: (863) 465-7636 00 Yrs/130 Yrs Bethesda Memorial Hospital JFK Medical Center North Campus M 1:00 AM - 5:00 PM PCMH: No

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Rivero, Evaristo DPM Provider ID: 216040 Gender: Male Foot Doctor Corporation 230 E Interlake Blvd Lake Placid, FL 33852 (863) 699-6001 Fax: (863) 699-6002 00 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Preventive Medicine Senatorov, Vladimir MD Provider ID: 1272018 Gender: Male Central Florida Health Care, Inc 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Pulmonary Disease Arias Howard, Guillermo MD Provider ID: 759834 Gender: Male Soham Pulmonary Group PA 6801 US Hwy 27 N Ste D4 Sebring, FL 33870 (863) 382-8877 Fax: (863) 382-9147 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Highlands Pulmonary Disease - cont. Bassetti, Dennis MD Provider ID: 1157133 Gender: Male Bassetti and Associates MD PA 5825 US Hwy 27 N Sebring, FL 33870 (863) 314-0001 Fax: (863) 314-0944 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Bhatt, Bipin MD Provider ID: 168312 Gender: Male Soham Pulmonary Group PA 6801 US Hwy 27 N Ste D4 Sebring, FL 33870 (863) 382-8877 Fax: (863) 382-9147 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No Wong, Philip MD Provider ID: 430754 Gender: Male Heartland Pulm Critical Care Spec 4421 Sun N Lake Blvd Ste B Sebring, FL 33872 (863) 382-1663 Fax: (863) 386-0162 12 Yrs/130 Yrs Florida Hospital Heartland Languages: Tagalog M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Radiation Oncology Wing, Michael MD Provider ID: 1027139 Gender: Male 21st Century Oncology LLC 3650 Emergency Ln Sebring, FL 33870 (863) 382-8811 Fax: (863) 382-6055 18 Yrs/130 Yrs Highlands Regional Medical Lakeside Medical Center Palms West Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Rheumatology Torres, Alexander MD Provider ID: 1229481 Gender: Male Highlands Advanced Rheumatology And 3750 Emergency Ln Ste 3 Sebring, FL 33870 (863) 314-8555 Fax: (863) 314-8505 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Thoracic & Cardiovascular Surgery Smith Jr, Ronald MD Provider ID: 594294 Gender: Male Riverview Cardiac Surgery PA 4759 Lakeview Dr Sebring, FL 33870 (941) 744-2640 Fax: (941) 744-2650 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Italian M-F 9:00 AM - 4:00 PM PCMH: No

Urology Chee Awai, Ronald MD Provider ID: 1352233 Gender: Male Fhhmc Cardiology Associates 1352 US Hwy 27 N Lake Placid, FL 33852 (863) 699-1602 Fax: (863) 386-0118 02 Yrs/130 Yrs Florida Hospital Heartland M-F 8:00 AM - 5:00 PM PCMH: No Chee Awai, Ronald MD Provider ID: 1352233 Gender: Male Florida Hospital Heartland Medical 4325 Sun N Lake Blvd Ste 105 Sebring, FL 33872 (863) 238-2224 Fax: (863) 382-1242 02 Yrs/130 Yrs Florida Hospital Heartland M-F 8:00 AM - 5:00 PM PCMH: No Clark, Randall MD Provider ID: 1087840 Gender: Male Florida Hospital Heartland Medical 4325 Sun N Lake Blvd Ste 105 Sebring, FL 33872 (863) 382-2248 Fax: (863) 382-1242 18 Yrs/130 Yrs MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

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Pobi, Kwabena MD Provider ID: 520281 Gender: Male Sebring Hma Physician Management LL 2373 US Hwy 27 S Sebring, FL 33870 (863) 382-2576 Fax: (863) 382-8490 12 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical M-F 9:00 AM - 5:00 PM PCMH: No

Vascular Surgery D'Alessandro, Matthew DO Provider ID: 1244436 Gender: Male Heart Vascular Institute of Florid 7 Ryant Blvd Ste 7 Sebring, FL 33870 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Adolescent Medicine Derasari, Kalyani MD Provider ID: 692922 Gender: Female 4202 E Fowler Ave Shs 100 Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 00 Yrs/130 Yrs Languages: Hindi, Gujarati, Swahili M-F 9:00 AM - 5:00 PM PCMH: No Puccio, Joseph MD Provider ID: 699211 Gender: Male 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Straub, Diane MD Provider ID: 202307 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 12 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 2 Weiss, Amy MD Provider ID: 1105073 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8700 Fax: (813) 259-8862 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Weiss, Amy MD Provider ID: 1105092 Gender: Female USF Physicians Group 5 Tampa General Cir Tampa, FL 33606 (813) 844-7473 Fax: (813) 844-1966 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Weiss, Amy MD Provider ID: 672684 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8862 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Dominguez, Jose MD Provider ID: 4456 Gender: Male 539 Medical Oaks Ave Brandon, FL 33511 (813) 657-1399 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Dominguez, Jose MD Provider ID: 4456 Gender: Male Allergy Asthma & Immunology 3645 Madaca Ln Tampa, FL 33618 (813) 969-0116 Fax: (813) 969-3794 00 Yrs/130 Yrs Brandon Regional Hospital Allergy & Immunology Florida Hospital Tampa St Josephs Hospital Chamarthy, Latha MD Languages: Spanish Provider ID: 28023 M 9:00 AM - 5:30 PM Gender: Female TWTHF 9:00 AM - 5:00 PM Advanced Allergy 7 Asthma Sat 9:00 AM - 2:00 PM Care, Inc 4543 S Manhattan Ave Ste 102 PCMH: No Tampa, FL 33611 Dominguez, Jose MD (727) 544-8100 Provider ID: 4456 Fax: (727) 544-8200 Gender: Male 00 Yrs/130 Yrs Allergy Asthma & Bayfront Medical Center Immunology Florida Hospital North Pinellas 4600 N Habana Ave Ste 8 Johns Hopkins All Childrens Tampa, FL 33614 Hospital Inc (813) 874-1305 Languages: Tamil, Telugu Fax: (813) 874-0059 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No Brandon Regional Hospital Florida Hospital Tampa Degala, Ami MD St Josephs Hospital Provider ID: 970029 Languages: Spanish Gender: Female M 1:30 AM - 5:30 PM Advanced Allergy Asthma TWTHF 9:00 AM - 5:00 PM Care Sat 9:00 AM - 2:00 PM 4543 S Manhattan Ave Ste 101 PCMH: No Tampa, FL 33611 (727) 544-8100 Fax: (727) 544-8200 02 Yrs/130 Yrs Languages: Gujarati M-TH 9:00 AM - 5:00 PM F 9:00 AM - 1:00 PM PCMH: No

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Downes, Sandra MD Provider ID: 166576 Gender: Female Allergy Asthma & Immunology 4600 N Habana Ave Ste 8 Tampa, FL 33614 (813) 874-1305 Fax: (813) 874-0059 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:30 PM Sat 9:00 AM - 2:00 PM PCMH: No Downes, Sandra MD Provider ID: 166576 Gender: Female Allergy Asthma Immunology Associate 3645 Madaca Ln Tampa, FL 33618 (813) 969-0116 Fax: (813) 969-3794 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:30 PM Sat 9:00 AM - 2:00 PM PCMH: No Downes, Sandra MD Provider ID: 166576 Gender: Female Allergy Asthma Immunology Associate 539 Medical Oaks Ave Brandon, FL 33511 (813) 655-9736 Fax: (813) 657-1399 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Allergy & Immunology cont. Gerrish, Prianka MD Provider ID: 904635 Gender: Female Karon Locicero MD PA 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 00 Yrs/130 Yrs M 10:00 AM - 6:00 PM T 9:00 AM - 4:00 PM W 11:00 AM - 7:00 PM TH 9:00 AM - 12:00 PM PCMH: No Iqbal, Shahid MD Provider ID: 152741 Gender: Male Shahid A Iqbal MD PA DBA Florida Al 4600 N Habana Ave Ste 25 Tampa, FL 33614 (813) 876-0502 Fax: (813) 872-6503 00 Yrs/130 Yrs Bayfront Health Dade City Lakeland Reg Medical Center Languages: Urdu MTWF 9:00 AM - 5:00 PM TH 9:00 AM - 1:00 PM PCMH: No Ledford, Dennis MD Provider ID: 7151 Gender: Male USF Physicicans Group 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2201 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Longley, Maliena MD Provider ID: 689649 Gender: Female Florida Pediatric Associates LLC 19039 N Dale Mabry Hwy Lutz, FL 33548 (813) 948-7000 Fax: (813) 948-7008 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Nallamshetty, Samridhi MD Provider ID: 483380 Gender: Female 12500 N Dale Mabry Hwy Ste D Tampa, FL 33618 (813) 388-6855 Fax: (813) 355-5894 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Nallamshetty, Samridhi MD Provider ID: 483380 Gender: Female Florida Medical Clinic PA 2020 Town Center Blvd Ste C Brandon, FL 33511 (813) 388-6855 Fax: (813) 355-5894 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Rohatgi, Nalini MD

Tabatabaian, Farnaz MD

Provider ID: 215810 Provider ID: 1129501 Gender: Female Gender: Female Allergy Asthma Sinusitis Clinic USF Physicians Group 2708 W Virginia Ave Ste A 5802 N 30th St Tampa, FL 33607 Tampa, FL 33610 (813) 875-7088 (813) 236-5350 Fax: (813) 875-8816 Fax: (813) 236-5332 00 Yrs/130 Yrs 00 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM St Josephs Hospital PCMH: No Tampa General Hospital Cardiac Electrophysiology Languages: Spanish, Hindi M-F 8:30 AM - 5:30 PM PCMH: No Chae, Sanders MD Provider ID: 558270 Salim, Nauman MD Gender: Male USF Physicians Group Provider ID: 1143565 13330 USF Laurel Dr Gender: Male Tampa, FL 33612 Sunshine Medicine Associates (813) 974-2201 Inc Fax: (813) 974-4695 13692 W Hillsborough Ave 18 Yrs/130 Yrs Tampa, FL 33635 M-F 8:00 AM - 5:00 PM (813) 252-2375 PCMH: No Fax: (813) 324-5680 00 Yrs/130 Yrs Chae, Sanders MD Gulf Coast Medical Center Provider ID: 558270 Mease Hospital Dunedin Gender: Male Morton Plant Hospital USF Physicians Group Languages: Hindi, Urdu, 2 Tampa General Cir 3rd Fl Punjabi Tampa, FL 33606 MT 8:00 AM - 4:30 PM (813) 259-0600 W 8:00 AM - 6:00 PM Fax: (813) 259-8679 THF 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Tabatabaian, Farnaz MD Provider ID: 1129501 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7550 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

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Chae, Sanders MD Provider ID: 558270 Gender: Male USF Physicians Group 509 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0485 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiac Electrophysiology Misiri, Juna MD - cont. Provider ID: 1126169 Fradley, Michael MD Provider ID: 787048 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Herweg, Bengt MD Provider ID: 672123 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 974-2201 Fax: (812) 259-8679 00 Yrs/130 Yrs Tampa General Hospital Languages: Italian, German M-F 8:00 AM - 5:00 PM PCMH: No Irwin, James MD Provider ID: 929241 Gender: Male Baycare Medical Group 4612 N Habana Ave Fl 2 Tampa, FL 33614 (813) 875-9000 Fax: (813) 874-3278 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Misiri, Juna MD Provider ID: 1126169 Gender: Female Bay Area Cardiology Associates, PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Female Bay Area Cardiology Associates, PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Misiri, Juna MD Provider ID: 1126169 Gender: Female Bay Area Cardiology Associates, PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Wilson, David MD Provider ID: 1244460 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Cardiology Agocha, Augustine MD Provider ID: 651393 Gender: Male 1601 W Timberlane Dr Ste 201 Plant City, FL 33566 (813) 754-4611 Fax: (813) 757-3252 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Agocha, Augustine MD

Arnold, Anita DO Provider ID: 687621 Gender: Female Provider ID: 651393 USF Physicians Group Gender: Male 3003 W Dr MLK Blvd Mab-2nd 13330 USF Laurel Dr 3rd Fl Fl Tampa, FL 33612 Tampa, FL 33607 (813) 974-2201 (813) 397-1251 Fax: (813) 259-8679 Fax: (813) 321-6998 00 Yrs/130 Yrs 18 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Almahasneh, Firas MD Provider ID: 1276693 Gender: Male Palma Ceia Heart Vascular 2919 W Swann Ave Ste 102 Tampa, FL 33609 (813) 870-3971 Fax: (813) 872-6594 00 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Arnold, Anita DO Provider ID: 687621 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Arnold, Anita DO Provider ID: 687621 Gender: Female USF Physicians Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Arnold, Anita DO Provider ID: 687621 Gender: Female USF Physicians Group 3100 E Fletcher Ave Tampa, FL 33613 (813) 974-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Arroyo, Luis MD Provider ID: 659730 Gender: Male Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No Ayoubi, Maher MD Provider ID: 1130182 Gender: Male Maher M Ayoubi MD 3401 W Waters Ave Ste 602 Tampa, FL 33614 (850) 960-1514 Fax: (850) 960-1514 18 Yrs/130 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Babayan, Zaruhi MD Provider ID: 1087217 Gender: Female Baycare Medical Group 3003 W Dr MLK Blvd Fl 2nd Tampa, FL 33607 (813) 875-9000 Fax: (813) 443-8136 18 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Babayan, Zaruhi MD Provider ID: 1087217 Gender: Female Baycare Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 443-8143 18 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Babayan, Zaruhi MD Provider ID: 1087217 Gender: Female Baycare Medical Group 4612 N Habana Ave 2nd Fl Tampa, FL 33614 (813) 875-9000 18 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Bakarania, Magan MD Provider ID: 214510 Gender: Male Brandon Cardiology Clinic PA 320 Oakfield Dr Ste A Brandon, FL 33511 (813) 689-1912 Fax: (813) 684-3335 00 Yrs/130 Yrs Brandon Regional Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Berlowitz, Michael MD Provider ID: 572781 Gender: Male USF Physicians Group 1 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Berman, Peter MD Provider ID: 4649 Gender: Male Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Betzu, Robert MD Provider ID: 8395 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Betzu, Robert MD Provider ID: 8395 Gender: Male Bay Area Cardiology Associates PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bugni, William MD Provider ID: 7399 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Betzu, Robert MD Provider ID: 8395 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bugni, William MD Provider ID: 7399 Gender: Male Bay Area Cardiology Associates PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Betzu, Robert MD Provider ID: 8395 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bugni, William MD Provider ID: 7399 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 102

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Bugni, William MD Provider ID: 7399 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chen, Allan MD Provider ID: 1276730 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chen, Allan MD Provider ID: 1276730 Gender: Male USF Physicians Group 509 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Chokshi, Saurabh MD Provider ID: 188 Gender: Male Bay Area Cardiology and Vascular Assoc 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Chokshi, Saurabh MD Provider ID: 188 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Chokshi, Saurabh MD Provider ID: 188 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No

Chokshi, Saurabh MD Provider ID: 188 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Cordova, Juan MD Provider ID: 1284345 Gender: Male Southshore Cardiovascualr Associate 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cordova, Juan MD Provider ID: 1284345 Gender: Male Southshore Cardiovascular Associate 10726 Ketchum Valley Dr Riverview, FL 33579 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cordova, Juan MD Provider ID: 1284345 Gender: Male Southshore Cardiovascular Associate 12110 N 56th St Tampa, FL 33617 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Cura, Jose MD Provider ID: 1140035 Gender: Male Baycare Medical Group 4612 N Habana Ave Fl 2 Tampa, FL 33614 (813) 875-9000 Fax: (813) 874-3278 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Delgado, Francisco DO Provider ID: 1093894 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Desaneto, Artur MD Provider ID: 1341600 Gender: Male Tampa Heart and Vascular Associates 4160 N Armenia Ave Tampa, FL 33607 (813) 673-8245 Fax: (813) 436-5459 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Desaneto, Artur MD Provider ID: 1341600 Gender: Male Tampa Heart and Vascular Associates 4543 S Manhattan Ave Tampa, FL 33611 (813) 837-2461 Fax: (813) 835-1731 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Devarakonda, Subrahmanyam MD Provider ID: 6845 Gender: Male Devarakonda Rajenebar 1507 W Reynolds St Ste B Plant City, FL 33563 (813) 752-1053 Fax: (813) 754-6739 18 Yrs/130 Yrs South Florida Baptist Hospital M-F 8:30 AM - 5:00 PM PCMH: No Dewhurst, Robert MD Provider ID: 355907 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Dewhurst, Robert MD Provider ID: 355907 Gender: Male Bay Area Cardiology Associates PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Dewhurst, Robert MD Provider ID: 355907 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Dewhurst, Robert MD Provider ID: 355907 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Diwadkar, Sachin MD Provider ID: 1425107 Gender: Male South Shore Cardiovascular Associat 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 Fax: (813) 661-6334 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Diwadkar, Sachin MD Provider ID: 1425107 Gender: Male Southshore Cardiovascular Associate 10726 Ketchum Valley Dr Riverview, FL 33579 (813) 661-6199 Fax: (813) 661-6334 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Diwadkar, Sachin MD Provider ID: 1425107 Gender: Male Southshore Cardiovascular Associate 12110 N 56th St Temple Terrace, FL 33617 (813) 661-6199 Fax: (813) 661-6334 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Elchahal, Sami MD Provider ID: 4498 Gender: Male Cardiovascular Center of Tampa 13801 Bru B Downs Blvd Ste 104 Tampa, FL 33613 (813) 972-5090 Fax: (813) 975-8748 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 104

Faghih, Fakhredin MD Provider ID: 9608 Gender: Male F Dean Faghih MD 3401 W Waters Ave Tampa, FL 33614 (813) 932-6106 Fax: (813) 915-0902 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Persian - Farsi M-TH 9:00 AM - 5:00 PM F 9:00 AM - 1:00 PM PCMH: No Feliz De LA Cruz, Victor MD Provider ID: 810957 Gender: Male Vasco M Marquez MD PA 3010 E 138th Ave Ste 12 Tampa, FL 33613 (813) 975-2800 Fax: (813) 977-7631 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Wesley Chapel Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Fernandez, Joel MD Provider ID: 197021 Gender: Male Florida Cardiovascular Institute PA 508 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Fradley, Michael MD Provider ID: 787048 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gallardo, Ignacio MD Provider ID: 688655 Gender: Male Heart Institute of Tampa PA 602 S Audubon Ave Ste C Tampa, FL 33609 (813) 374-2325 Fax: (813) 374-2364 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Gandhi, Adithya MD Provider ID: 1041996 Gender: Male Adithya K Gandhi MD Plc 1218 Millennium Pkwy Brandon, FL 33511 (813) 767-0956 Fax: (813) 684-3335 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gandhi, Adithya MD Provider ID: 1041996 Gender: Male Adithya K Gandhi MD Plc 13007 Summerfield Square Dr Riverview, FL 33578 (813) 767-0956 Fax: (813) 684-3335 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Gandhi, Adithya MD

Garcia, Juan MD Goldman, Anthony MD Provider ID: 1341604 Provider ID: 929247 Gender: Male Gender: Male Provider ID: 169011 Tampa Heart and Vascular Baycare Medical Group Gender: Male Associates 4612 N Habana Ave Fl 2 Brandon Cardiology Clinic PA 13701 Bru B Downs Blvd Ste 101 Tampa, FL 33614 320 Oakfield Dr Ste A Tampa, FL 33613 (813) 875-9000 Brandon, FL 33511 (813) 971-2600 Fax: (813) 874-3278 (813) 689-1912 Fax: (813) 979-4511 18 Yrs/130 Yrs Fax: (813) 684-3335 18 Yrs/130 Yrs St Josephs Hospital 18 Yrs/130 Yrs Tampa Community Hospital M-F 9:00 AM - 5:00 PM Brandon Regional Hospital M-F 8:00 AM - 5:00 PM St Josephs Hospital PCMH: No Tampa General Hospital PCMH: No Gowda, Umesh MD M-F 9:00 AM - 5:00 PM Garcia, Juan MD PCMH: No Provider ID: 1341604 Provider ID: 413454 Gangadharan, Gender: Male Gender: Male Venkataramanan MD Tampa Heart and Vascular Bay Area Cardiology Associates Associates PA 4160 N Armenia Ave Provider ID: 1341582 13029 Summerfield Square Dr Tampa, FL 33607 Gender: Male Riverview, FL 33578 (813) 673-8245 Tampa Heart and Vascular (813) 443-0880 Associates 18 Yrs/130 Yrs Fax: (813) 443-8335 13701 Bru B Downs Blvd Ste 101 Tampa Community Hospital 18 Yrs/130 Yrs Tampa, FL 33613 M-F 9:00 AM - 5:00 PM Brandon Regional Hospital (813) 971-2600 PCMH: No Columbia South Bay Hospital Fax: (813) 979-4511 Tampa General Hospital Garcia, Juan MD 18 Yrs/130 Yrs Languages: Spanish, Kannada Provider ID: 1341604 Tampa Community Hospital M-F 8:00 AM - 5:00 PM Gender: Male M-F 8:00 AM - 5:00 PM PCMH: No Tampa Heart and Vascular PCMH: No Associates Gowda, Umesh MD Gangadharan, 6101 Webb Rd Ste 206 Venkataramanan MD Tampa, FL 33615 Provider ID: 413454 (813) 884-0897 Gender: Male Fax: (813) 903-8132 Provider ID: 1341582 Bay Area Cardiology 18 Yrs/130 Yrs Gender: Male Associates PA Tampa Community Hospital Tampa Heart and Vascular 3920 Galen Ct Associates M-F 8:00 AM - 5:00 PM Sun City Center, FL 33573 6101 Webb Rd Ste 206 PCMH: No (813) 634-7200 Tampa, FL 33615 Fax: (813) 633-3841 Glover, Matthew MD (813) 884-0897 18 Yrs/130 Yrs Fax: (813) 903-8132 Brandon Regional Hospital 18 Yrs/130 Yrs Provider ID: 929253 Columbia South Bay Hospital Tampa General Hospital Tampa Community Hospital Gender: Male Languages: Spanish, Kannada M-F 8:00 AM - 5:00 PM Baycare Medical Group M-F 8:00 AM - 5:00 PM PCMH: No 4612 N Habana Ave Fl 2 PCMH: No Tampa, FL 33614 (813) 875-9000 Fax: (813) 874-3278 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 105

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Gowda, Umesh MD Provider ID: 413454 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish, Kannada M-F 8:00 AM - 5:00 PM PCMH: No Gowda, Umesh MD Provider ID: 413454 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish, Kannada M-F 8:00 AM - 5:00 PM PCMH: No Harrison, Eric MD Provider ID: 40 Gender: Male Harrison Cardiovascular Center 602 S Audubon Ave Ste B Tampa, FL 33609 (813) 348-4885 Fax: (813) 875-4149 18 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 4:00 PM PCMH: No

Herweg, Bengt MD

Khadim, Ghazanfar MD

Khan, Tehreen MD Provider ID: 270612 Gender: Female Provider ID: 672123 Provider ID: 456632 Bay Area Cardiology Gender: Male Gender: Male Associates PA USF Physicians Group Florida Heart Institute 3920 Galen Ct 2 Tampa General Cir 3rd Fl 1907 S Alexander St Sun City Center, FL 33573 Tampa, FL 33606 Plant City, FL 33566 (813) 634-7200 (813) 974-2201 (813) 780-6687 Fax: (813) 633-3841 Fax: (812) 259-8679 Fax: (813) 788-6554 18 Yrs/130 Yrs 00 Yrs/130 Yrs 18 Yrs/130 Yrs Brandon Regional Hospital Tampa General Hospital Bayfront Health Dade City Columbia South Bay Hospital Florida Hospital Zephyrhills Languages: Italian, German Florida Hospital Zephyrhills South Florida Baptist Hospital M-F 8:00 AM - 5:00 PM Languages: Urdu Languages: Spanish, Chinese, PCMH: No M-F 8:00 AM - 5:00 PM Burmese PCMH: No M-F 9:00 AM 5:00 PM Hulse III, Ronald MD PCMH: No Khan, Tehreen MD Provider ID: 516652 Khadim, Ghazanfar MD Provider ID: 270612 Gender: Male Gender: Female Ronald S Hulse III MD Bay Area Cardiology Provider ID: 456632 5 Tampa General Cir Ste 830 Associates PA Gender: Male Tampa, FL 33606 5 Tampa General Cir Ste 850 Florida Heart Institute (813) 251-5511 Tampa, FL 33606 310 W Alexander St Fax: (813) 251-5521 (813) 684-6000 Plant City, FL 33563 18 Yrs/130 Yrs Fax: (813) 654-9032 (813) 780-6687 Memorial Hospital of Tampa 18 Yrs/130 Yrs Fax: (813) 788-6554 Tampa General Hospital Brandon Regional Hospital 18 Yrs/130 Yrs M-F 9:00 AM - 5:30 PM Columbia South Bay Hospital Bayfront Health Dade City PCMH: No Florida Hospital Zephyrhills Florida Hospital Zephyrhills Languages: Urdu South Florida Baptist Hospital Khadim, Ghazanfar MD M-F 8:00 AM - 5:00 PM Languages: Spanish, Chinese, PCMH: No Burmese Provider ID: 456632 MT 1:00 AM 5:00 PM Gender: Male Khan, Tehreen MD W 8:00 AM - 12:00 PM Florida Heart Institute Provider ID: 270612 PCMH: No 1703 Thonotosassa Rd Gender: Female Plant City, FL 33563 Bay Area Cardiology Khan, Tehreen MD (813) 780-6687 Associates PA Provider ID: 270612 Fax: (813) 788-6554 635 Eichenfeld Dr Gender: Female 18 Yrs/130 Yrs Brandon, FL 33511 Bay Area Cardiology Bayfront Health Dade City (813) 684-6000 Associates PA Florida Hospital Zephyrhills Fax: (813) 643-2836 13029 Summerfield Square Dr South Florida Baptist Hospital 18 Yrs/130 Yrs Riverview, FL 33578 Languages: Spanish, Chinese, Brandon Regional Hospital (813) 443-0880 Burmese Columbia South Bay Hospital Fax: (813) 443-8335 M 8:00 AM - 5:00 PM Florida Hospital Zephyrhills 18 Yrs/130 Yrs PCMH: No Languages: Urdu Brandon Regional Hospital M-F 8:00 AM - 5:00 PM Columbia South Bay Hospital PCMH: No Florida Hospital Zephyrhills Languages: Urdu M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 106

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Khant, Ranchhod MD Provider ID: 187 Gender: Male Bay Area Cardiology and Vascular Assoc 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Khant, Ranchhod MD Provider ID: 187 Gender: Male Bay Area Cardiology and Vascular Assoc 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Khant, Ranchhod MD Provider ID: 187 Gender: Male Bay Area Cardiology and Vascular Assoc 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Khant, Ranchhod MD Provider ID: 187 Gender: Male Bay Area Cardiology and Vascular Assoc 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kumar, Siva MD Provider ID: 551008 Gender: Male Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Tampa General Hospital Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Labovitz, Arthur MD Provider ID: 234492 Gender: Male USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 974-2201 Fax: (813) 259-0665 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Labovitz, Arthur MD

Malik, Shahid MD Provider ID: 4194 Gender: Male Provider ID: 234492 Northside Cardiology PLLC Gender: Male 1134 Kyle Wood Ln USF Physicians Group 2 Tampa General Cir 5th Fl Ste Brandon, FL 33511 5073 (813) 633-9700 Tampa, FL 33606 Fax: (813) 217-5389 (813) 259-0817 18 Yrs/130 Yrs Fax: (813) 259-0665 Brandon Regional Hospital Columbia South Bay Hospital 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Leche, Carlos MD Provider ID: 958252 Gender: Male 1601 W Reynolds St Ste 102 Plant City, FL 33563 (813) 413-1455 Fax: (813) 413-1454 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No Mackie, Benjamin MD Provider ID: 711467 Gender: Male Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Makati, Kevin MD Provider ID: 451309 Gender: Male 4211 Van Dyke Rd Ste 205 Lutz, FL 33558 (813) 418-0100 Fax: (813) 902-6950 18 Yrs/130 Yrs Largo Medical Center Mease Countryside Hospital Morton Plant Hospital M-F 9:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 107

Malik, Shahid MD Provider ID: 4194 Gender: Male Northside Cardiology PLLC 733 Cortaro Dr Sun City Center, FL 33573 (813) 633-9700 Fax: (813) 217-5389 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Maniscalco, Benedict MD Provider ID: 1352193 Gender: Male Tampa Heart and Vascular Associates 6101 Webb Rd Ste 206 Tampa, FL 33615 (813) 884-0897 Fax: (813) 903-8132 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Marques, Vasco MD Provider ID: 168322 Gender: Male Vasco M Marques MD PA 3010 E 138th Ave Ste 12 Tampa, FL 33613 (813) 975-2800 Fax: (813) 977-7631 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Wesley Chapel Tampa Community Hospital Languages: Spanish, French, Italian, Portuguese M-F 8:30 AM - 5:00 PM PCMH: No Matar, Fadi MD Provider ID: 32 Gender: Male 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital Languages: French, Arabic PCMH: No Matar, Fadi MD Provider ID: 32 Gender: Male Florida Cardiovascular Institute PA 137 S Pebble Beach Blvd Ste 101 Sun City Center, FL 33573 (813) 634-8000 Fax: (813) 634-8099 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

Matar, Fadi MD Provider ID: 32 Gender: Male Florida Cardiovascular Institute PA 509 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Mathew, Dilip MD Provider ID: 366043 Gender: Male Heart Rhythm Consultants 10726 Ketchum Valley Dr Riverview, FL 33579 (941) 484-6758 Fax: (941) 404-4451 18 Yrs/130 Yrs Sarasota Memorial Hospital St Josephs Hospital Venice Regional Medical Center Languages: Malayalam M-F 9:00 AM - 5:00 PM PCMH: No Mester, Stephen MD Provider ID: 190 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Mester, Stephen MD Provider ID: 190 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Mester, Stephen MD Provider ID: 190 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Michel, Alejandro MD

Misiri, Juna MD Provider ID: 1126169 Gender: Female Bay Area Cardiology Associates, PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Misiri, Juna MD Provider ID: 1126169 Gender: Female Bay Area Cardiology Associates, PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Misiri, Juna MD Provider ID: 1126169 Gender: Female Bay Area Cardiology Associates, PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1341599 Morales Pabon, Cesar MD Gender: Male Tampa Heart and Vascular Associates Provider ID: 977869 13701 Bru B Downs Blvd Ste 101 Gender: Male Tampa, FL 33613 Harrison Cardiovascular (813) 971-2600 Center PA Fax: (813) 979-4511 602 S Audubon Ave Ste B 12 Yrs/130 Yrs Tampa, FL 33609 Tampa Community Hospital (813) 348-4885 Languages: Spanish Fax: (813) 343-6089 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Memorial Hospital of Tampa M-TH 9:00 AM - 5:00 PM F 9:00 AM - 4:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont.

Patel, Aarti MD Provider ID: 1108173 O'Hara, Mitchell DO Gender: Female 2 Tampa General Cir 3rd Fl Tampa, FL 33606 Provider ID: 1341603 (813) 259-0600 Gender: Male Fax: (813) 259-8679 Tampa Heart and Vascular Associates 18 Yrs/130 Yrs 13701 Bru B Downs Blvd Ste 101 M-F 8:00 AM - 5:00 PM Tampa, FL 33613 PCMH: No (813) 971-2600 Patel, Roshankumar MD Fax: (813) 979-4511 18 Yrs/130 Yrs Tampa Community Hospital Provider ID: 1314996 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Heart Vascular Institute of Florid O'Hara, Mitchell DO 310 W Alexander St Plant City, FL 33563 (863) 424-3278 Provider ID: 1341603 Fax: (863) 420-9701 Gender: Male 00 Yrs/130 Yrs Tampa Heart and Vascular Associates M-F 9:00 AM - 5:00 PM 6101 Webb Rd Ste 206 PCMH: No Tampa, FL 33615 Perzanowski Obregon, (813) 884-0897 Christian MD Fax: (813) 903-8132 Provider ID: 410548 18 Yrs/130 Yrs Gender: Male Tampa Community Hospital Bay Area Cardiology M-F 8:00 AM - 5:00 PM Associates PA PCMH: No 5 Tampa General Cir Ste 850 Tampa, FL 33606 Pascual, Eduardo MD (813) 684-6000 Provider ID: 1198506 Fax: (813) 654-9032 Gender: Male 18 Yrs/130 Yrs USF Physicians Group Brandon Regional Hospital 13330 USF Laurel Dr 3rd Fl Columbia South Bay Hospital Tampa, FL 33612 Tampa General Hospital (813) 259-0600 M-F 8:00 AM - 5:00 PM Fax: (813) 974-4695 PCMH: No 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Potorski, Robert MD PCMH: No Patel, Aarti MD Provider ID: 1108173 Gender: Female 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-0600 Fax: (813) 974-4695 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1270846 Gender: Male South Shore Cardiovascular Associat 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Potorski, Robert MD Provider ID: 1270846 Gender: Male Southshore Cardiovascular Associate 10726 Ketchum Valley Dr Riverview, FL 33579 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Potorski, Robert MD Provider ID: 1270846 Gender: Male Southshore Cardiovascular Associate 12110 N 56th St Temple Terrace, FL 33617 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Prida, Xavier MD Provider ID: 982658 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Prida, Xavier MD Provider ID: 982658 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-8679 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Rajendran, Pattabhraman MD Provider ID: 6843 Gender: Male Devarakonda S 1507 W Reynolds St Ste B Plant City, FL 33563 (813) 752-1053 Fax: (813) 754-6739 18 Yrs/130 Yrs Florida Hospital Zephyrhills South Florida Baptist Hospital Languages: Hindi M-F 8:30 AM - 5:00 PM PCMH: No Ramirez, John MD Provider ID: 571 Gender: Male USF Physicians Group 509 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 00 Yrs/130 Yrs Florida Hospital Tampa Memorial Hospital of Tampa Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rao, Ramanath MD Provider ID: 1262 Gender: Male Pasco Cardiology Associates 6725 Cedar Ridge Dr Temple Terrace, FL 33542 (813) 788-0439 Fax: (813) 788-6194 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Tampa Florida Hospital Zephyrhills Languages: Spanish, Hindi PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Rattes, Max MD Provider ID: 1418113 Gender: Male Tgmf Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Rinde-Hoffman, Debbie MD Provider ID: 659697 Gender: Female Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Florida Hospital Tampa Tampa Community Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Rolando MD Provider ID: 13308 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Columbia South Bay Hospital Memorial Hospital of Tampa Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rodriguez, Rolando MD Provider ID: 13308 Gender: Male Bay Area Cardiology Associates PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Columbia South Bay Hospital Memorial Hospital of Tampa Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Rolando MD Provider ID: 13308 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Columbia South Bay Hospital Memorial Hospital of Tampa Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Rolando MD Provider ID: 13308 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 681-9584 18 Yrs/130 Yrs Columbia South Bay Hospital Memorial Hospital of Tampa Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rogal, Philip MD Provider ID: 361001 Gender: Male 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-0600 Fax: (813) 974-7589 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Rogal, Philip MD Provider ID: 361001 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, French M-F 9:00 AM - 5:00 PM PCMH: No Roy, Bipul MD Provider ID: 1039188 Gender: Male South Shore Cardiovascular Associat 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Bengali M-F 9:00 AM - 5:00 PM PCMH: No Sadanandan, Saihari MD Provider ID: 1256811 Gender: Male Baycare Medical Group Inc 4612 N Habana Ave 2nd Fl Tampa, FL 33614 (813) 875-9000 Fax: (813) 874-3278 18 Yrs/130 Yrs Mease Countryside Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Saiyad, Saleem MD Provider ID: 1217578 Gender: Male Care Cardiology and Vein Center 13618 W Hillsborough Ave Tampa, FL 33635 (813) 818-0100 Fax: (813) 818-0144 18 Yrs/130 Yrs Mease Countryside Hospital Tampa Community Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 9:00 AM - 7:00 PM Sat 8:00 AM - 1:00 PM PCMH: No Sawar, Asad MD Provider ID: 521080 Gender: Male 3010 E 138th Ave Ste 12 Tampa, FL 33613 (813) 975-2800 Fax: (813) 977-7631 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Wesley Chapel Tampa Community Hospital Languages: Hindi M-F 8:30 AM - 5:00 PM PCMH: No Sayad, Dany MD Provider ID: 150298 Gender: Male Florida Cardiovascular Institu 137 S Pebble Beach Blvd Ste 101 Sun City Center, FL 33573 (813) 634-8000 Fax: (813) 634-8099 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Sayad, Dany MD Provider ID: 150298 Gender: Male Florida Cardiovascular Institute PA 509 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Siddiqui, Irfan DO Provider ID: 584117 Gender: Female Heart and Vascular Plc 310 W Alexander St Plant City, FL 33563 (863) 424-3278 Fax: (863) 420-9701 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Singh, Alok MD Provider ID: 929235 Gender: Male Baycare Medical Group 4612 N Habana Ave Fl 2 Tampa, FL 33614 (813) 875-9000 Fax: (813) 874-3278 18 Yrs/130 Yrs St Josephs Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Singh, Harshinder MD Provider ID: 455542 Gender: Male 10726 Ketchum Valley Dr Riverview, FL 33579 (813) 677-9200 Fax: (813) 677-9224 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Singh, Harshinder MD Provider ID: 455542 Gender: Male Southshore Cardiovascular Associate 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 Fax: (813) 661-6334 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Smith, James MD Provider ID: 1198508 Gender: Male USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-0600 Fax: (813) 974-4695 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Stonerock, Mary MD Provider ID: 200298 Gender: Female Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stonerock, Mary MD Provider ID: 200298 Gender: Female Bay Area Cardiology Associates PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stonerock, Mary MD Provider ID: 200298 Gender: Female Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Stonerock, Mary MD Provider ID: 200298 Gender: Female Bay Area Cardiology Stauffer, Marc MD Associates PA Provider ID: 370287 635 Eichenfeld Dr Gender: Male Palma Ceia Heart and Vascular Brandon, FL 33511 (813) 684-6000 2919 W Swann Ave Ste 102 Fax: (813) 643-2836 Tampa, FL 33609 18 Yrs/130 Yrs (813) 870-3971 M-F 8:00 AM - 5:00 PM Fax: (813) 872-6594 PCMH: No 12 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Sullebarger, John MD Provider ID: 1310245 Gender: Male Florida Medical Clinic, PA 3860 Sun City Center Blvd Sun City Center, FL 33573 (813) 633-1980 Fax: (813) 355-5104 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital MT 8:00 AM - 5:00 PM PCMH: No Sullebarger, John MD Provider ID: 1310245 Gender: Male Florida Medical Clinic, PA 4200 N Armenia Ave Ste 5 Tampa, FL 33607 (813) 284-2200 Fax: (813) 377-1006 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-W 8:00 AM - 5:00 PM PCMH: No Sullebarger, John MD Provider ID: 1310245 Gender: Male Florida Medical Clinic, PA 4210 W Linebaugh Ave Tampa, FL 33624 (813) 884-0923 Fax: (813) 377-1006 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital MT 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Talit, Uzi MD Provider ID: 15305 Gender: Male Southshore Cardiovascular Associate 10726 Ketchum Valley Dr Riverview, FL 33579 (813) 677-9200 Fax: (813) 677-9224 00 Yrs/18 Yrs Bartow Regional Medical Center Lakeland Reg Medical Center St Josephs Hospital Languages: Spanish, Italian, Hebrew M-F 9:00 AM - 5:00 PM PCMH: No Talit, Uzi MD Provider ID: 15305 Gender: Male Southshore Cardiovascular Associate 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 00 Yrs/18 Yrs Bartow Regional Medical Center Lakeland Reg Medical Center St Josephs Hospital Languages: Spanish, Italian, Hebrew M-F 8:00 AM - 5:00 PM PCMH: No Tamboli, Hoshedar MD Provider ID: 189 Gender: Male Bay Area Cardiology Associates PA 13029 Summerfield Square Dr Riverview, FL 33578 (813) 443-0880 Fax: (813) 443-8335 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Tamboli, Hoshedar MD Provider ID: 189 Gender: Male Bay Area Cardiology Associates PA 3920 Galen Ct Sun City Center, FL 33573 (813) 634-7200 Fax: (813) 633-3841 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tamboli, Hoshedar MD Provider ID: 189 Gender: Male Bay Area Cardiology Associates PA 5 Tampa General Cir Ste 850 Tampa, FL 33606 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tamboli, Hoshedar MD Provider ID: 189 Gender: Male Bay Area Cardiology Associates PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 643-2836 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Thangam, Sabanayagam MD Provider ID: 214520 Gender: Male Brandon Cardiology Clinic PA 320 Oakfield Dr Ste A Brandon, FL 33511 (813) 689-1912 Fax: (813) 684-3335 00 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa General Hospital Languages: Hindi, Indian M-F 9:00 AM - 5:00 PM PCMH: No Tun, Aung MD Provider ID: 19694 Gender: Male Aung Tun MD PA 1907 S Alexander St Plant City, FL 33566 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills Languages: Burmese M-F 8:00 AM - 5:00 PM PCMH: No Tun, Aung MD Provider ID: 19694 Gender: Male Aung Tun MD PA 301 W Alexander St Plant City, FL 33566 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills Languages: Burmese M-F 8:00 AM - 5:00 PM PCMH: No

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Velusamy, Muthusamy MD Provider ID: 1170547 Gender: Male Cardiovascular Institute of America 6328 Gunn Hwy Ste C Tampa, FL 33625 (813) 610-9510 Fax: (844) 224-0312 18 Yrs/130 Yrs Medical Center of Trinity Languages: Tamil M-F 9:00 AM - 4:00 PM PCMH: No Weston, Mark MD Provider ID: 212032 Gender: Male Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Whitaker, David MD Provider ID: 544854 Gender: Male USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7229 Fax: (813) 844-7871 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Cardiology - cont. Whitaker, David MD

Child Neurology Andrade, Edgard MD

Provider ID: 544854 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1282699 Gender: Male Pediatric Epilepsy and Neurology SP 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Wilson, David MD Provider ID: 1244460 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Chung, Elizabeth MD Provider ID: 347406 Gender: Female Pediatric Epilepsy and Neurology 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs Florida Hospital Tampa Tampa General Hospital M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No

Cardiovascular Surgery

Ferreira, Carmen MD Provider ID: 337687 Gender: Female Pediatric Epilepsy and Neurology SP 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs Florida Hospital Carrollwood St Josephs Hospital Tampa General Hospital Languages: Spanish M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Ferreira, Jose MD Provider ID: 17780 Gender: Male Pediatric Epilepsy and Neurology 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs St Josephs Hospital Tampa General Hospital Languages: Spanish M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No

Ilercil, Arzu MD Provider ID: 591820 Fernandez, Raymond MD Gender: Female University Med Svcs Assoc Inc Provider ID: 1278973 2 Tampa General Cir 3rd Fl Gieron Korthals, Maria MD Gender: Male Tampa, FL 33606 Hriners Hospitals For Children (813) 974-2201 Provider ID: 1213433 12502 USF Pine Dr Fax: (813) 259-8679 Gender: Female Tampa, FL 33612 18 Yrs/130 Yrs Shriners Hospitals For (813) 972-2250 Memorial Hospital of Tampa Children 00 Yrs/18 Yrs Tampa General Hospital 12502 USF Pine Dr M-F 8:00 AM - 5:00 PM Languages: Turkish Tampa, FL 33612 PCMH: No M-F 8:00 AM - 5:00 PM (813) 972-2250 PCMH: No Fax: (813) 975-7125 00 Yrs/18 Yrs Rosenblum, Harry MD M-F 9:00 AM - 5:00 PM PCMH: No Provider ID: 1145958 Gender: Male Baycare Medical Group 3003 W Dr MLK Blvd Mab-2nd Fl Tampa, FL 33607 (813) 321-6580 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Gieron-Korthals, Maria MD Provider ID: 7095 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-2717 Fax: (813) 259-8771 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gieron-Korthals, Maria MD Provider ID: 7095 Gender: Female USF Physicicans Group 6 Tampa General Cir 1st Fl Tampa, FL 33606 (813) 844-7900 Fax: (813) 844-4058 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gonzalezabella, Beatriz MD Provider ID: 1289506 Gender: Female USF Physicians Group 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8093 Fax: (813) 554-8657 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jacinto, Sergio MD Provider ID: 5320 Gender: Male Sergio J Jacinto MD PA 4507 N Armenia Ave Tampa, FL 33603 (813) 876-4100 Fax: (813) 876-4153 00 Yrs/18 Yrs Brandon Regional Hospital Florida Hospital Tampa Tampa General Hospital Languages: Spanish M-F 8:30 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Child Neurology - cont. Mukalel, Ninon MD Provider ID: 815769 Gender: Female Pediatric Epilepsy and Neurology SP 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs St Josephs Hospital Tampa General Hospital M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Nallu, Sagarika MD Provider ID: 1162054 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2583 Fax: (813) 259-8748 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nallu, Sagarika MD Provider ID: 1162054 Gender: Female USF Physicians Group 6 Tampa General Cir Tampa, FL 33606 (813) 974-2583 Fax: (813) 259-8748 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Colin MD Provider ID: 686240 Gender: Male Pediatric Physician Services 12220 Bruce B Downs Blvd Tampa, FL 33612 (272) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Rao, Radhakrishna MD Provider ID: 224595 Gender: Male Tampa Childrens Spec Clinic 2508 W Saint Isabel St Ste A Tampa, FL 33607 (813) 876-3783 Fax: (813) 876-2525 00 Yrs/18 Yrs St Josephs Hospital Languages: Hindi, Indonesian, Tamil, Kannada M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 461042 Gender: Male 12220 Bruce B Downs Blvd Tampa, FL 33612 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 461042 Gender: Male 885 S Parsons Ave Brandon, FL 33511 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 461042 Gender: Male Center For Pediatric Neurosurger 1 Tampa General Cir Tampa, FL 33606 (863) 299-1251 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Chiropractic Barry, Scott DC Provider ID: TPV10651-01 Gender: Male Bay City Chiropractic Inc 4624 N Armenia Ave Tampa, FL 33603 (813) 874-2646 Fax: (813) 874-2656 00 Yrs/99 Yrs Languages: Spanish MWF 8:00 AM - 7:00 PM TTH 2:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Brecher, Matthew DC Provider ID: TPV10821-02 Gender: Male Active Health Wellness Center Inc 4015 N Armenia Ave Tampa, FL 33607 (813) 933-5259 Fax: (813) 935-3698 00 Yrs/99 Yrs Languages: Spanish M-W 8:30 AM - 6:30 PM PCMH: No Caez, Brian DC Provider ID: TPV11423-01 Gender: Male Caez Chiropractic 1001 N Macdill Ave Tampa, FL 33607 (813) 872-4455 Fax: (813) 464-7756 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM PCMH: No Cheatwood, Janice DC Provider ID: TPV10833-01 Gender: Female Janice A Cheatwood DC, LLC 303 Bryan Rd Ste 2 Brandon, FL 33511 (813) 681-4418 Fax: (813) 684-8397 04 Yrs/90 Yrs MW 8:30 AM - 6:00 PM TTH 11:00 AM - 7:00 PM F 8:30 AM - 1:00 PM PCMH: No

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Cox, Stephen DC Provider ID: TPV10137-01 Gender: Male Dr Stephen M Cox PA 603 W Bloomingdale Ave Brandon, FL 33511 (813) 654-7999 Fax: (813) 662-4809 00 Yrs/99 Yrs Languages: Spanish MWTHF 8:00 AM - 7:00 PM T 8:00 AM - 3:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Hensley, Scott DC Provider ID: TPV10951-02 Gender: Male Scott H Hensley DC Inc 205 W Dr MLK Jr Blvd Ste 101 Tampa, FL 33603 (813) 374-9935 Fax: (888) 299-9352 00 Yrs/99 Yrs MT 8:00 AM - 5:00 PM PCMH: No Jones, Nathan DC Provider ID: TPV11434-01 Gender: Male Nathan A Jones DC PA 3333 W Waters Ave Ste C Tampa, FL 33614 (813) 935-2099 Fax: (813) 935-1388 00 Yrs/99 Yrs MW 8:00 AM - 5:00 PM TTH 1:00 AM - 7:00 PM F 8:00 AM - 3:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Mohr, Travis DC Provider ID: TPV11256-01 Gender: Male North Tampa Spine Joint Center 17429 Bridge Hill Ct Tampa, FL 33647 (813) 983-7921 Fax: (813) 333-2788 10 Yrs/99 Yrs MW 9:00 AM - 6:00 PM TTH 2:00 AM - 6:00 PM F 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Chiropractic - cont. Rice, Charles DC Provider ID: TPV17685-01 Gender: Male Total Health Chiropractic Center 6541 Gunn Hwy Tampa, FL 33625 (813) 269-0437 Fax: (813) 963-5557 00 Yrs/99 Yrs MWF 9:00 AM - 7:00 PM TTH 3:00 AM - 7:00 PM PCMH: No Rodriguez, Robert DC Provider ID: TPV10529-01 Gender: Male Robert J Rodriguez DC PA 4407 Kelly Rd Tampa, FL 33615 (813) 887-5560 Fax: (813) 885-7123 00 Yrs/99 Yrs Languages: Spanish M-W 10:00 AM - 8:00 PM TH 10:00 AM - 2:00 PM PCMH: No St. Hilaire, Nicholas DC Provider ID: TPV10818-02 Gender: Male Active Health Wellness Center Inc 4015 N Armenia Ave Tampa, FL 33607 (813) 933-5259 Fax: (813) 935-3698 00 Yrs/99 Yrs MT 8:30 AM - 6:00 PM W 9:00 AM - 12:00 PM PCMH: No

Stangherlin, Michael DC Wages, David DC Provider ID: TPV11246-01 Provider ID: TPV10895-01 Gender: Male Gender: Male Stangherlin Chiropractic Clinic Advanced Care Chiropractic 8834 N 56th St 115 Margaret St Ste F Tampa, FL 33617 Brandon, FL 33511 (813) 983-1400 (813) 655-1310 Fax: (813) 983-1441 Fax: (813) 655-1305 10 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: French, Italian Languages: Spanish MW 11:00 AM - 7:00 PM MW 8:30 AM - 6:30 PM T 8:00 AM - 12:00 PM T 8:30 AM - 11:30 PM TH 8:00 AM - 7:00 PM TH 3:30 AM - 6:30 PM PCMH: No F 8:30 AM - 4:00 PM Sat 9:00 AM - 10:00 PM Trussell, Kenneth DC PCMH: No Provider ID: TPV10714-01 Gender: Male Williams, Christopher DC Kenneth W Trussell DC PA Provider ID: TPV10932-01 113 W Robertson St Gender: Male Brandon, FL 33511 Advanced Chiropractic (813) 685-4222 Rehabilitation Fax: (813) 689-3832 13813 W Hillsborough Ave 00 Yrs/99 Yrs Tampa, FL 33635 MWF 9:00 AM - 6:30 PM (813) 925-1700 TTH 8:30 AM - 12:00 PM Fax: (813) 925-1744 Sat 9:00 AM - 12:00 PM 01 Yrs/99 Yrs PCMH: No Languages: Spanish M 7:00 AM - 12:00 PM Venturino, Nicholas DC TW 7:30 AM - 6:00 PM Provider ID: TPV11105-01 TH 1:30 AM - 6:00 PM Gender: Male F 8:00 AM - 12:00 PM Healing Hands Chiropractic PA PCMH: No 14491 University Cove Williams, Christopher DC Tampa, FL 33613 Provider ID: TPV10932-02 (813) 977-2383 Gender: Male Fax: (813) 977-2585 Advanced Chiropractic 00 Yrs/99 Yrs Rehabilitation M-TH 9:00 AM - 7:00 PM 701 W Fletcher Ste B F 9:00 AM - 12:30 PM Tampa, FL 33612 PCMH: No (813) 968-9800 Fax: (813) 968-9887 01 Yrs/99 Yrs Languages: Spanish M 1:30 AM - 6:30 PM TW 7:30 AM - 12:30 PM PCMH: No

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Williams, Gregory DC Provider ID: TPV10169-01 Gender: Male Medical Chiropractic Clinic Inc 4602 N Nebraska Ave Tampa, FL 33603 (813) 237-3791 Fax: (813) 237-3792 00 Yrs/99 Yrs M-W 9:00 AM - 7:00 PM PCMH: No Willmitch, Martin DC Provider ID: TPV10948-01 Gender: Male Willmitch Chiropractic PA 2801 W Busch Blvd Ste 103 Tampa, FL 33618 (813) 933-6481 Fax: (813) 932-2229 10 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 8:00 AM - 4:00 PM PCMH: No

Colon & Rectal Surgery Brannan, Anthony MD Provider ID: 666601 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 879-5010 Fax: (813) 443-8148 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chudzinski, Allen MD Provider ID: 1222282 Gender: Male Fhpg Advanced Center For Colorectal Su 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-7366 Fax: (813) 615-8008 16 Yrs/130 Yrs Florida Hospital Tampa M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Colon & Rectal Surgery - Sanchez, Jamie MD cont. Provider ID: 684434 Farooq, Shiraz MD Provider ID: 1356313 Gender: Male Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 18 Yrs/130 Yrs Brandon Regional Hospital Tampa General Hospital M 1:00 AM - 5:00 PM PCMH: No Marcet, Jorge MD Provider ID: 7164 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-3976 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Massarotti, Haane MD Provider ID: 1356614 Gender: Female Fhpg Advanced Center For Colorectal Gs 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-7366 Fax: (813) 615-8350 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Myers, Elizabeth MD Provider ID: 1323377 Gender: Female Baycare Medical Group Inc 4301 N Habana Ave Tampa, FL 33607 (813) 879-5010 Fax: (813) 873-1304 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male 1 Tampa General Cir Tampa, FL 33606 (813) 844-4545 Fax: (813) 844-3976 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Sanchez, Jamie MD Provider ID: 684434 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 844-4545 Fax: (813) 844-3976 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Sanchez, Jamie MD Provider ID: 684434 Gender: Male 2 Tampa General Cir Tampa, FL 33606 (813) 844-4545 Fax: (813) 844-3976 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Santiago, Cesar MD Provider ID: 356337 Gender: Male Baycare Medical Group 2727 W Dr MLK Blvd Tampa, FL 33607 (813) 879-5010 Fax: (813) 443-8148 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Dermatology Belongie, Iriana MD Provider ID: 755816 Gender: Female Academic Alliance In Dermatology 5210 Webb Rd Tampa, FL 33615 (813) 882-9986 Fax: (813) 882-9849 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Community Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Caban, Francis MD Provider ID: 196601 Gender: Male Caban Skin Institute 109 Margaret St Brandon, FL 33511 (813) 654-2544 Fax: (813) 653-4391 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-W 9:00 AM - 5:30 PM PCMH: No Caban, Francis MD Provider ID: 196601 Gender: Male Caban Skin Institute 4164 N Armenia Ave Tampa, FL 33607 (813) 879-7546 Fax: (813) 871-6842 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-W 8:30 AM - 4:30 PM TH 8:30 AM - 12:00 PM PCMH: No

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Cherpelis, Basil MD Provider ID: 279836 Gender: Male USF Physicians Group 10920 McKinley Dr Tampa, FL 33612 (813) 745-8482 Fax: (813) 745-7192 00 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM PCMH: No Cherpelis, Basil MD Provider ID: 279836 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4744 Fax: (813) 974-2132 00 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM PCMH: No Cottam, John MD Provider ID: 162223 Gender: Male Dr John Cottam Dermatology and Cuta 14310 N Dale Mabry Hwy Ste 180 Tampa, FL 33618 (813) 962-4210 Fax: (813) 962-0566 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Cottam, John MD Provider ID: 162223 Gender: Male Dr John Cottam Dermatology and Cuta 500 Vonderburg Dr Ste 212 W Brandon, FL 33511 (813) 962-4210 Fax: (813) 571-3234 00 Yrs/130 Yrs M 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Dermatology - cont. Donelan, Peter MD Provider ID: 1299137 Gender: Male Florida Medical Clinic, PA 3000 E Fletcher Ave Ste Ste 200 Tampa, FL 33613 (813) 972-1229 Fax: (813) 972-1889 05 Yrs/130 Yrs MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 11:30 PM PCMH: No Dorton, David DO Provider ID: 1114683 Gender: Male Bay Dermatology & Cosmetic Surgery 3657 Madaca Ln Tampa, FL 33618 (813) 264-5447 Fax: (813) 264-0817 00 Yrs/130 Yrs Largo Medical Center Indian Rocks Medical Center of Trinity Morton Plant North Bay Hospital MWTHF 9:00 AM - 5:00 PM T 0:00 AM - 5:00 PM PCMH: No Forman, Seth MD Provider ID: 388520 Gender: Male 4915 Ehrlich Rd Tampa, FL 33624 (813) 960-2400 Fax: (813) 960-2410 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Murray, David MD Provider ID: 12240 Gender: Male Advanced Dermatology and Cosmetic S 2005 W Reynolds St Plant City, FL 33563 (813) 720-2012 Fax: (813) 720-2013 00 Yrs/130 Yrs Citrus Surgical Center Lakeland Reg Medical Center Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No Nelson, Christopher MD Provider ID: 626019 Gender: Male USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4744 Fax: (813) 974-2132 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Nyanda, Hoka MD Provider ID: 1007752 Gender: Female Academic Alliance In Dermatology I 3000 E Fletcher Ave Ste 205 Tampa, FL 33613 (813) 341-1488 Fax: (813) 341-1489 00 Yrs/21 Yrs Florida Hospital Wesley Chapel Johns Hopkins All Childrens Hospital Inc St Josephs Hospital MT 8:00 AM - 5:00 PM PCMH: No Patel, Nishit MD Provider ID: 964289 Gender: Male USF Physicians Group 13330 USF Laurel Dr Fl 6 Tampa, FL 33612 (813) 974-4744 Fax: (813) 974-2132 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Proper, Steven MD Provider ID: 164836 Gender: Male Advanced Dermatology Cosmetic Surg 2835 W De Leon St Ste 103 Tampa, FL 33609 (813) 287-0443 Fax: (813) 289-3552 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Proper, Steven MD Provider ID: 164836 Gender: Male Advanced Dermatology & Cosmetic Sur 13142 Elk Mountain Dr Riverview, FL 33579 (813) 287-0443 Fax: (813) 289-3552 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Proper, Steven MD Provider ID: 164836 Gender: Male Advanced Dermatology & Cosmetic Sur 14521 University Point Pl Tampa, FL 33613 (813) 977-3600 Fax: (813) 977-1664 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Romagnolo, Stephen MD Provider ID: 472296 Gender: Male Center For Dermatology and Skin 14521 University Point Pl Tampa, FL 33613 (813) 977-3600 Fax: (813) 977-1664 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

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Romagnolo, Stephen MD Provider ID: 472296 Gender: Male Center For Dermatology and Skin 2835 W De Leon St Ste 103 Tampa, FL 33609 (813) 287-0443 Fax: (813) 289-3552 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Romagnolo, Stephen MD Provider ID: 916158 Gender: Male Leavitt Medical Associates of Flori 2835 W De Leon St Ste 103 Tampa, FL 33609 (813) 287-0443 Fax: (813) 289-3552 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Sable, David MD Provider ID: 703023 Gender: Male Academic Alliance In Dermatology 131 N Oakwood Ave Ste 135 Brandon, FL 33510 (813) 440-5544 Fax: (813) 440-5545 00 Yrs/130 Yrs Memorial Hospital of Tampa Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Dermatology - cont. Sable, David MD Provider ID: 703023 Gender: Male Academic Alliance In Dermatology 4238 W Kennedy Blvd Tampa, FL 33609 (813) 879-6040 Fax: (813) 879-6043 00 Yrs/130 Yrs Memorial Hospital of Tampa Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Sable, David MD Provider ID: 703023 Gender: Male Academic Alliance In Dermatology 5210 Webb Rd Tampa, FL 33615 (813) 882-9986 Fax: (813) 882-9849 00 Yrs/130 Yrs Memorial Hospital of Tampa Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Sable, David MD Provider ID: 703023 Gender: Male Academic Alliance In Dermatology 6901 Simmons Loop Ste 207 Riverview, FL 33578 (813) 868-3052 Fax: (813) 868-3046 00 Yrs/130 Yrs Memorial Hospital of Tampa Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Scannon, Michael MD Provider ID: 131 Gender: Male 4200 N Armenia Ave Ste 1 Tampa, FL 33607 (813) 877-4811 Fax: (813) 872-8978 18 Yrs/130 Yrs St Josephs Hospital M-TH 7:00 AM - 5:00 PM F 7:00 AM - 4:00 PM PCMH: No Scannon, Michael MD Provider ID: 131 Gender: Male 772 Cortaro Dr Sun City Center, FL 33573 (813) 877-4811 Fax: (813) 872-8978 18 Yrs/130 Yrs St Josephs Hospital M-TH 7:00 AM - 5:00 PM F 7:00 AM - 4:00 PM PCMH: No Taylor, Thomas MD Provider ID: 4622 Gender: Male Thomas Taylor MD PA 3514 W Bay To Bay Blvd Ste 3 Tampa, FL 33629 (813) 440-2462 Fax: (813) 877-6556 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish MW 8:00 AM - 5:00 PM TTH 9:30 AM - 7:00 PM PCMH: No Taylor, Thomas MD Provider ID: 1356311 Gender: Male Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 18 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Thareja, Sumeet MD Provider ID: 1352221 Gender: Male Indigo Dermatology LLC 1101 E Cumberland Ave Ste 301 L Tampa, FL 33602 (321) 951-1010 Fax: (321) 956-8471 12 Yrs/130 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM PCMH: No Vasiloudes, Panos MD Provider ID: 209502 Gender: Male Academic Alliance In Dermatology, I 4238 W Kennedy Blvd Tampa, FL 33609 (813) 879-6040 Fax: (813) 879-6043 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Community Hospital Languages: Spanish, German, Greek MT 8:00 AM - 5:00 PM PCMH: No Vasiloudes, Panos MD Provider ID: 209502 Gender: Male Academic Alliance In Dermatology, I 5210 Webb Rd Tampa, FL 33615 (813) 882-9986 Fax: (813) 882-9849 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Community Hospital Languages: Spanish, German, Greek M-W 8:00 AM - 5:00 PM PCMH: No

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Zook, Matthew MD Provider ID: 759269 Gender: Male Academic Alliance In Dermatology, I 2919 W Swann Ave Ste 205 Tampa, FL 33609 (813) 514-8985 Fax: (813) 514-8983 00 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 5:00 PM PCMH: No

Dermatopathology Belongie, Iriana MD Provider ID: 755816 Gender: Female Academic Alliance In Dermatology 5210 Webb Rd Tampa, FL 33615 (813) 882-9986 Fax: (813) 882-9849 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Community Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Eng, William MD Provider ID: 678339 Gender: Male 10420 US Hwy 301 S Riverview, FL 33578 (813) 880-7546 Fax: (813) 249-5210 00 Yrs/130 Yrs Languages: Spanish MWF 8:30 AM - 5:00 PM TTH 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Dermatopathology - cont. El-Deiry, Mark MD Eng, William MD Provider ID: 678339 Gender: Male 8002 Beaty Grove Dr Tampa, FL 33626 (813) 880-7546 Fax: (813) 249-5210 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Rodriguez Waitkus, Paul MD Provider ID: 787111 Gender: Male USF Physicians Group 13330 USF Laurel Dr Fl 4 Tampa, FL 33612 (813) 974-3744 Fax: (813) 974-0337 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Xu, Su MD Provider ID: 519374 Gender: Female Florida Dermatology and Skin Cancer 4915 Ehrlich Rd Tampa, FL 33624 (813) 960-2400 Fax: (813) 960-2410 02 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM PCMH: No

Ear, Nose & Throat Archibald, David MD Provider ID: 672983 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8596 Fax: (813) 259-2217 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 391505 Gender: Male USF Physicicans Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-3980 Fax: (813) 974-7586 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kampsen, Edward MD Provider ID: 1108 Gender: Male 2835 W De Leon St Ste 202 Tampa, FL 33609 (813) 877-2685 Fax: (813) 876-5872 00 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Konka, Anita MD Provider ID: 978481 Gender: Female USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 974-4683 Fax: (813) 250-2217 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No McCaffrey, Thomas MD Provider ID: 21602 Gender: Male USF Physicicans Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 974-4683 Fax: (813) 974-7586 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Novis, Sarah MD Provider ID: 1108169 Gender: Female 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 974-4683 Fax: (813) 250-2217 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Patel, Nalin MD Provider ID: 271692 Gender: Male Florida Pediatric Associates LLC 3000 Medical Park Dr Ste 200 Tampa, FL 33613 (813) 972-3353 Fax: (813) 978-3667 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc New Tampa Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Tabesh, Amanollah MD Provider ID: 181 Gender: Male 3709 W Hamilton Ave Ste 1 Tampa, FL 33614 (813) 932-0804 Fax: (813) 932-8163 05 Yrs/130 Yrs Florida Hospital Tampa Tampa Community Hospital Tampa General Hospital Languages: Spanish, Faroese M-F 9:30 AM - 5:00 PM PCMH: No Tabor, Mark MD Provider ID: 220097 Gender: Male USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 974-4683 Fax: (813) 974-7586 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Ridley, Marion MD Provider ID: 7222 Gender: Female USF Physicicans Group 13131 Magnolia Dr Tampa, FL 33612 (813) 974-4683 Fax: (813) 974-7586 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Teng, James MD Provider ID: 1244458 Gender: Male USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 974-4683 Fax: (813) 250-2217 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Sargi, Zoukaa MD Provider ID: 523309 Gender: Male UMDC Dept of Otolaryngology 1120 NW 14th St CRB 5th Fl Tampa, FL 33613 (305) 243-4387 00 Yrs/21 Yrs Languages: French, Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Wasylik, Kathleen MD

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Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head Nec 4726 N Habana Ave Ste 204 Tampa, FL 33614 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Ear, Nose & Throat - cont. Endocrinology, Diabetes, Morrison, Anthony MD Metabolism Wasylik, Kathleen MD

Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head & Nec 10080 Balaye Run Dr Tampa, FL 33619 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head & Nec 14111 State Rd 54 Odessa, FL 33556 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Baig, Mohammad MD Provider ID: 192967 Gender: Male Endocrinology Diabetes Care 3226 Cove Bend Dr Tampa, FL 33613 (813) 977-0778 Fax: (813) 977-2685 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Hindi MT 8:15 AM - 5:00 PM W 8:15 AM - 4:00 PM TH 8:15 AM - 5:30 PM F 8:15 AM - 12:00 PM PCMH: No Jacovino, Crystal DO Provider ID: 1037037 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jacovino, Crystal DO Provider ID: 1037037 Gender: Female USF Physicians Group 4001 E Fletcher Ave Tampa, FL 33613 (813) 974-2201 Fax: (813) 374-3313 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Provider ID: 1364943 Gender: Male Tampa General Hospital 5802 N 30th St Tampa, FL 33610 (813) 236-5350 Fax: (813) 236-5303 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Patel, Sonal MD Provider ID: 1356345 Gender: Female Florida Diabetes and Endocrine Assoc 7001 N Dale Mabry Hwy Ste 2 Tampa, FL 33614 (813) 252-9849 Fax: (813) 283-9000 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Languages: Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Santana Hernandez, Omar MD Provider ID: 1139272 Gender: Male Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5551 Fax: (813) 844-1655 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Endodontics Gargasz, Bret DDS Provider ID: TPVP42269-01 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-02 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-03 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Endodontics - cont. Gargasz, Bret DDS Provider ID: TPVP42269-04 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Gargasz, Bret DDS Provider ID: TPVP42269-14 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-17 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-60 Gender: Male Coast Dental - Plant City South 2803 James L Redman Pkwy Ste 1 Plant City, FL 33566 (813) 567-7151 Fax: (813) 567-7156 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Kan, Elena DDS Provider ID: TPVP128847-02 Gender: Female Coast Dental - Town N Country 7340 W Waters Ave Tampa, FL 33634 (813) 886-1800 Fax: (813) 886-0519 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Kellogg, David DDS Provider ID: TPVP147486-06 Gender: Male Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-02 Gender: Female Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-35 Gender: Female Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No

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Millstein, Ashley DMD Provider ID: TPVP139323-36 Gender: Female Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-38 Gender: Female Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-39 Gender: Female Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Endodontics - cont. Millstein, Ashley DMD Provider ID: TPVP139323-40 Gender: Female Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-41 Gender: Female Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Oguntebi, Bamiduro DDS Provider ID: TPVP43089-01 Gender: Male Duro Oguntebi DDS MSD 110 N Armenia Ave Ste B Tampa, FL 33609 (813) 254-0041 Fax: (813) 253-8841 00 Yrs/99 Yrs M-W 8:00 AM - 5:00 PM TH 8:00 AM - 2:00 PM PCMH: No

Oguntebi, Bamiduro DDS Provider ID: TPVP43089-02 Gender: Male Duro Oguntebi DDS MSD 623 E Alexander Ave Plant City, FL 33563 (813) 254-0041 Fax: (813) 253-8841 00 Yrs/99 Yrs M 9:00 AM - 3:30 PM PCMH: No

Family Practice Asuncion, Melissa MD Provider ID: 1108134 Gender: Female Bluestone Physician Services Florid 300 S Hyde Park Ave Ste 210 Tampa, FL 33606 (813) 259-1013 Fax: (813) 354-0396 18 Yrs/130 Yrs Languages: French MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Braun, Edward MD Provider ID: 1308264 Gender: Male Comprehensive Care Center Inc DBA C 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3075 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Narducci, Dusty MD Provider ID: 1365586 Gender: Female USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 974-2918 Fax: (813) 974-0072 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Tanner, John DO Provider ID: 987510 Gender: Male Faculty Group Practice 324 S Hyde Park Ave Ste 375, UF Health Recovery CenterTampa Tampa, FL 33606 (813) 251-9000 Fax: (813) 251-4567 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gastroenterology Agrawal, Saurabh MD Provider ID: 1418103 Gender: Male Tampa General Medical Grouptgmg Bay 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5460 Fax: (813) 844-1655 18 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM PCMH: No

Koslacz Kolanko, Elzbieta MD Provider ID: 1419436 Gender: Female Tgmg Fcc Kennedy 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-1385 Fax: (813) 254-0230 00 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: Yes, Level 3

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Al-Nakshabendi, Imad MD Provider ID: 200782 Gender: Male 1447 Oakfield Dr Brandon, FL 33511 (813) 972-3750 Fax: (813) 972-3749 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Tampa General Hospital M 8:30 AM - 6:30 PM TWTHF 8:30 AM - 4:30 PM PCMH: No Brady, Patrick MD Provider ID: 7034 Gender: Male USF Physicicans Group 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2920 00 Yrs/130 Yrs PCMH: No Caire, Michael MD Provider ID: 1301715 Gender: Male Tgmg BayshoreGastroenterology 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5460 Fax: (813) 844-1655 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Cauble, Elliot MD Provider ID: 1331286 Gender: Male Baycare Medical Group Inc 10141 Big Bend Rd 206 Riverview, FL 33578 (813) 397-1274 Fax: (813) 605-6003 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Gastroenterology - cont. Chang, John MD Chae, Soojong MD Provider ID: 609579 Gender: Female USF Physicians Group 13330 USF Laurel Dr 6th Fl Tampa, FL 33612 (813) 974-4115 Fax: (813) 905-9901 18 Yrs/130 Yrs Tampa General Hospital USF Endoscopy & Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Chae, Soojong MD Provider ID: 609579 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5250 Fax: (813) 236-5220 18 Yrs/130 Yrs Tampa General Hospital USF Endoscopy & Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Chang, John MD Provider ID: 378706 Gender: Male West Central Gastroenterology LLP 11912 Sheldon Rd Ste B Tampa, FL 33626 (813) 920-8882 Fax: (813) 920-8883 18 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital Tampa Community Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 378706 Gender: Male West Central Gastroenterology LLP 4695 Van Dyke Rd Lutz, FL 33558 (813) 920-8882 Fax: (813) 920-8883 18 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital Tampa Community Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Chin Lue, Roland MD Provider ID: 518629 Gender: Male Healthpoint Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 321-1878 18 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Delgado, John MD Provider ID: 1070686 Gender: Male West Central Gastroenterology LLP 2919 W Swann Ave Ste 106 Tampa, FL 33609 (813) 930-2829 Fax: (813) 930-9522 18 Yrs/130 Yrs Florida Hospital Tampa Memorial Hospital of Tampa Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Grauer, Leopoldo MD Provider ID: 4020 Gender: Male West Central Gastroenterology LLP 4600 N Habana Ave Ste 29 Tampa, FL 33614 (813) 673-8545 Fax: (813) 872-0835 12 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Harris, Michael MD Provider ID: 564998 Gender: Male Fhpg Gastroenterology Center 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-7028 Fax: (813) 615-8008 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Heiman, David MD Provider ID: 16695 Gender: Male Florida Medical Cli Market Fam 4224 N Tampania Ave Tampa, FL 33607 (813) 874-1353 Fax: (813) 876-5090 18 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No

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Heiman, David MD Provider ID: 979896 Gender: Female Florida Medical Cli Market Fam 4224 N Tampania Ave Tampa, FL 33607 (813) 280-7111 Fax: (813) 876-5090 00 Yrs/130 Yrs St Josephs Hospital M-TH 8:00 AM - 5:00 PM F 1:00 AM - 3:00 PM PCMH: No Jacobs, John MD Provider ID: 978502 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5250 Fax: (813) 236-5220 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kaif, Mohamed MD Provider ID: 1244686 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4115 Fax: (813) 905-9901 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Gastroenterology - cont. Mamel, Jay MD Kero, Shawkat MD Provider ID: 1143642 Gender: Male Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Oak Hill Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM Sun 9:00 AM - 1:30 PM PCMH: No Laffer, Dennis MD Provider ID: 171655 Gender: Male Healthpointe Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 321-1878 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lopez, Luis MD Provider ID: 300592 Gender: Male 4700 N Habana Ave Ste 701 Tampa, FL 33614 (813) 324-5888 Fax: (813) 374-8891 18 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital Tampa Community Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 7163 Gender: Male USF Physicicans Group 13330 USF Laurel Dr 6th Fl Tampa, FL 33612 (813) 974-4115 Fax: (813) 905-9901 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Marchioni Beery, Renee DO Provider ID: 1244691 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4115 Fax: (813) 905-9901 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Marchioni Beery, Renee DO Provider ID: 1244691 Gender: Female USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-3976 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mehta, Ashwin MD Provider ID: 167 Gender: Male 3709 W Hamilton Ave Ste 5 Tampa, FL 33614 (813) 932-4430 Fax: (813) 932-4250 18 Yrs/130 Yrs Florida Hospital Carrollwood St Josephs Hospital Tampa Community Hospital Languages: Gujarati, Swahili M-F 9:00 AM - 4:00 PM PCMH: No

Mendoza, Alfredo MD Provider ID: 378269 Gender: Male West Central Gastroenterology LLP 11912 Sheldon Rd Ste B Tampa, FL 33626 (813) 920-8882 Fax: (813) 920-8883 18 Yrs/130 Yrs Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Mendoza, Alfredo MD Provider ID: 378269 Gender: Male West Central Gastroenterology LLP 4695 Van Dyke Rd Lutz, FL 33558 (813) 920-8882 Fax: (813) 920-8883 18 Yrs/130 Yrs Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Mompi, Emmanuel MD Provider ID: 19385 Gender: Male 341 Bullard Pkwy Ste A-B Tampa, FL 33617 (813) 983-0700 Fax: (813) 983-0600 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Slovak M-F 8:00 AM - 5:00 PM PCMH: No Nieves Costas, Javier MD Provider ID: 1140041 Gender: Male Baycare Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 443-8143 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Nieves Costas, Javier MD Provider ID: 1140041 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33614 (813) 876-0951 Fax: (813) 443-8140 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patel, Bharatkumar MD Provider ID: 556880 Gender: Male Physician Group of Florida Inc 11031 Countryway Blvd Tampa, FL 33626 (813) 854-4124 Fax: (813) 854-5952 12 Yrs/130 Yrs Tampa Community Hospital M-F 8:00 AM - 5:00 PM PCMH: No Powell, Donna DO Provider ID: 718163 Gender: Female Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 876-0951 Fax: (813) 443-8140 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Prasad, Ishwari MD Provider ID: 10721 Gender: Male 14447 University Cove Pl Tampa, FL 33613 (813) 632-8819 Fax: (813) 972-9158 18 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Florida Hospital Tampa Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Gastroenterology - cont. Saeed, Farrukh MD Qazi, Arif MD Provider ID: 515390 Gender: Male Digestive Care Pl 515 Medical Oaks Ave Brandon, FL 33511 (813) 685-5100 Fax: (813) 689-6797 16 Yrs/130 Yrs Brandon Regional Hospital M-TH 8:30 AM - 4:30 PM F 8:30 AM - 3:30 PM PCMH: No Richter, Joel MD Provider ID: 672876 Gender: Male USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 974-3374 Fax: (813) 974-7031 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Richter, Joel MD Provider ID: 672876 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-3374 Fax: (813) 974-7031 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Rosario, Angel MD Provider ID: 3801 Gender: Male 6919 N Dale Mabry Hwy Ste 320 Tampa, FL 33614 (813) 930-8816 Fax: (813) 930-2747 18 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Tampa Community Hospital Languages: Spanish M-TH 9:00 AM - 5:00 PM PCMH: No

Provider ID: 187990 Gender: Male Digestive Diseases Assoc of Tampa 876 S Parsons Ave Brandon, FL 33511 (813) 653-3359 Fax: (813) 662-9639 18 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa General Hospital Languages: Urdu M-F 8:30 AM - 4:30 PM PCMH: No Saloum, Yasser MD Provider ID: 1160849 Gender: Male Fhpg Gastroenterology Center 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-5028 Fax: (813) 615-8080 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sanjeevi, Arthi MD Provider ID: 608760 Gender: Female Fhpg Gastroenterology Center 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-7028 Fax: (813) 615-8008 00 Yrs/130 Yrs Florida Hospital Tampa Languages: Hindi, Tamil, Telugu M-F 8:00 AM - 5:00 PM PCMH: No

Small, Michael MD Provider ID: 683578 Gender: Male Baycare Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 443-8143 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Young, Juan MD Provider ID: 572230 Gender: Male Healthpointmedicalgroup 4211 Van Dyke Rd Lutz, FL 33558 (813) 264-6490 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Taunk, Pushpak MD

Abreu, Edward DMD Provider ID: TPVP102533-02 Gender: Male Skylight Dental Care PLLC 117 N Oakwood Ave Brandon, FL 33510 (813) 530-0991 Fax: (813) 530-0986 00 Yrs/99 Yrs Languages: Spanish M-TH 8:30 AM - 5:00 PM PCMH: No

Provider ID: 1108177 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4115 Fax: (813) 905-9901 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

General Dentistry

Ward, Eugene MD Provider ID: 1127066 Gender: Male Eugene A Ward, MD 3450 E Fletcher Ave Ste 310 Tampa, FL 33613 (813) 972-1654 Fax: (813) 972-7176 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital MTTH 8:00 AM - 6:00 PM WF 8:00 AM - 5:00 PM PCMH: No

Adderly, Erica DDS Provider ID: TPVP131028-08 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Weintraub, Alan MD

Adderly, Erica DDS Provider ID: TPVP131028-14 Gender: Female Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Provider ID: 1064348 Gender: Male 4108 Henderson Blvd Tampa, FL 33629 (813) 289-4321 Fax: (813) 287-2949 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Adibi, Farnaz DMD Adderly, Erica DDS Provider ID: TPVP131028-15 Gender: Female Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Adibi, Farnaz DMD Provider ID: TPVP133168-21 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Adibi, Farnaz DMD Provider ID: TPVP133168-22 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP133168-23 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Adibi, Farnaz DMD Provider ID: TPVP133168-27 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Akel, Amir DMD Provider ID: TPVP72625-03 Adibi, Farnaz DMD Gender: Male Provider ID: TPVP133168-24 Akel Dental of Tampa PLLC Gender: Female 2727 W Martin Luther King Jr Palm River Community Health Ste 120 Center Tampa, FL 33607 7728 Palm River Rd (813) 873-9100 Tampa, FL 33619 Fax: (813) 873-9176 (813) 630-3635 00 Yrs/99 Yrs Fax: (813) 620-1614 Languages: Spanish 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Alvarez, Juan DDS Provider ID: TPVP100736-03 Adibi, Farnaz DMD Gender: Male Provider ID: TPVP133168-25 Happy Kids Pediatric Gender: Female Dentistry Brandon Community Health 7715 W Hillsborough Ave Centers Tampa, FL 33615 313 S Lakewood Dr (813) 887-5437 Brandon, FL 33511 Fax: (813) 887-5433 (813) 349-7907 00 Yrs/99 Yrs Fax: (813) 685-9111 Languages: Spanish 00 Yrs/99 Yrs M-TH 8:30 AM - 5:00 PM Languages: Spanish PCMH: No MTWTHFSat 8:00 AM - 5:00 PM Alvarez, Juan DDS PCMH: No Provider ID: TPVP100736-04 Gender: Male Adibi, Farnaz DMD Juan L Alvarez DDS PA Provider ID: TPVP133168-26 11758 Dr Martin Luther King Jr Gender: Female Blvd E Oakfield Community Dental Seffner, FL 33584 Care (813) 651-9411 710 Oakfield Dr Ste 105 Fax: (813) 653-0041 Brandon, FL 33511 00 Yrs/99 Yrs (813) 689-4782 Languages: Spanish Fax: (813) 684-1579 M-TH 8:00 AM - 5:00 PM 00 Yrs/99 Yrs PCMH: No Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Amrooei, Danoosh DMD Provider ID: TPVP45050-01 Gender: Female Great Expressions Dental Centers 5101 E Busch Blvd Ste 13 Tampa, FL 33617 (813) 988-1167 Fax: (813) 985-7302 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Amrooei, Danoosh DMD Provider ID: TPVP45050-02 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No Amrooei, Danoosh DMD Provider ID: TPVP45050-03 Gender: Female Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ankalikar, Satish DDS Provider ID: TPVP43848-01 Gender: Male SP Ankalikar DDS 5225 Ehrlich Rd Ste A Tampa, FL 33624 (813) 963-3111 Fax: (813) 961-9043 00 Yrs/99 Yrs Languages: Hindi MTH 9:00 AM - 5:00 PM TW 10:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Atkinson, William DDS Arnedo, Johanna DDS Provider ID: TPVP146775-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Arora, Payal DDS Provider ID: TPVP147886-01 Gender: Female Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Arora, Payal DDS Provider ID: TPVP147886-02 Gender: Female Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP44289-04 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Attie, Abelardo DMD Provider ID: TPVP156288-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Austin, Deborah DDS Provider ID: TPV11764-01 Gender: Female Deborah Austin-Brown DDS PA 420 N Alexander St Plant City, FL 33563 (813) 752-5520 Fax: (813) 759-1820 00 Yrs/99 Yrs Languages: Spanish M-W 8:00 AM - 4:00 PM THF 8:00 AM - 12:00 PM PCMH: No

Awad, Asma DDS Provider ID: TPVP45545-01 Gender: Female Brandon Smile Center 3413 S Kings Ave Ste 200 Brandon, FL 33511 (813) 643-9029 Fax: (813) 643-9039 00 Yrs/99 Yrs Languages: Arabic M-TH 9:00 AM - 5:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-01 Gender: Female Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-02 Gender: Female Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

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Bacchelli, Lara DMD Provider ID: TPVP156856-03 Gender: Female Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-04 Gender: Female Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-05 Gender: Female Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Baez, Tomas DDS Provider ID: TPVP158350-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Bacchelli, Lara DMD Provider ID: TPVP156856-06 Gender: Female Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Baez Henry, Carlianette DMD

Bacchelli, Lara DMD Provider ID: TPVP156856-09 Gender: Female Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Provider ID: TPVP150151-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Bacchelli, Lara DMD Provider ID: TPVP156856-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Barlow, Kathleen DDS Provider ID: TPVP43616-01 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Barlow, Kathleen DDS Provider ID: TPVP43616-02 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Barlow, Kathleen DDS Provider ID: TPVP43616-03 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Barlow, Kathleen DDS Provider ID: TPVP43616-04 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Barlow, Kathleen DDS Provider ID: TPVP43616-05 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Barlow, Kathleen DDS Provider ID: TPVP43616-06 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Barlow, Kathleen DDS Provider ID: TPVP43616-07 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Barrett, Steven DDS Provider ID: TPV12124-66 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Belaunzaran, Pedro DDS Provider ID: TPVP44544-01 Gender: Male Pedro A Belaunzaran DDS PA Assc 8130 W Waters Ave Ste 200-B Tampa, FL 33615 (813) 243-4142 Fax: (813) 886-1660 00 Yrs/99 Yrs Languages: Spanish, Arabic MTTHF 9:00 AM - 5:00 PM W 2:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Biandudi, Odessa DDS Biandudi, Odessa DDS Provider ID: TPVP120881-01 Gender: Female Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Biandudi, Odessa DDS Provider ID: TPVP120881-02 Gender: Female Great Expressions Dental Centers 1620 State Rd 60 Ste E Valrico, FL 33594 (813) 681-4874 Fax: (813) 681-3046 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 10:00 AM - 7:00 PM PCMH: No Biandudi, Odessa DDS Provider ID: TPVP120881-03 Gender: Female Great Expressions Dental Centers 1060 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 931-4000 Fax: (813) 932-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP120881-04 Gender: Female Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Biandudi, Odessa DDS Provider ID: TPVP120881-05 Gender: Female Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Biandudi, Odessa DDS Provider ID: TPVP120881-07 Gender: Female Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Biandudi, Odessa DDS Provider ID: TPVP120881-09 Gender: Female Great Expressions Dental Centers 15148 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-0106 Fax: (813) 265-8126 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Biandudi, Odessa DDS Provider ID: TPVP120881-11 Gender: Female Great Expressions Dental Centers 5101 E Busch Blvd Ste 13 Tampa, FL 33617 (813) 988-1167 Fax: (813) 985-7302 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Boswell, Gibson DMD Provider ID: TPVP156855-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Brachowicz, Maria DDS Provider ID: TPVP140155-01 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brachowicz, Maria DDS Provider ID: TPVP140155-02 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Brachowicz, Maria DDS Provider ID: TPVP140155-03 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brachowicz, Maria DDS Provider ID: TPVP140155-04 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brachowicz, Maria DDS Provider ID: TPVP140155-05 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Brachowicz, Maria DDS Provider ID: TPVP140155-06 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Branscombe, Tyler DMD Brachowicz, Maria DDS Provider ID: TPVP140155-07 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Bradley, Ashley DMD Provider ID: TPVP153368-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Branscombe, Tyler DMD Provider ID: TPVP134684-01 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No

Provider ID: TPVP134684-02 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Branscombe, Tyler DMD Provider ID: TPVP134684-03 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No Branscombe, Tyler DMD Provider ID: TPVP134684-04 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No

Branscombe, Tyler DMD Provider ID: TPVP134684-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Branscombe, Tyler DMD Provider ID: TPVP134684-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Branscombe, Tyler DMD Provider ID: TPVP134684-09 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

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Branscombe, Tyler DMD Provider ID: TPVP134684-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Brattain, Andrew DMD Provider ID: TPVP158347-01 Gender: Male Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brito, Daryl DMD Provider ID: TPVP145792-15 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Caputo, Michael DDS Bushati, Ivo DMD Provider ID: TPVP134886-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-39 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-40 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP156605-41 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-47 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-54 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Carbonell, Kevin DMD Provider ID: TPVP152393-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Carbonell, Kevin DMD Provider ID: TPVP152393-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

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Chase, Kely DMD Provider ID: TPVP137786-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-01 Gender: Male Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-03 Gender: Male Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Chekan, Theodore DDS Chekan, Theodore DDS Provider ID: TPVP43857-04 Gender: Male Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-05 Gender: Male Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-06 Gender: Male Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-07 Gender: Male Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cisneros, Aura DMD Provider ID: TPVP133760-01 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cisneros, Aura DMD Provider ID: TPVP133760-05 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Chekan, Theodore DDS Provider ID: TPVP43857-09 Gender: Male Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Cisneros, Aura DMD Provider ID: TPVP133760-02 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Chekan, Theodore DDS Provider ID: TPVP43857-10 Gender: Male Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cisneros, Aura DMD Provider ID: TPVP133760-03 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cisneros, Aura DMD Provider ID: TPVP133760-06 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP43857-08 Gender: Male Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Childers, Seldon DDS Provider ID: TPVP134123-01 Gender: Male Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cisneros, Aura DMD Provider ID: TPVP133760-04 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Cisneros, Aura DMD Provider ID: TPVP133760-07 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Das, Shilpa DDS Provider ID: TPVP121131-01 Gender: Female Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Desinor, Darlene DDS Das, Shilpa DDS Provider ID: TPVP121131-02 Gender: Female Great Expressions Dental Centers 10924 Cross Creek Blvd Tampa, FL 33647 (813) 982-1777 Fax: (813) 986-6230 00 Yrs/99 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No Decambra, Nicole DMD Provider ID: TPVP134605-01 Gender: Female Great Expressions Dental Centers 10924 Cross Creek Blvd Tampa, FL 33647 (813) 982-1777 Fax: (813) 986-6230 00 Yrs/99 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No Desinor, Darlene DDS Provider ID: TPVP137553-07 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Desinor, Darlene DDS Provider ID: TPVP137553-09 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP137553-10 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Desinor, Darlene DDS Provider ID: TPVP137553-11 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Desinor, Darlene DDS Provider ID: TPVP137553-12 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Desinor, Darlene DDS Provider ID: TPVP137553-13 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Desinor, Darlene DDS Provider ID: TPVP137553-14 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Dietz, Rodney DDS Provider ID: TPVP132897-01 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Desinor, Darlene DDS Provider ID: TPVP137553-15 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Dietz, Rodney DDS Provider ID: TPVP132897-02 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Desinor, Darlene DDS Provider ID: TPVP137553-16 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Diaz, Jany DMD Provider ID: TPVP152982-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

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Dietz, Rodney DDS Provider ID: TPVP132897-03 Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Dietz, Rodney DDS Provider ID: TPVP132897-04 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Dinh, Lan DMD Dietz, Rodney DDS Provider ID: TPVP132897-05 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP136001-02 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Dinh, Lan DMD Provider ID: TPVP136001-06 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Dinh, Lan DMD Provider ID: TPVP136001-03 Dinh, Lan DMD Gender: Male Dietz, Rodney DDS Provider ID: TPVP136001-07 Tom Lee Community Health Center Gender: Male Provider ID: TPVP132897-06 14254 Martin Luther King Blvd Ruskin Health Center Gender: Male 2814 14th Ave SE Palm River Community Health SR 574 Dover, FL 33527 Center Ruskin, FL 33570 (813) 349-7736 7728 Palm River Rd (813) 349-7588 Fax: (813) 349-7561 Tampa, FL 33619 Fax: (813) 349-7890 00 Yrs/99 Yrs (813) 630-3635 00 Yrs/99 Yrs Languages: Spanish Fax: (813) 620-1614 Languages: Spanish M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM Dinh, Lan DMD Dire, Anthony DMD PCMH: No Provider ID: TPVP136001-04 Provider ID: TPVP42170-03 Dietz, Rodney DDS Gender: Male Gender: Male Palm River Community Health Brandon Mall Dental PA Provider ID: TPVP132897-07 Center Gender: Male 675 Brandon Town Center 7728 Palm River Rd Mall Brandon Community Health Tampa, FL 33619 Centers Brandon, FL 33511 (813) 630-3635 313 S Lakewood Dr (813) 681-8600 Fax: (813) 620-1614 Brandon, FL 33511 Fax: (813) 681-7400 00 Yrs/99 Yrs (813) 349-7907 00 Yrs/99 Yrs Languages: Spanish Fax: (813) 685-9111 Languages: Russian M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs M 10:00 AM - 4:00 PM PCMH: No Languages: Spanish TTHSat 10:00 AM - 5:00 PM MTWTHFSat 8:00 AM - 5:00 W 10:00 AM - 6:00 PM Dinh, Lan DMD PM F 9:00 AM - 5:00 PM Provider ID: TPVP136001-05 PCMH: No PCMH: No Gender: Male Dinh, Lan DMD Brandon Community Health Centers Provider ID: TPVP136001-01 313 S Lakewood Dr Gender: Male Brandon, FL 33511 Plant City Family Care (813) 349-7907 508 N Maryland Ave Fax: (813) 685-9111 Plant City, FL 33563 00 Yrs/99 Yrs (813) 349-7635 Languages: Spanish Fax: (813) 938-6423 MTWTHFSat 8:00 AM - 5:00 00 Yrs/99 Yrs PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

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Dockus, Matthew DMD Provider ID: TPVP157263-01 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-02 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-03 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Dockus, Matthew DMD Dockus, Matthew DMD Provider ID: TPVP157263-04 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP157263-09 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Dolce, Vincent DMD Provider ID: TPVP145740-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Dos Passos II, John DMD Provider ID: TPVP45398-01 Gender: Male Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Dos Passos II, John DMD Provider ID: TPVP45398-02 Gender: Male Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Dos Passos II, John DMD Provider ID: TPVP45398-03 Gender: Male Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Doshi, Amit DDS Provider ID: TPVP132173-02 Gender: Male Broadway Dental 5811 E Broadway Ave Tampa, FL 33619 (813) 623-1014 Fax: (813) 620-3863 00 Yrs/99 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

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Durve, Aparna DMD Provider ID: TPVP153195-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Eckels, Shane DDS Provider ID: TPVP134881-45 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No El-Sherbini, Sara DDS Provider ID: TPVP145514-07 Gender: Female Coast Dental - Town N Country 7340 W Waters Ave Tampa, FL 33634 (813) 886-1800 Fax: (813) 886-0519 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Espinal, Licette DDS Provider ID: TPV19212-04 Gender: Female Skylight Dental Care PLLC 117 N Oakwood Ave Brandon, FL 33510 (813) 530-0991 Fax: (813) 530-0986 00 Yrs/99 Yrs Languages: Spanish M-TH 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Fox, Julie DDS Espino, Derek DDS Provider ID: TPV19453-02 Gender: Male Smile Design 5306 Van Dyke Rd Lutz, FL 33558 (813) 960-3300 Fax: (888) 582-0179 00 Yrs/99 Yrs MF 8:00 AM - 4:00 PM T 9:00 AM - 6:00 PM WTH 8:00 AM - 5:00 PM PCMH: No Espino, Derek DDS Provider ID: TPV19453-04 Gender: Male Smile Design Fletcher 4446 E Fletcher Ave Ste F Tampa, FL 33613 (813) 910-2345 Fax: (888) 582-0179 00 Yrs/99 Yrs M 10:00 AM - 7:00 PM T 8:00 AM - 4:00 PM WTHF 8:00 AM - 5:00 PM PCMH: No Fornos, Jorge DDS Provider ID: TPVP149429-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP43181-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Fox, Julie DDS Provider ID: TPVP43181-02 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Fox, Julie DDS Provider ID: TPVP43181-03 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Fox, Julie DDS Provider ID: TPVP43181-04 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Fox, Julie DDS Provider ID: TPVP43181-05 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Fox, Julie DDS Provider ID: TPVP43181-09 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Fox, Julie DDS Provider ID: TPVP43181-06 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Fuller, Ellis DDS Provider ID: TPVP45413-13 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Fox, Julie DDS Provider ID: TPVP43181-07 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fox, Julie DDS Provider ID: TPVP43181-08 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Gagnon, Robyn DMD Provider ID: TPVP134608-01 Gender: Female Great Expressions Dental Centers 5658 Fishhawk Crossing Blvd Lithia, FL 33547 (813) 490-1982 Fax: (813) 689-5908 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Genninger, Jasen DMD Gagnon, Robyn DMD Provider ID: TPVP134608-02 Gender: Female Great Expressions Dental Centers 1006 N Florida Ave Tampa, FL 33602 (813) 223-3266 Fax: (813) 221-6402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-01 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-02 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP148171-03 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-04 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Genninger, Jasen DMD Provider ID: TPVP148171-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Goldstein, Alexander DDS Provider ID: TPVP149777-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Genninger, Jasen DMD Provider ID: TPVP148171-09 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Gonzalez, Yanela DMD Provider ID: TPVP147283-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Genninger, Jasen DMD Provider ID: TPVP148171-17 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

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Green, George DDS Provider ID: TPVP44723-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Guerra, William DDS Greenberg, Andrew DDS Provider ID: TPV7501-61 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Greer, Lucia DDS Provider ID: TPVP128478-02 Gender: Female Great Expressions Dental Centers 1006 N Florida Ave Tampa, FL 33602 (813) 223-3266 Fax: (813) 221-6402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Guerra, William DDS Provider ID: TPVP121560-01 Gender: Male Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP121560-03 Gender: Male Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Guerra, William DDS Provider ID: TPVP121560-04 Gender: Male Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Guerra, William DDS Provider ID: TPVP121560-05 Gender: Male Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Guerra, William DDS Provider ID: TPVP121560-06 Gender: Male Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Guerra, William DDS Provider ID: TPVP121560-07 Gender: Male Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Haggerty, Megan DMD Provider ID: TPVP138817-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Guerra, William DDS Provider ID: TPVP121560-08 Gender: Male Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Haggerty, Megan DMD Provider ID: TPVP138817-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Guerra, William DDS Provider ID: TPVP121560-09 Gender: Male Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Guerra, William DDS Provider ID: TPVP121560-10 Gender: Male Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Haggerty, Megan DMD Provider ID: TPVP138817-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Haggerty, Megan DMD Provider ID: TPVP138817-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Hall, Joshua DMD Haggerty, Megan DMD Provider ID: TPVP138817-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Haggerty, Megan DMD Provider ID: TPVP138817-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Haggerty, Megan DMD Provider ID: TPVP138817-08 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP156847-01 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-04 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-09 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-02 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-03 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

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Hamblen, Terry DMD Provider ID: TPVP43579-06 Gender: Male Smile Design Lithia 3442 Lithia Pinecrest Rd Valrico, FL 33596 (813) 662-1111 Fax: (888) 582-0179 00 Yrs/99 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Howell, Dina DDS Hannah-Jones, Kimberly DMD Provider ID: TPVP134031-01 Gender: Female Complete Dental Care PA 11213 N Nebraska Ave Ste 406C Tampa, FL 33612 (813) 977-4819 Fax: (813) 977-4568 00 Yrs/99 Yrs M-W 8:00 AM - 5:00 PM TH 8:00 AM - 11:30 PM F 8:00 AM - 2:00 PM PCMH: No Hernandez, Celia DDS Provider ID: TPV11459-01 Gender: Female Crown Dental Inc 4812 N Habana Ave Tampa, FL 33614 (813) 873-0271 Fax: (813) 873-2929 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Hernandez, Gredell DDS Provider ID: TPVP44259-01 Gender: Female Gredell Hernandez DDS 2509 W Crest Ave Ste 4 Tampa, FL 33614 (813) 877-4638 Fax: (813) 872-0689 00 Yrs/99 Yrs Languages: Spanish MTTH 9:00 AM - 5:00 PM W 8:00 AM - 4:00 PM F 8:00 AM - 2:00 PM PCMH: No

Provider ID: TPVP43854-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-07 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Howell, Dina DDS Provider ID: TPVP43854-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Howell, Dina DDS Provider ID: TPVP43854-11 Gender: Female Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-01 Gender: Female Great Expressions Dental Centers 1060 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 931-4000 Fax: (813) 932-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-02 Gender: Female Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-03 Gender: Female Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Immadi, Lakshmi DDS Immadi, Lakshmi DDS Provider ID: TPVP107938-04 Gender: Female Great Expressions Dental Centers 10924 Cross Creek Blvd Tampa, FL 33647 (813) 982-1777 Fax: (813) 986-6230 00 Yrs/99 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-05 Gender: Female Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-06 Gender: Female Great Expressions Dental Centers 1620 State Rd 60 Ste E Valrico, FL 33594 (813) 681-4874 Fax: (813) 681-3046 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 10:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP107938-08 Gender: Female Great Expressions Dental Centers 5101 E Busch Blvd Ste 13 Tampa, FL 33617 (813) 988-1167 Fax: (813) 985-7302 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-09 Gender: Female Great Expressions Dental Centers 5658 Fishhawk Crossing Blvd Lithia, FL 33547 (813) 490-1982 Fax: (813) 689-5908 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-10 Gender: Female Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Immadi, Lakshmi DDS Provider ID: TPVP107938-11 Gender: Female Great Expressions Dental Centers 15148 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-0106 Fax: (813) 265-8126 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Inaba, Caroline DDS Provider ID: TPVP165330-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Jackson, Anthony DDS Provider ID: TPVP42182-01 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jackson, Anthony DDS Provider ID: TPVP42182-02 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jackson, Anthony DDS Provider ID: TPVP42182-03 Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Jackson, Anthony DDS Provider ID: TPVP42182-04 Gender: Male Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jackson, Anthony DDS Provider ID: TPVP42182-05 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jackson, Anthony DDS Provider ID: TPVP42182-06 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jackson, Anthony DDS Provider ID: TPVP42182-07 Gender: Male Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Jenkins, Tawana DDS Jakubiec, Jacqueline DMD Provider ID: TPVP157134-01 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP151744-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Jenkins, Tawana DDS Provider ID: TPVP151744-08 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-09 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Tawana DDS Provider ID: TPVP151744-10 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Johnson, Jonathan DDS Provider ID: TPV18142-07 Gender: Male Smile Design Lithia 3442 Lithia Pinecrest Rd Valrico, FL 33596 (813) 662-1111 Fax: (888) 582-0179 00 Yrs/99 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

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Jourdan, Myriam DMD Provider ID: TPVP127548-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jourdan, Myriam DMD Provider ID: TPVP127548-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jourdan, Myriam DMD Provider ID: TPVP127548-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jourdan, Myriam DMD Provider ID: TPVP127548-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Jourdan, Myriam DMD Jourdan, Myriam DMD Provider ID: TPVP127548-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jourdan, Myriam DMD Provider ID: TPVP127548-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jourdan, Myriam DMD Provider ID: TPVP127548-08 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jourdan, Myriam DMD Provider ID: TPVP127548-09 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP127548-10 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-16 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-17 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Kanach, Paul DMD Provider ID: TPVP137705-18 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-19 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-20 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

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Kanach, Paul DMD Provider ID: TPVP137705-21 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-24 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-30 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Kanner, Leah DMD Kanner, Leah DMD Provider ID: TPVP140817-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kanner, Leah DMD Provider ID: TPVP140817-02 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kanner, Leah DMD Provider ID: TPVP140817-03 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kanner, Leah DMD Provider ID: TPVP140817-04 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP140817-05 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kanner, Leah DMD Provider ID: TPVP140817-06 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Kanner, Leah DMD Provider ID: TPVP140817-07 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kanner, Leah DMD Provider ID: TPVP140817-08 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Kanner, Leah DMD Provider ID: TPVP140817-09 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Kiani, Kamran DMD Provider ID: TPVP139839-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Kapadia, Mukesh DDS Provider ID: TPV10771-01 Gender: Male Dr Mukesh Kapadia Kohn, Heather DDS 613 W Martin Luther King Bldv Provider ID: TPVP137917-03 Ste 103 Gender: Female Tampa, FL 33603 Brandon Mall Dental PA (813) 237-2882 675 Brandon Town Center 00 Yrs/99 Yrs Mall Languages: Hindi Brandon, FL 33511 M-TH 9:30 AM - 6:00 PM (813) 681-8600 PCMH: No Fax: (813) 681-7400 00 Yrs/99 Yrs Karthik, Aneetha DDS Languages: Russian Provider ID: TPVP45069-01 M 10:00 AM - 4:00 PM Gender: Female TTHSat 10:00 AM - 5:00 PM Great Expressions Dental W 10:00 AM - 6:00 PM Centers F 9:00 AM - 5:00 PM 15148 N Dale Mabry Hwy PCMH: No Tampa, FL 33618 (813) 960-0106 Kopynets, Viktor DDS Fax: (813) 265-8126 Provider ID: TPVP134963-08 00 Yrs/99 Yrs Gender: Male Languages: Spanish Brandon Mall Dental PA M-F 8:00 AM - 5:00 PM 675 Brandon Town Center PCMH: No Mall Brandon, FL 33511 Katsur, Justin DDS (813) 681-8600 Provider ID: TPV16372-78 Fax: (813) 681-7400 Gender: Male 00 Yrs/99 Yrs Greenberg Dental Languages: Russian Orthodontics M 10:00 AM - 4:00 PM 9618 US Hwy 301 S TTHSat 10:00 AM - 5:00 PM Riverview, FL 33578 W 10:00 AM - 6:00 PM (813) 867-7062 F 9:00 AM - 5:00 PM Fax: (813) 867-7281 PCMH: No 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Lee-Loy, Ingrid DDS Krasnov, Rostislav DDS Provider ID: TPV16377-18 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Kuntsmann, Vivian DDS Provider ID: TPVP45145-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Lee-Loy, Ingrid DDS Provider ID: TPVP43283-03 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP43283-04 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lee-Loy, Ingrid DDS Provider ID: TPVP43283-05 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lee-Loy, Ingrid DDS Provider ID: TPVP43283-08 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Leon, Ana DDS Provider ID: TPVP43856-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lee-Loy, Ingrid DDS Provider ID: TPVP43283-09 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Leon, Ana DDS Provider ID: TPVP43856-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lee-Loy, Ingrid DDS Provider ID: TPVP43283-06 Leon, Ana DDS Gender: Female Palm River Community Health Provider ID: TPVP43856-01 Center Gender: Female 7728 Palm River Rd Tampa Family Health Centers Inc Tampa, FL 33619 1502 E Fowler Ave (813) 630-3635 Tampa, FL 33612 Fax: (813) 620-1614 (813) 866-0950 00 Yrs/99 Yrs Fax: (813) 405-3176 Languages: Spanish 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM Lee-Loy, Ingrid DDS PCMH: No Provider ID: TPVP43283-07 Leon, Ana DDS Gender: Female Provider ID: TPVP43856-03 Ruskin Health Center Gender: Female 2814 14th Ave SE Tampa Family Health Centers Ruskin, FL 33570 Inc (813) 349-7588 4620 N 22nd St Fax: (813) 349-7890 Tampa, FL 33610 00 Yrs/99 Yrs (813) 272-6240 Languages: Spanish Fax: (813) 405-3176 M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs PCMH: No Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Leon, Ana DDS Provider ID: TPVP43856-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Leon, Ana DDS Provider ID: TPVP43856-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Lipton, Barry DDS Leon, Ana DDS Provider ID: TPVP43856-08 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Leon, Ana DDS Provider ID: TPVP43856-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Leon, Ana DDS Provider ID: TPVP43856-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lepore, Krystina DDS Provider ID: TPVP131893-02 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

Provider ID: TPVP138203-04 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Lopez, Grace DMD Provider ID: TPVP126209-09 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Spanish, Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Lopez, Kenia DDS Provider ID: TPVP134074-01 Gender: Female Westwood Family Dental Center 8573 W Linebaugh Ave Tampa, FL 33625 (813) 852-2007 Fax: (813) 852-2011 00 Yrs/99 Yrs Languages: Spanish M-W 8:00 AM - 4:00 PM TH 9:00 AM - 4:00 PM PCMH: No

Lopez, Sergio DDS Provider ID: TPV18229-12 Gender: Male Sergio M Lopez DDS PLLC 3102 W Waters Ave Ste 101 Tampa, FL 33614 (813) 374-2441 Fax: (813) 513-2925 00 Yrs/99 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Mahdavieh, Sadaf DMD Provider ID: TPVP156891-01 Gender: Female Great Expressions Dental Centers 1620 State Rd 60 Ste E Valrico, FL 33594 (813) 681-4874 Fax: (813) 681-3046 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 10:00 AM - 7:00 PM PCMH: No

Louis, Salwan DDS Mann, Nicholas DMD Provider ID: TPVP144628-01 Provider ID: TPVP134710-03 Gender: Male Gender: Male Pedro A Belaunzaran DDS PA Assc Mann Orthodontics PA 8130 W Waters Ave Ste 200-B 5103 N Armenia Ave Tampa, FL 33615 Tampa, FL 33603 (813) 243-4142 (813) 877-2333 Fax: (813) 886-1660 Fax: (813) 877-2337 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Arabic MT 9:00 AM - 5:00 PM MTTHF 9:00 AM - 5:00 PM PCMH: No W 2:00 AM - 5:00 PM Manzur, Kasim DDS PCMH: No Provider ID: TPVP137303-03 Lugo, Francis DDS Gender: Male Provider ID: TPVP144629-01 Brandon Mall Dental PA Gender: Female 675 Brandon Town Center Mall Pedro A Belaunzaran DDS PA Assc Brandon, FL 33511 8130 W Waters Ave Ste 200-B (813) 681-8600 Tampa, FL 33615 Fax: (813) 681-7400 (813) 243-4142 00 Yrs/99 Yrs Fax: (813) 886-1660 Languages: Russian 00 Yrs/99 Yrs M 10:00 AM - 4:00 PM Languages: Arabic TTHSat 10:00 AM - 5:00 PM MTTHF 9:00 AM - 5:00 PM W 10:00 AM - 6:00 PM W 2:00 AM - 5:00 PM F 9:00 AM - 5:00 PM PCMH: No PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Matthews, Irina DMD Marshall, Kristine DDS Provider ID: TPVP42582-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP127504-02 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Mazariegos, Stephanie DMD

Martinez, Gustavo DMD Provider ID: TPVP156290-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Spanish, Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Mazariegos, Stephanie DMD

Martinez, Magela DMD Provider ID: TPVP137758-44 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP156700-02 Gender: Female Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP156700-01 Gender: Female Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No

Mazariegos, Stephanie DMD

Mazariegos, Stephanie DMD

Provider ID: TPVP156700-03 Gender: Female Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No

Provider ID: TPVP156700-06 Gender: Female Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Mazariegos, Stephanie DMD Provider ID: TPVP156700-04 Gender: Female Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-05 Gender: Female Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

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Mazariegos, Stephanie DMD Provider ID: TPVP156700-09 Gender: Female Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Modaff, Michelle DDS Melean, Alfonso DMD Provider ID: TPVP130412-01 Gender: Male East Tampa Dental 4802 E 7th Ave Tampa, FL 33605 (813) 248-8515 Fax: (813) 241-2709 00 Yrs/99 Yrs Languages: Spanish MT 9:00 AM - 3:00 PM PCMH: No Minias, Andrew DDS Provider ID: TPVP158431-01 Gender: Male Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP64856-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-07 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Modaff, Michelle DDS Provider ID: TPVP64856-10 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-11 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Modaff, Michelle DDS Provider ID: TPVP64856-12 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Moore, Alicia DDS Provider ID: TPVP134368-03 Gender: Female El Moore DDS PA 6702 N Armenia Ave Tampa, FL 33604 (813) 932-0458 Fax: (813) 935-5214 00 Yrs/99 Yrs Languages: Spanish M-W 9:00 AM - 4:00 PM TH 7:00 AM - 2:00 PM PCMH: No

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Moore, Edith DDS Provider ID: TPVP134020-03 Gender: Female El Moore DDS PA 6702 N Armenia Ave Tampa, FL 33604 (813) 932-0458 Fax: (813) 935-5214 00 Yrs/99 Yrs Languages: Spanish M-W 9:00 AM - 4:00 PM TH 7:00 AM - 2:00 PM PCMH: No Morell, Omar DMD Provider ID: TPVP165512-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Morelli, Karen DDS Provider ID: TPVP45041-01 Gender: Female Great Expressions Dental Centers 1060 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 931-4000 Fax: (813) 932-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Nazco Batista, Maria DDS Mutawalli, Khalid DDS Provider ID: TPVP149932-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Nalley, Brittany DMD Provider ID: TPVP158535-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP124076-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Nazco Batista, Maria DDS Provider ID: TPVP124076-07 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-08 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nazco Batista, Maria DDS Provider ID: TPVP124076-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Ngo, Denise DDS Provider ID: TPVP134878-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Nguyen, David DMD Provider ID: TPVP138472-22 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Nguyen, Phuc-Hau DMD Provider ID: TPVP44170-01 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Phuc-Hau DMD Provider ID: TPVP44170-02 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Nguyen, Phuc-Hau DMD Nguyen, Phuc-Hau DMD Provider ID: TPVP44170-03 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Phuc-Hau DMD Provider ID: TPVP44170-04 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Phuc-Hau DMD Provider ID: TPVP44170-05 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ogunbameru, Aderonke DDS

Ogunbameru, Aderonke DDS

Provider ID: TPVP44170-07 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153285-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153285-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ogunbameru, Aderonke DDS

Ogunbameru, Aderonke DDS

Provider ID: TPVP153285-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153285-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ogunbameru, Aderonke DDS

Ogunbameru, Aderonke DDS

Provider ID: TPVP153285-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153285-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Nguyen, Phuc-Hau DMD Provider ID: TPVP44170-06 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ogunbameru, Aderonke DDS Provider ID: TPVP153285-08 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Ogunbameru, Aderonke DDS Provider ID: TPVP153285-09 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ogunbameru, Aderonke DDS Provider ID: TPVP153285-10 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Painter, Lisa DDS Ormaza, Efren DMD Provider ID: TPVP157469-01 Gender: Male Broadway Dental 5811 E Broadway Ave Tampa, FL 33619 (813) 623-1014 Fax: (813) 620-3863 00 Yrs/99 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP134923-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-08 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Painter, Lisa DDS Provider ID: TPVP134923-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Painter, Lisa DDS Provider ID: TPVP134923-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Pansuriya, Dharmendra DMD Provider ID: TPVP159199-02 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

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Park, James DDS Provider ID: TPVP153012-01 Gender: Male Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-02 Gender: Male Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-03 Gender: Male Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-04 Gender: Male Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Park, James DDS Park, James DDS Provider ID: TPVP153012-05 Gender: Male Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-06 Gender: Male Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-08 Gender: Male Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-09 Gender: Male Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153012-10 Gender: Male Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Parker, David DDS Provider ID: TPV11501-01 Gender: Male David G Parker DDS 227 N Knights Ave Brandon, FL 33510 (813) 685-5611 Fax: (813) 689-5904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 6:00 PM PCMH: No Patel, Asha DMD Provider ID: TPVP137686-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Patel, Asha DMD Provider ID: TPVP137686-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-08 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Asha DMD Provider ID: TPVP137686-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Kinjalben DMD Provider ID: TPVP137746-45 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

www.wellcare.com/Florida | 152

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Perez, Monica DDS Perez, Monica DDS Provider ID: TPVP93670-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perez, Monica DDS Provider ID: TPVP93670-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perez, Monica DDS Provider ID: TPVP93670-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perez, Monica DDS Provider ID: TPVP93670-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP93670-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perez, Monica DDS Provider ID: TPVP93670-07 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perez, Monica DDS Provider ID: TPVP93670-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Perez, Monica DDS Provider ID: TPVP93670-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Perez Diaz, Elizabeth DMD Provider ID: TPVP134196-02 Gender: Female Cordica Dental Designs Inc 220 W Brandon Blvd Ste 106 Brandon, FL 33511 (813) 661-1800 Fax: (813) 661-1300 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Pham, Thi DDS Provider ID: TPVP43265-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Phan, Christine DMD Provider ID: TPVP127987-44 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

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Ponce, Rolando DDS Provider ID: TPVP42572-01 Gender: Male Mapledale Dental 15711 Mapledale Blvd Tampa, FL 33624 (813) 264-1600 Fax: (813) 264-1660 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Porro, Guillermo DMD Provider ID: TPVP44012-01 Gender: Male Guillermo Porro DMD PA 7059 W Waters Ave Tampa, FL 33634 (813) 889-8599 Fax: (813) 249-1301 00 Yrs/99 Yrs Languages: Spanish M-TH 8:30 AM - 5:00 PM PCMH: No Prabhakar, Ankita DDS Provider ID: TPVP152845-01 Gender: Female Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Prabhakar, Ankita DDS Provider ID: TPVP152845-02 Gender: Female Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Quevedo, Fernando DDS Prato-Guia, Yelena DDS Provider ID: TPVP141347-04 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Prendiville, Mary DDS Provider ID: TPVP126545-14 Gender: Female Center For Oral Health 9309 N Florida Ave Ste 111 Tampa, FL 33612 (813) 473-8200 Fax: (813) 315-7104 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Qadri, Subuhi DMD Provider ID: TPVP148112-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP147279-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Quevedo, Rachel DDS Provider ID: TPVP150163-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-07 Gender: Female Smile Design Riverview 11693 Boyette Rd Riverview, FL 33569 (813) 672-2066 Fax: (888) 582-0179 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Reed, Samantha DDS Provider ID: TPVP43792-08 Gender: Female Smile Design Westchase 12113 W Linebaugh Ave Tampa, FL 33626 (813) 854-1933 Fax: (888) 582-0179 00 Yrs/99 Yrs M 10:00 AM - 7:00 PM T 8:00 AM - 5:00 PM WF 8:00 AM - 4:00 PM TH 9:00 AM - 6:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-09 Gender: Female Smile Design Lithia 3442 Lithia Pinecrest Rd Valrico, FL 33596 (813) 662-1111 Fax: (888) 582-0179 00 Yrs/99 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-12 Gender: Female Smile Design Tampa Palms 16021 Tampa Palms Blvd W Tampa, FL 33647 (813) 866-1100 00 Yrs/99 Yrs M 10:00 AM - 7:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-16 Gender: Female Smile Design Citrus Park 13246 N Dale Mabry Hwy Tampa, FL 33618 (813) 926-6776 Fax: (888) 582-0179 00 Yrs/99 Yrs M 8:00 AM - 5:00 PM TTH 8:30 AM - 5:30 PM W 10:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

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Reed, Samantha DDS Provider ID: TPVP43792-19 Gender: Female Smile Design 5306 Van Dyke Rd Lutz, FL 33558 (813) 960-3300 Fax: (888) 582-0179 00 Yrs/99 Yrs MF 8:00 AM - 4:00 PM T 9:00 AM - 6:00 PM WTH 8:00 AM - 5:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-21 Gender: Female Smile Design Fletcher 4446 E Fletcher Ave Ste F Tampa, FL 33613 (813) 910-2345 Fax: (888) 582-0179 00 Yrs/99 Yrs M 10:00 AM - 7:00 PM T 8:00 AM - 4:00 PM WTHF 8:00 AM - 5:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-24 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Reinhart, Joel DMD Provider ID: TPVP45468-01 Gender: Male Keystone Dental Excellence 8325 Gunn Hwy Tampa, FL 33626 (813) 792-0041 Fax: (813) 792-0051 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Robbins, Jeremy DDS Ribot, Aliana DMD Provider ID: TPVP145397-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Rivera, Jade DMD Provider ID: TPVP155459-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Rizner, Amanda DMD Provider ID: TPVP131828-44 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP148089-01 Gender: Male Great Expressions Dental Centers 1620 State Rd 60 Ste E Valrico, FL 33594 (813) 681-4874 Fax: (813) 681-3046 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 10:00 AM - 7:00 PM PCMH: No Robbins, Jeremy DDS Provider ID: TPVP148089-02 Gender: Male Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Robbins, Jeremy DDS Provider ID: TPVP148089-03 Gender: Male Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No Robbins, Jeremy DDS Provider ID: TPVP148089-04 Gender: Male Great Expressions Dental Centers 1006 N Florida Ave Tampa, FL 33602 (813) 223-3266 Fax: (813) 221-6402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ruiz, Hugo DDS Provider ID: TPV12639-01 Gender: Male Crown Dental Inc 4812 N Habana Ave Tampa, FL 33614 (813) 873-0271 Fax: (813) 873-2929 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Sanchez-Diu, Monica DMD Provider ID: TPVP35809-01 Gender: Female Opes Dental 912 Channelside Dr Ste 2103 Tampa, FL 33602 (813) 906-6737 Fax: (855) 916-6737 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Schaffner, Daniel DDS Provider ID: TPVP45055-05 Gender: Male Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Selz, Amrita DMD Provider ID: TPVP121160-03 Gender: Female Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Schaffner, Daniel DDS Provider ID: TPVP45055-01 Gender: Male Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Selz, Amrita DMD Provider ID: TPVP121160-04 Gender: Female Great Expressions Dental Centers 1006 N Florida Ave Tampa, FL 33602 (813) 223-3266 Fax: (813) 221-6402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Schaffner, Daniel DDS Provider ID: TPVP45055-02 Gender: Male Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Selz, Amrita DMD Provider ID: TPVP121160-05 Gender: Female Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 155

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Simeoni, Anna DDS Selz, Amrita DMD Provider ID: TPVP121160-06 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No Simeoni, Anna DDS Provider ID: TPVP134211-05 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Simeoni, Anna DDS Provider ID: TPVP134211-06 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Simeoni, Anna DDS Provider ID: TPVP134211-07 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP134211-08 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Simeoni, Anna DDS Provider ID: TPVP134211-13 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Spouh, Mohammad DDS Provider ID: TPVP134609-02 Gender: Male Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Simeoni, Anna DDS Provider ID: TPVP134211-09 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Simeoni, Anna DDS Provider ID: TPVP134211-14 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Simeoni, Anna DDS Provider ID: TPVP134211-11 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Slement, Gaby DMD Provider ID: TPVP130869-14 Gender: Female Smile Design Lithia 3442 Lithia Pinecrest Rd Valrico, FL 33596 (813) 662-1111 Fax: (888) 582-0179 00 Yrs/99 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

Spouh, Mohammad DDS Provider ID: TPVP134609-03 Gender: Male Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

Simeoni, Anna DDS Provider ID: TPVP134211-12 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Slement, Gaby DMD Provider ID: TPVP130869-24 Gender: Female Kidzone Dentistry 13039 Summerfield Square Dr Riverview, FL 33578 (813) 677-3047 Fax: (813) 649-6376 00 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 156

Spouh, Mohammad DDS Provider ID: TPVP134609-04 Gender: Male Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Spouh, Mohammad DDS Provider ID: TPVP134609-05 Gender: Male Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Trivedi, Mehulkumar DMD Provider ID: TPVP153681-01 Gender: Male Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-04 Gender: Male Greenberg Dental Orthodontics 3942 Britton Plz Tampa, FL 33611 (813) 365-3024 Fax: (813) 443-5621 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-09 Gender: Male Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Taylor, Lindsey DMD Provider ID: TPVP149280-01 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-02 Gender: Male Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-05 Gender: Male Greenberg Dental Orthodontics 2702 W Hillsborough Ave Tampa, FL 33614 (813) 365-3021 Fax: (813) 443-8274 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Teresi, Kirsten DMD Provider ID: TPVP155452-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-03 Gender: Male Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-06 Gender: Male Greenberg Dental Orthodontics 234 E Bearss Ave Tampa, FL 33613 (813) 337-6353 Fax: (813) 443-5261 00 Yrs/99 Yrs Languages: Spanish MW 11:00 AM - 7:00 PM TTH 8:00 AM - 4:00 PM F 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Stilian, Douglas DMD Provider ID: TPVP144279-01 Gender: Male Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

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Tutay, John DMD Provider ID: TPVP137170-02 Gender: Male Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Twiggs, Rudolph DMD Provider ID: TPVP130419-01 Gender: Male West Waters Dental Center 1804 W Waters Ave Tampa, FL 33604 (813) 933-6825 Fax: (813) 930-7346 00 Yrs/99 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Valdez, Harvey DMD Uzunova-Dimova, Kalina DDS Provider ID: TPVP145103-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Valdez, Harvey DMD Provider ID: TPVP42183-01 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Valdez, Harvey DMD Provider ID: TPVP42183-02 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP42183-03 Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Valdez, Harvey DMD Provider ID: TPVP42183-04 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Valdez, Harvey DMD Provider ID: TPVP42183-05 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Valdez, Harvey DMD Provider ID: TPVP42183-07 Gender: Male Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Valdman, Vadim DDS Provider ID: TPV17761-16 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Vergara, Claudia DDS Provider ID: TPVP42434-01 Gender: Female Westwood Family Dental Center 8573 W Linebaugh Ave Tampa, FL 33625 (813) 852-2007 Fax: (813) 852-2011 00 Yrs/99 Yrs Valdez, Harvey DMD Languages: Spanish Provider ID: TPVP42183-06 M-W 8:00 AM - 4:00 PM Gender: Male TH 9:00 AM - 4:00 PM Palm River Community Health PCMH: No Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Wade, Brianne DMD Provider ID: TPVP156720-01 Gender: Female Greenberg Dental Orthodontics 8851 N 56th St Temple Terrace, FL 33617 (813) 381-5628 Fax: (813) 989-1780 00 Yrs/99 Yrs Languages: Spanish, Portuguese MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 4:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-02 Gender: Female Greenberg Dental- Brandon 511 W Brandon Blvd Brandon, FL 33511 (813) 381-5632 Fax: (813) 381-5634 00 Yrs/99 Yrs Languages: Spanish M 11:00 AM - 7:00 PM T 11:00 AM - 4:00 PM WTHF 7:00 AM - 3:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-03 Gender: Female Greenberg Dental Orthodontics 12030 Anderson Rd Tampa, FL 33625 (813) 381-5646 Fax: (813) 425-2773 00 Yrs/99 Yrs Languages: Spanish MTFSat 8:00 AM - 3:00 PM WTH 11:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Wells, Rachelle DDS Wade, Brianne DMD Provider ID: TPVP156720-09 Gender: Female Greenberg Dental Orthodontics PA 10041 W Hillsborough Ave Tampa, FL 33615 (813) 235-0957 Fax: (813) 418-7144 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-16 Gender: Female Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Weisser, Ettie DDS Provider ID: TPVP148109-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP138895-01 Gender: Female Tampa Family Health Centers Inc 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wells, Rachelle DDS Provider ID: TPVP138895-03 Gender: Female Tampa Family Health Centers Inc 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wells, Rachelle DDS Provider ID: TPVP138895-04 Gender: Female Tampa Family Health Centers Inc 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 405-3939 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wells, Rachelle DDS Provider ID: TPVP138895-05 Gender: Female Tampa Family Health Centers Inc 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Wells, Rachelle DDS Provider ID: TPVP138895-06 Gender: Female Tampa Family Health Centers Inc 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Wells, Rachelle DDS Provider ID: TPVP138895-10 Gender: Female Tampa Family Health Centers Inc 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Wells, Rachelle DDS Provider ID: TPVP138895-07 Gender: Female Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Whittington, Candace DDS

Wells, Rachelle DDS Provider ID: TPVP138895-08 Gender: Female Tampa Family Health Centers Inc 3901 S W Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 405-3176 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wells, Rachelle DDS Provider ID: TPVP138895-09 Gender: Female Tampa Family Health Centers Inc 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 405-3176 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Provider ID: TPVP125771-01 Gender: Female Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Whittington, Candace DDS Provider ID: TPVP125771-02 Gender: Female Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Dentistry - cont. Woo, Kyung DDS Whittington, Candace DDS Provider ID: TPVP125771-03 Gender: Female Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Whittington, Candace DDS Provider ID: TPVP125771-04 Gender: Female Great Expressions Dental Centers 5658 Fishhawk Crossing Blvd Lithia, FL 33547 (813) 490-1982 Fax: (813) 689-5908 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No Williams, Tosha DDS Provider ID: TPVP111140-12 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP147278-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian, Korean M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Yoho, Thomas DDS Provider ID: TPV6479-02 Gender: Male Broadway Dental 5811 E Broadway Ave Tampa, FL 33619 (813) 623-1014 Fax: (813) 620-3863 00 Yrs/99 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No Zand, Maximus DMD Provider ID: TPVP131010-12 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Zariffard, Ehsan DMD Provider ID: TPVP145622-03 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Spanish, Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

General Practice

Albrink, Michael MD Provider ID: 7001 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-1920 00 Yrs/130 Yrs University Hospital Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM PCMH: No Alfonso, Dennis MD Provider ID: 211110 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Mason, Stephanie MD Provider ID: 1312049 Gender: Female Accelecare Wound Professionals Of K 701 S Howard Ave Ste 106-239 Tampa, FL 33606 (813) 632-8861 Fax: (440) 627-2157 00 Yrs/130 Yrs Armstrong, Brett MD Languages: Spanish Provider ID: 1331288 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Baycare Medical Group Inc 4211 Van Dyke Rd 200 General Surgery Lutz, FL 33558 (813) 264-6490 Albrink, Michael MD Fax: (813) 443-8143 18 Yrs/130 Yrs Provider ID: 7001 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No USF Physicians Group 13330 USF Laurel Dr Armstrong, John MD Tampa, FL 33612 Provider ID: 355286 (813) 974-2201 Gender: Male Fax: (813) 844-1920 USF Physicians Group 00 Yrs/130 Yrs 1 Tampa General Cir University Hospital Tampa, FL 33606 Languages: Spanish, Creole (813) 844-7968 M-F 8:00 AM - 5:00 PM Fax: (813) 844-4049 PCMH: No 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough General Surgery - cont. Bailey, Charles MD Provider ID: 1047908 Gender: Male West Florida Cardiology Network LLC 270 S Moon Ave Brandon, FL 33511 (813) 571-9988 Fax: (813) 571-9922 18 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Butler, Stephen MD

Chandler, Nicole MD Provider ID: 461033 Gender: Female Pediatric Physician Services 885 S Parsons Ave Brandon, FL 33511 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No Ciesla, David MD Provider ID: 436018 Gender: Male USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7968 Fax: (813) 844-4049 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Clark, Colby MD Provider ID: 1256804 Gender: Male Florida Medical Clinic, PA 2020 Town Center Blvd Ste C Brandon, FL 33511 (813) 280-7676 Fax: (813) 355-5098 05 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Coughlin, John MD Provider ID: 5639 Gender: Male 10080 Balaye Run Dr Tampa, FL 33619 (813) 631-5034 Fax: (813) 631-5061 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Pediatric Surgery Center LLC Odessa M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 792524 Gender: Male Healthpoint Medical Group 1601 W Timberlane Dr Ste 100 Plant City, FL 33566 (813) 708-1312 Fax: (813) 443-8147 00 Yrs/130 Yrs South Florida Baptist Hospital Ciesla, David MD M-F 9:00 AM - 5:00 PM Coughlin, John MD Provider ID: 436018 PCMH: No Provider ID: 5639 Gender: Male Gender: Male USF Physicicans Group Cha, John MD 14111 SR 54 2 Tampa General Cir Provider ID: 498299 Odessa, FL 33556 Tampa, FL 33606 Gender: Male (813) 631-5034 (813) 974-2201 USF Physicians Group Fax: (813) 631-5061 Fax: (813) 259-0886 1 Tampa General Cir 00 Yrs/21 Yrs 00 Yrs/130 Yrs Tampa, FL 33606 Brandon Regional Hospital M-F 8:00 AM - 5:00 PM (813) 844-7968 Florida Hospital Carrollwood PCMH: No Fax: (813) 844-4049 Pediatric Surgery Center LLC 18 Yrs/130 Yrs Odessa Clark, Colby MD Languages: Korean M-F 8:30 AM - 5:00 PM Provider ID: 1256804 M-F 8:00 AM - 5:00 PM PCMH: No Gender: Male PCMH: No Florida Medical Clinic, PA 14547 Bruce B Downs Blvd Ste Coughlin, John MD Cha, John MD Provider ID: 5639 B Provider ID: 498299 Gender: Male Tampa, FL 33613 Gender: Male John P. Coughlin, MD PA (813) 280-7676 USF Physicians Group 12220 Bruce B Downs Blvd Fax: (813) 355-5098 2 Tampa General Cir 3rd Fl Tampa, FL 33612 05 Yrs/130 Yrs Tampa, FL 33606 (813) 631-5034 Florida Hospital Tampa (813) 259-0929 Fax: (813) 631-5061 M-F 8:00 AM - 5:00 PM Fax: (813) 259-0886 00 Yrs/21 Yrs PCMH: No 18 Yrs/130 Yrs Brandon Regional Hospital Languages: Korean Florida Hospital Carrollwood M-F 8:00 AM - 5:00 PM Pediatric Surgery Center LLC PCMH: No Odessa M-F 8:30 AM - 5:00 PM PCMH: No

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Cox, Charles MD Provider ID: 7057 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 793-4272 Fax: (813) 374-9495 00 Yrs/130 Yrs Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM PCMH: No Cox, Charles MD Provider ID: 7057 Gender: Male USF Physicians Group 3000 Medical Park Dr Ste 140 Tampa, FL 33613 (813) 793-4272 Fax: (813) 374-9495 00 Yrs/130 Yrs Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM PCMH: No Davis, Donald MD Provider ID: 696730 Gender: Male 1 Tampa General Cir Tampa, FL 33606 (813) 844-7968 Fax: (813) 844-4049 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Dicicco, Richard MD Provider ID: 648444 Gender: Male Greater Tampa Bay Physician Special 508 S Habana Ave Ste 160 Tampa, FL 33609 (813) 877-6000 Fax: (813) 877-6002 12 Yrs/130 Yrs Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Surgery - cont. Dietrick, John MD Provider ID: 1356533 Gender: Male Fhpg Surgical Weight Loss Institute 3000 Medical Park Dr Ste 340 Tampa, FL 33613 (813) 971-2470 Fax: (813) 971-2491 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Docobo, Angel MD Provider ID: 2016 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Docobo, Angel MD Provider ID: 2016 Gender: Male Healthpoint Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 321-1878 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Echevarria, David MD Provider ID: 178323 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 879-5010 Fax: (813) 443-8148 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Fernandez, Alfredo MD Provider ID: 274859 Gender: Male Alfredo Fernandez MD PA 6101 Webb Rd Ste 101 Tampa, FL 33615 (813) 496-9663 Fax: (813) 496-9921 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Tampa Community Hospital Languages: Spanish MTH 10:00 AM - 6:00 PM TWF 9:00 AM - 5:00 PM PCMH: No Gabordi II, Robert MD Provider ID: 1045225 Gender: Male Healthpoint Medical Group 4321 N Macdill Ave Ste 203 Tampa, FL 33607 (813) 873-7615 Fax: (813) 443-8134 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Gniady, Michelle MD Provider ID: 1366934 Gender: Female Accelecare Wound Professionals Of K 701 S Howard Ave Ste 106 239 Tampa, FL 33606 (855) 267-4138 Fax: (440) 922-0143 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Goldberg, Dean DO Provider ID: 668959 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Gonzalvo, John DO Provider ID: 296093 Gender: Male 5 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 844-7473 Fax: (813) 844-1966 18 Yrs/130 Yrs Mease Countryside Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Haslup, Forrest MD Provider ID: 25906 Gender: Male Healthpoint Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 443-8143 18 Yrs/130 Yrs St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Hechtman, Jason MD Provider ID: 244246 Gender: Male Hechtman Surgical LLC 888 S Parsons Ave Brandon, FL 33511 (813) 676-2273 Fax: (813) 684-6975 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

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Hodes, Ashley MD Provider ID: 978509 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-1920 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Hodes, Ashley MD Provider ID: 978509 Gender: Female USF Physicians Group 3000 Medical Park Dr Tampa, FL 33613 (813) 259-0929 Fax: (813) 844-1920 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Hodges, Richard MD Provider ID: 22688 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ismail, Sajid DO Provider ID: 1355809 Gender: Male Heart and Vascular Institute of Flo 310 W Alexander St Plant City, FL 33563 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Surgery - cont. Jurusz, Daniel MD Provider ID: 587361 Gender: Male Baycare Medical Group Inc 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 18 Yrs/130 Yrs St Josephs Hospital M-F 8:30 AM - 5:00 PM PCMH: No Kaufmann, Barry MD Provider ID: 5008 Gender: Male 6001 Webb Rd Ste 102 Town N Country, FL 33615 (813) 915-6126 02 Yrs/130 Yrs Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No Kaufmann, Barry MD Provider ID: 5008 Gender: Male 6101 Webb Rd Ste 102 Tampa, FL 33615 (813) 915-6126 Fax: (813) 915-6624 02 Yrs/130 Yrs Tampa Community Hospital M-W 1:00 AM - 5:00 PM TH 11:00 AM - 3:00 PM PCMH: No Lentz, Scott MD Provider ID: 568160 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Lynn, Suzanne MD Provider ID: 501925 Gender: Female 4321 N Macdill Ave Tampa, FL 33607 (813) 873-7615 Fax: (813) 321-6574 18 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Makdisi, George MD Provider ID: 1350631 Gender: Male USF Physicians Group 5 Tampa General Cir 8th Fl Tampa, FL 33606 (813) 844-3228 Fax: (813) 844-7730 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Menon, Meera MD Provider ID: 386054 Gender: Female Integrated Surgical Care PA 500 Vonderburg Dr Ste 206 East Tower Fl 3 Brandon, FL 33511 (813) 684-8045 Fax: (813) 684-8046 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Hindi, Tamil, Malayalam M-F 9:00 AM - 5:00 PM PCMH: No Murr, Michel MD Provider ID: 19843 Gender: Male USF Physicians Group 5 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 844-7473 Fax: (813) 844-1966 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Nguyen, Thanh MD Provider ID: 724852 Gender: Female 508 S Habana Ave Ste 160 Tampa, FL 33609 (813) 875-9739 Fax: (813) 873-2603 18 Yrs/130 Yrs Memorial Hospital of Tampa M-W 8:30 AM - 5:00 PM PCMH: No Patel, Ajay MD Provider ID: 296125 Gender: Male Fhpg Carrollwood Surgical Associate 6919 N Dale Mabry Hwy Ste 200 Tampa, FL 33614 (813) 933-3324 Fax: (813) 932-4357 16 Yrs/130 Yrs Florida Hospital Carrollwood Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Patel, Ravindra MD Provider ID: 239 Gender: Male Fhpg Carrollwood Surgical Associate 6919 N Dale Mabry Hwy Ste 200 Tampa, FL 33614 (813) 933-3324 Fax: (813) 932-4357 16 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Patel, Sharad MD Provider ID: 191 Gender: Male Fhpg Carrollwood Surgical Associate 6919 N Dale Mabry Hwy Ste 200 Tampa, FL 33614 (813) 933-3324 Fax: (813) 932-4357 18 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Tampa Bay Surgery Center Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Pernicone, Meira MD Provider ID: 5343 Gender: Female 3000 Medical Park Dr Ste 495 Tampa, FL 33613 (813) 793-4272 Fax: (813) 374-9495 00 Yrs/130 Yrs Languages: German, Hebrew M-F 8:00 AM - 5:00 PM PCMH: No Pernicone, Meira MD Provider ID: 5343 Gender: Female USF Physcicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 793-4272 Fax: (813) 374-9495 00 Yrs/130 Yrs Languages: German, Hebrew M-F 8:00 AM - 5:00 PM PCMH: No Reintgen, Douglas MD Provider ID: 7221 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 905-9891 02 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Surgery - cont. Rodriguez, Wilina MD Provider ID: 1404266 Gender: Female Accelecare Wound Professionals Of K 701 S Howard Ave Ste 106 239 Tampa, FL 33606 (855) 267-4138 Fax: (440) 922-0143 00 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No Rosemurgy, Alexander MD Provider ID: 7232 Gender: Male Florida Hospital Tampa General Surg 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-7028 Fax: (813) 615-8350 18 Yrs/130 Yrs University Hospital M-F 8:30 AM - 5:00 PM PCMH: No Ross, Sharona MD Provider ID: 462324 Gender: Female Florida Hospital Tampa General Surg 3000 Medical Park Dr Ste 500 Tampa, FL 33613 (813) 615-7028 Fax: (813) 615-8350 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Ross, Sharona MD Provider ID: 462324 Gender: Female USF Physicicans Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 396-9946 Fax: (813) 844-1920 18 Yrs/130 Yrs Florida Hospital Tampa Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Straub, Donald DO Provider ID: 373582 Gender: Male Baycare Medical Group 4301 N Habana Ave Tampa, FL 33607 (813) 870-4064 Fax: (813) 443-8146 18 Yrs/130 Yrs St Josephs Hospital Languages: German M-F 8:00 AM - 5:00 PM PCMH: No

Rossi, Anthony DO Provider ID: 800324 Straub, Donald DO Gender: Male Healthpoint Medical Group Provider ID: 373582 1601 W Timberlane Dr Ste 300 Gender: Male Plant City, FL 33566 Healthpoint Medical Group (813) 708-1312 4211 Van Dyke Rd Ste 200 Fax: (813) 443-8147 Lutz, FL 33558 18 Yrs/130 Yrs (813) 264-6490 South Florida Baptist Hospital Fax: (813) 321-1878 M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No St Josephs Hospital Languages: German Smith, Paul MD M-F 8:00 AM - 5:00 PM Provider ID: 177618 PCMH: No Gender: Male USF Physicians Group Sucandy, Iswanto MD 12902 USF Magnolia Dr Tampa, FL 33612 Provider ID: 1346440 (813) 844-8783 Gender: Male Fax: (813) 844-1928 Fhpg Tam General Surgery 00 Yrs/130 Yrs 3000 Medical Park Dr Ste 500 M-F 8:00 AM - 5:00 PM Tampa, FL 33613 PCMH: No (813) 615-7030 Fax: (813) 615-8008 Sokolich, Julio MD 16 Yrs/130 Yrs Provider ID: 1428583 Florida Hospital Carrollwood Gender: Male Florida Hospital Tampa Tgmg Bayshore M-F 9:00 AM - 5:00 PM 409 Bayshore Blvd PCMH: No Tampa, FL 33606 (813) 844-5544 Tran, Quan MD Fax: (813) 844-1655 Provider ID: 695322 18 Yrs/130 Yrs Gender: Male M-F 7:30 AM - 5:00 PM 4211 Van Dyke Rd Ste 200 PCMH: No Lutz, FL 33558 (813) 264-6490 Fax: (813) 321-1878 00 Yrs/130 Yrs St Josephs Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

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Tummel, Evan MD Provider ID: 1095785 Gender: Male Women's Care Florida LLC 602 Vonderburg Dr Ste 101 Brandon, FL 33511 (813) 286-0033 Fax: (813) 282-1806 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Tummel, Evan MD Provider ID: 1095785 Gender: Male Womens Care Florida LLC 4213 N Gomez Ave Tampa, FL 33607 (813) 530-4944 Fax: (813) 530-4945 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Tummel, Evan MD Provider ID: 1095785 Gender: Male Womens Care Florida LLC 5 Tampa General Cir Ste 650 Tampa, FL 33606 (813) 530-4944 Fax: (813) 530-4945 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Tyler Jr, Gilman MD Provider ID: 1311 Gender: Male Greater Tampa Bay Physician Special 602 S Anderson Ave Ste A Tampa, FL 33609 (813) 877-1415 Fax: (813) 877-7602 00 Yrs/130 Yrs Memorial Hospital of Tampa MTWF 9:00 AM - 4:00 PM TH 9:00 AM - 12:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough General Surgery - cont. Vaikunth, Sachin MD Provider ID: 1023602 Gender: Male Fhpg Carrollwood Surgical Associate 6919 N Dale Mabry Hwy Ste 200 Tampa, FL 33614 (813) 933-3324 Fax: (813) 932-4357 18 Yrs/130 Yrs Florida Hospital Carrollwood Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Vaikunth, Sachin MD Provider ID: 1023602 Gender: Male Fhpg Cw Medical Center 3615 W Hamilton Ave Tampa, FL 33614 (813) 915-5626 Fax: (813) 915-5634 18 Yrs/130 Yrs Florida Hospital Carrollwood Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Velanovich, Vic MD Provider ID: 628247 Gender: Male USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-7396 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Velanovich, Vic MD Provider ID: 628247 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0929 Fax: (813) 844-7396 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Velanovich, Vic MD Provider ID: 628247 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-7396 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Velanovich, Vic MD Provider ID: 628247 Gender: Male USF Physicians Group 3000 Medical Park Dr Tampa, FL 33613 (813) 259-0929 Fax: (813) 844-1920 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Velanovich, Vic MD Provider ID: 628247 Gender: Male USF Physicians Group 3100 E Fletcher Ave Tampa, FL 33613 (813) 844-7396 Fax: (813) 844-7396 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 885 S Parsons Ave Brandon, FL 33511 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No Watson, Robert MD Provider ID: 1367279 Gender: Female Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5544 Fax: (813) 844-1655 18 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM PCMH: No

Geriatric Medicine Choksi, Tarak MD Provider ID: 292393 Gender: Male Sunmed Primary Care 18928 N Dale Mabry Hwy Ste 101 Lutz, FL 33548 (813) 909-1146 Fax: (813) 909-4334 18 Yrs/130 Yrs Florida Hospital Carrollwood Languages: Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

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Hussain, Sayyed MD Provider ID: 918556 Gender: Male 10335 Cross Creek Blvd Ste 20 Tampa, FL 33647 (813) 388-6838 Fax: (813) 388-9526 12 Yrs/130 Yrs Florida Hospital Wesley Chapel South Florida Baptist Hospital Languages: Hindi, Urdu, Pashtu M-F 9:00 AM - 4:00 PM PCMH: No

Gynecology Lynch, Catherine MD Provider ID: 7161 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8585 Fax: (813) 259-8582 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Williams, J Kell MD Provider ID: 7298 Gender: Male USF Physicians Group - IPA 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2919 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Hand Surgery Belsole, Robert MD Provider ID: 7020 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0854 Fax: (813) 259-0885 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Hand Surgery - cont.

Mendez, Pedro MD Samper-Pena, Carolina MD Gupta, Eva MD Provider ID: 12386 Provider ID: 1424359 Gender: Male Halpern, David MD Gender: Female Provider ID: 173 Oncology Associates PA Provider ID: 27232 Florida Cancer Specialists Gender: Female Gender: Male 3402 W Dr Martin Luther King 205 N Plant Ave Karon R Locicero MD PA DBA Plant City, FL 33563 Jr Blvd Tampa Bay Plastic Surgery Inc Locicero (813) 872-0613 Tampa, FL 33607 120 S Fremont Ave 2605 W Swann Ave Ste 600 Fax: (813) 879-2644 (813) 875-3950 Tampa, FL 33606 Tampa, FL 33609 00 Yrs/130 Yrs Fax: (813) 872-2741 (813) 871-5000 (813) 876-7073 Florida Hospital Tampa 18 Yrs/130 Yrs Fax: (813) 250-0108 Fax: (813) 877-1277 South Florida Baptist Hospital 18 Yrs/130 Yrs Florida Hospital Carrollwood 00 Yrs/130 Yrs Tampa Community Hospital Memorial Hospital of Tampa Memorial Hospital of Tampa Florida Hospital Tampa Languages: Spanish St Josephs Hospital St Josephs Hospital St Josephs Hospital M-F 9:00 AM - 2:00 PM Languages: Hindi Tampa General Hospital Tampa General Hospital PCMH: No M-F 9:00 AM - 5:00 PM Languages: Spanish Languages: Spanish PCMH: No M-F 8:00 AM - 4:30 PM M-F 9:00 AM - 5:00 PM Mendez, Pedro MD PCMH: No PCMH: No Provider ID: 12386 Gupta, Eva MD Gender: Male Schwartz-Fernandes, Francisco Provider ID: 1424359 Saranga Perry, Vita MD Oncology Associates PA MD Gender: Female 4700 N Habana Ave Ste 702 Provider ID: 996629 Florida Cancer Specialists Pl Provider ID: 990551 Tampa, FL 33614 Gender: Male 403 S Kings Ave Ste 100 Gender: Female (813) 872-0613 USF Physicians Group Brandon, FL 33511 1601 W Timberlane Dr Ste 100 Fax: (813) 879-2644 13330 USF Laurel Dr (813) 982-3460 Plant City, FL 33566 00 Yrs/130 Yrs Tampa, FL 33612 Fax: (813) 982-3461 (813) 708-1312 Florida Hospital Tampa (813) 396-9422 18 Yrs/130 Yrs South Florida Baptist Hospital Fax: (813) 321-1877 Fax: (813) 396-9495 Florida Hospital Carrollwood 18 Yrs/130 Yrs Tampa Community Hospital Memorial Hospital of Tampa 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No M-W 8:00 AM - 4:00 PM Languages: Hindi PCMH: No PCMH: No M-F 9:00 AM - 5:00 PM Hematology & Oncology Hematology PCMH: No Mendez, Pedro MD Al-Hassani, Yaser MD Provider ID: 12386 Hough, Bruce MD Gupta, Eva MD Provider ID: 172918 Gender: Male Provider ID: 655260 Provider ID: 1424359 Gender: Male Oncology Associates PA Gender: Male Gender: Female University Hematology 500 Vonderburg Dr Ste 204E Healthpoint Medical Group Florida Cancer Specialists Oncology PA Brandon, FL 33511 Inc 3000 Medical Park Dr Ste 250 6171 E Fowler Ave (813) 872-0613 3001 W Dr MLK Blvd Mab-2nd Tampa, FL 33613 Temple Terrace, FL 33617 Fax: (813) 879-2644 Fl (813) 632-6220 (813) 988-6569 00 Yrs/130 Yrs Tampa, FL 33607 Fax: (813) 971-5893 Fax: (813) 988-6481 Florida Hospital Tampa (813) 321-6589 18 Yrs/130 Yrs 00 Yrs/130 Yrs South Florida Baptist Hospital Fax: (813) 321-6590 Florida Hospital Carrollwood Florida Hospital Tampa Tampa Community Hospital 00 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital Languages: Spanish St Josephs Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM M-F 9:00 AM 2:00 PM M-F 9:00 AM - 5:00 PM Languages: Hindi PCMH: No PCMH: No PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Hematology & Oncology Cogburn, Julia MD - cont. Provider ID: 463233 Ayer-Cole, Jawan MD Provider ID: 245457 Gender: Female Jawan Ayer Cole MD LLC 800 W MLK Blvd Ste 4 Tampa, FL 33603 (813) 910-8700 Fax: (813) 978-3070 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Blanco, Rafael MD Provider ID: 8038 Gender: Male Florida Cancer Specialist 4301 N Habana Ave Ste 1 Tampa, FL 33607 (813) 875-2300 Fax: (813) 876-5661 18 Yrs/120 Yrs Florida Hospital Tampa Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No Cogburn, Julia MD Provider ID: 463233 Gender: Female 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Female Florida Cancer Specialists 13801 Bruce B Downs Blvd Blvd Ste Tampa, FL 33613 (813) 977-2003 Fax: (813) 979-0516 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Cogburn, Julia MD Provider ID: 463233 Gender: Female Florida Cancer Specialists 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Cogburn, Julia MD Provider ID: 463233 Gender: Female Florida Cancer Specialists 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Crescentini, Robert MD Provider ID: 791868 Gender: Male Baycare Medical Group 1601 W Timberlane Dr Ste 100 Plant City, FL 33566 (813) 708-1312 Fax: (813) 321-1877 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Crescentini, Robert MD Provider ID: 791868 Gender: Male Baycare Medical Group 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 321-6589 Fax: (813) 443-8151 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 6:00 PM PCMH: No Djulbegovic, Benjamin MD Provider ID: 21607 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 905-8909 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No George, Christopher MD Provider ID: 335941 Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No George, Christopher MD Provider ID: 335941 Gender: Male 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Giglia, Jennifer MD Provider ID: 497336 Gender: Female 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Hasija, Nalini MD Provider ID: 1278574 Gender: Female Florida Cancer Specialists 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Hussein, Mohammad MD Provider ID: 611919 Gender: Male 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-9476 18 Yrs/130 Yrs Tampa General Hospital Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Melchert, Magda MD Provider ID: 343717 Gender: Female 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Hematology & Oncology Park, Y K Peter MD - cont. Provider ID: 173015 Melchert, Magda MD Provider ID: 343717 Gender: Female Florida Cancer Specialists 13801 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-2003 Fax: (813) 979-0516 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No Melchert, Magda MD Provider ID: 343717 Gender: Female Florida Cancer Specialists 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No Michaels, Samantha MD Provider ID: 1144351 Gender: Female Baycare Medical Group Inc 3001 W Dr MLK Blvd 1st Fl Tampa, FL 33607 (813) 321-6820 Fax: (813) 287-6306 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No Park, Y K Peter MD Provider ID: 173015 Gender: Male 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Visweshwar, Nathan MD Provider ID: 796689 Gender: Male USF Physicians Group 13330 USF Laurel Dr Fl 6 Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-9476 18 Yrs/130 Yrs Tampa General Hospital Languages: Tamil M-F 9:00 AM - 5:00 PM PCMH: No Wright, David MD Provider ID: 205019 Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Shah, Ramesh MD Provider ID: 1705 Wright, David MD Gender: Male Provider ID: 205019 3000 Medical Park Dr Unit 530 Gender: Male Tampa, FL 33613 Florida Cancer Specialists (813) 632-6220 13801 Bruce B Downs Blvd Fax: (813) 971-5893 Tampa, FL 33613 18 Yrs/130 Yrs (813) 977-2003 Florida Hospital Tampa Fax: (813) 979-0516 St Josephs Hospital 18 Yrs/130 Yrs Tampa Community Hospital Brandon Regional Hospital Languages: Hindi, Indonesian Florida Hospital Carrollwood M-F 9:00 AM - 5:00 PM Memorial Hospital of Tampa PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Shah, Ramesh MD Provider ID: 1705 Wright, David MD Gender: Male Provider ID: 205019 Florida Cancer Specialists Gender: Male 3402 W Dr MLK Blvd Florida Cancer Specialists Tampa, FL 33607 3402 W Dr MLK Blvd (813) 875-3950 Tampa, FL 33607 Fax: (813) 872-2741 (813) 875-3950 18 Yrs/130 Yrs Fax: (813) 872-2741 Florida Hospital Tampa 18 Yrs/130 Yrs St Josephs Hospital Brandon Regional Hospital Tampa Community Hospital Florida Hospital Carrollwood Languages: Hindi, Indonesian Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No

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Wright, David MD Provider ID: 205019 Gender: Male Florida Cancer Specialists 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

HIV/AIDS Braun, Edward MD Provider ID: 1308264 Gender: Male Comprehensive Care Center Inc DBA C 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3075 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Prieto, Jose MD Provider ID: 4041 Gender: Male 214 Morrison Rd Ste 104 Brandon, FL 33511 (813) 681-6474 Fax: (813) 621-6474 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Hospice and Palliative Care

Buhari, Mudathiru MD

Cancio, Margarita MD Provider ID: 151923 Gender: Female Provider ID: 757935 Wilson, Amanda MD Infectious Disease Associates Gender: Male Provider ID: 1119165 Gulf To Bay Infectious Disease 4729 N Habana Ave Cons Tampa, FL 33614 Gender: Female 2901 W Saint Isabel St Ste D (813) 251-8444 USF Physicians Group Tampa, FL 33607 Fax: (813) 254-6414 1 Tampa General Cir (813) 541-1466 00 Yrs/130 Yrs Tampa, FL 33606 Fax: (813) 281-8705 St Josephs Hospital (813) 974-2201 Tampa General Hospital 18 Yrs/130 Yrs Fax: (813) 974-7589 Languages: Spanish Tampa General Hospital 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Languages: Yoruba M-F 8:00 AM - 5:00 PM PCMH: No M-F 9:00 AM 4:00 PM PCMH: No PCMH: No Carrington, Moise MD Infectious Disease Busciglio, Lindell MD Provider ID: 608164 Gender: Female Aneja, Parul MD Provider ID: 151921 Infectious Disease Associates Gender: Female Provider ID: 1045022 of Ta Infectious Disease Associates Gender: Male 4729 N Habana Ave 4729 N Habana Ave Fhpg Infectious Disease of Tampa, FL 33614 Tampa Tampa, FL 33614 (813) 251-8444 7001 N Dale Mabry Hwy Ste 6 (813) 251-8444 Fax: (813) 254-6414 Tampa, FL 33614 Fax: (813) 254-6414 18 Yrs/130 Yrs (813) 915-5454 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Fax: (813) 915-5461 Memorial Hospital of Tampa PCMH: No St Josephs Hospital 18 Yrs/130 Yrs Tampa General Hospital Florida Hospital Orlando Casanas, Beata DO M-F 8:30 AM - 5:00 PM Languages: Hindi, Punjabi, PCMH: No Tamil, Kannada Provider ID: 295630 M-F 8:00 AM - 5:00 PM Cancio, Margarita MD Gender: Female PCMH: No Provider ID: 151923 Hillsborough County Health Barbour, Ronald MD Gender: Female Dept Infectious Disease Associates 1105 E Kennedy Blvd Provider ID: 149303 4 Columbia Dr Ste 820 Tampa, FL 33602 Gender: Male Tampa, FL 33606 (813) 307-8015 Ronald L Barbour PA (813) 251-8444 Fax: (813) 276-2999 341 Bullard Pkwy Ste A & B Fax: (813) 254-6414 00 Yrs/130 Yrs Temple Terrace, FL 33617 00 Yrs/130 Yrs Languages: Spanish, Polish (813) 983-0700 St Josephs Hospital M 9:30 AM - 12:30 PM Fax: (813) 983-0600 Tampa General Hospital T 8:00 AM - 2:00 PM 18 Yrs/130 Yrs Languages: Spanish W 10:30 AM - 2:30 PM Florida Hospital Tampa M-F 8:30 AM - 5:00 PM PCMH: No Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

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Dunn, Michael MD Provider ID: 938262 Gender: Male Comprehensive Care Center Inc 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3705 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Han, John MD Provider ID: 208225 Gender: Male 13140 Elk Mountain Dr Riverview, FL 33579 (813) 671-1155 Fax: (813) 671-2244 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM PCMH: No Holt, Douglas MD Provider ID: 1016306 Gender: Male Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8060 Fax: (813) 276-2999 12 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Irby, Rachel MD Provider ID: 593800 Gender: Female Infectious Disease Assoc. 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Infectious Disease - cont. Klauber-Choephel, Enid MD Khan, Nadeem MD Provider ID: 228433 Gender: Male 4 Columbia Dr Ste 820 Tampa, FL 33606 (813) 251-8444 Fax: (813) 254-6414 00 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish, Hindi, Urdu M-F 8:30 AM - 5:00 PM PCMH: No Khan, Nadeem MD Provider ID: 228433 Gender: Male Infectious Disease Associates 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 00 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish, Hindi, Urdu M-F 8:30 AM - 5:00 PM PCMH: No Khan, Nadeem MD Provider ID: 713452 Gender: Male St Josephs Tampa Care 4600 N Habana Ave Ste 15 Tampa, FL 33614 (813) 870-4460 Fax: (813) 870-4459 18 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Urdu M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 343022 Gender: Female 214 Morrison Rd Ste 104 Brandon, FL 33511 (813) 681-6474 Fax: (813) 654-8473 18 Yrs/130 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Lakshmi, Seetha MD Provider ID: 1226409 Gender: Female USF Physician Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7670 Fax: (813) 844-7605 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lakshmi, Seetha MD Provider ID: 1226409 Gender: Female USF Physician Group 5802 N 30th St Tampa, FL 33610 (813) 236-5200 Fax: (813) 236-5332 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mai, Jane MD Provider ID: 1107294 Gender: Female Infectious Disease Associates of Ta 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Martinez, Juan MD Provider ID: 166 Gender: Male Juan M Martinez 2123 W MLK Blvd Ste 202 Tampa, FL 33607 (813) 875-6520 Fax: (813) 875-6416 05 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-TH 10:00 AM - 5:00 PM PCMH: No Martinez, Juan MD Provider ID: 986512 Gender: Male Help US Help U 3228 Cove Bend Dr Tampa, FL 33613 (813) 279-6787 Fax: (813) 330-3129 05 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Mayer, Cynthia DO Provider ID: 10312 Gender: Female 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 00 Yrs/130 Yrs Memorial Hospital of Tampa Tampa Community Hospital Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Mohmand, Asad MD Provider ID: 1261859 Gender: Male Margarita R. Cancio, MD, PA D/B/A I 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Montero, Jose MD Provider ID: 19421 Gender: Male Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8015 Fax: (813) 276-2999 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M 9:30 AM - 1:30 PM T 9:00 AM - 12:00 PM W 8:30 AM - 1:30 PM PCMH: No Morano, Jamie MD Provider ID: 1026399 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 00 Yrs/130 Yrs Tampa General Hospital M-TH 8:00 AM - 4:30 PM PCMH: No Morano, Jamie MD Provider ID: 793238 Gender: Female USF Physicians Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-8565 Fax: (813) 745-8468 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, Chinese M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Infectious Disease - cont. Prieto, Jose MD Morano, Jamie MD Provider ID: 793238 Gender: Female USF Physicians Group 1300 Bruce B Downs Blvd Tampa, FL 33612 (813) 972-2000 Fax: (813) 978-5983 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, Chinese M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 4041 Gender: Male 214 Morrison Rd Ste 104 Brandon, FL 33511 (813) 681-6474 Fax: (813) 621-6474 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Noel, Pamela MD Provider ID: 786420 Gender: Female Margarita R Cancio MD PA 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Rihana, Nancy MD Provider ID: 979040 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7670 Fax: (813) 844-7605 00 Yrs/130 Yrs Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Yagneshvari MD

Somboonwit, Charurut MD

Provider ID: 457906 Gender: Female Infectious Desease Associates 4 Columbia Dr Ste 820 Tampa, FL 33606 (813) 251-8444 Fax: (813) 254-6414 00 Yrs/130 Yrs Florida Hospital Carrollwood Tampa Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No Patel, Yagneshvari MD Provider ID: 457906 Gender: Female Infectious Disease Assoc of Tampa B 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 00 Yrs/130 Yrs Florida Hospital Carrollwood Tampa Community Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 1027412 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 00 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 1:30 PM T 10:00 AM - 2:00 PM W 8:00 AM - 12:30 PM PCMH: No

Thiel, Derrick DO Provider ID: 523744 Gender: Male Jose R Prieto MD PA 214 Morrison Rd Ste 104 Brandon, FL 33511 (813) 681-6474 Fax: (813) 651-8473 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Ubillos, Scott MD Provider ID: 162128 Gender: Male Infectious Disease Associates 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 00 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Vasquez, Jose MD Provider ID: 172789 Gender: Male 214 Morrison Rd Ste 104 Brandon, FL 33511 (813) 681-6474 Fax: (813) 654-8473 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Sriaroon, Chakrapol MD Provider ID: 1108175 Gender: Male 2 Tampa General Cir Tampa, FL 33606 (813) 259-0619 Fax: (813) 259-0620 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3075 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-F 8:00 AM - 5:00 PM PCMH: No Wills, Todd MD Provider ID: 204295 Gender: Male USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7670 Fax: (813) 844-7605 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Internal Medicine Agrawal, Saurabh MD Provider ID: 1418103 Gender: Male Tampa General Medical Grouptgmg Bay 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5460 Fax: (813) 844-1655 18 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Internal Medicine - cont. Chang Chen Lin, Yih MD Aneja, Parul MD Provider ID: 787072 Provider ID: 1045022 Gender: Male Gender: Male USF Physicians Group Fhpg Infectious Disease of 13330 USF Laurel Dr Tampa Tampa, FL 33612 7001 N Dale Mabry Hwy Ste 6 (813) 974-4115 Tampa, FL 33614 Fax: (813) 974-5229 (813) 915-5454 00 Yrs/130 Yrs Fax: (813) 915-5461 Languages: Chinese 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Florida Hospital Orlando PCMH: No Languages: Hindi, Punjabi, Tamil, Kannada Chang Chen Lin, Yih MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 787072 Gender: Male Asuncion, Melissa MD USF Physicians Group 5802 N 30th St Provider ID: 1108134 Tampa, FL 33610 Gender: Female (813) 236-5300 Bluestone Physician Services Fax: (813) 236-5220 Florid 00 Yrs/130 Yrs 300 S Hyde Park Ave Ste 210 Languages: Chinese Tampa, FL 33606 M-F 8:00 AM - 5:00 PM (813) 259-1013 PCMH: No Fax: (813) 354-0396 18 Yrs/130 Yrs Dastgir, Farooque MD Languages: French MTWTHFSat 8:00 AM - 5:00 Provider ID: 509799 PM Gender: Male PCMH: No Digestive Disease Assoc of Tampa Ba Casanas, Beata DO 876 S Parsons Ave Brandon, FL 33511 Provider ID: 295630 (813) 653-3359 Gender: Female Fax: (813) 662-9639 Hillsborough County Health 18 Yrs/130 Yrs Dept Brandon Regional Hospital 1105 E Kennedy Blvd M-F 8:00 AM - 4:30 PM Tampa, FL 33602 PCMH: No (813) 307-8015 Fax: (813) 276-2999 Edwards, Charles MD 00 Yrs/130 Yrs Provider ID: 178722 Languages: Spanish, Polish Gender: Male M 9:30 AM - 12:30 PM USF Physicicans Group T 8:00 AM - 2:00 PM 1 Tampa General Cir W 10:30 AM - 2:30 PM Tampa, FL 33606 PCMH: No (813) 844-3397 Fax: (813) 844-1934 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Flannery, Michael Thomas MD Humphrey, Deborah DO Provider ID: 5046 Gender: Female Provider ID: 7083 USF Physicicans Group Gender: Male 12901 Bruce B Downs Blvd USF Physicicans Group Tampa, FL 33612 1 Tampa General Cir (813) 974-2142 Tampa, FL 33606 18 Yrs/130 Yrs (813) 259-0670 M-F 9:00 AM - 5:00 PM Fax: (813) 259-8748 PCMH: No 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Humphrey, Deborah DO PCMH: No Provider ID: 7128 Gender: Female Heart, Rami DO USF Physicicans Group Provider ID: 1297790 1 Tampa General Cir Gender: Male Tampa, FL 33606 Heart and Vascular Plc (813) 844-3397 310 W Alexander St Fax: (813) 844-1934 Plant City, FL 33563 00 Yrs/130 Yrs (863) 424-3278 M-F 8:00 AM - 5:00 PM Fax: (863) 420-9701 PCMH: No 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Jeyabarath, Ananthi MD PCMH: No Hoy, Jeffrey MD Provider ID: 1317861 Gender: Female Baycare Medical Group Inc 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 321-6589 Fax: (813) 321-6590 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hulse III, Ronald MD Provider ID: 516652 Gender: Male Ronald S Hulse III MD 5 Tampa General Cir Ste 830 Tampa, FL 33606 (813) 251-5511 Fax: (813) 251-5521 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital M-F 9:00 AM - 5:30 PM PCMH: No

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Provider ID: 272355 Gender: Female Bluestone Physician Services Florid 300 S Hyde Park Ave Ste 210 Tampa, FL 33606 (813) 259-1013 Fax: (813) 354-0396 18 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Khadim, Ghazanfar MD Provider ID: 456632 Gender: Male Florida Heart Institute 1703 Thonotosassa Rd Plant City, FL 33563 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills South Florida Baptist Hospital Languages: Spanish, Chinese, Burmese M 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Internal Medicine - cont. Mai, Cuc MD Provider ID: 320733 Gender: Female USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-3397 Fax: (813) 844-1934 18 Yrs/130 Yrs Languages: Vietnamese M-F 8:00 AM - 5:00 PM PCMH: No

Khadim, Ghazanfar MD Provider ID: 456632 Gender: Male Florida Heart Institute 1907 S Alexander St Plant City, FL 33566 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills South Florida Baptist Hospital Maniscalco, Benedict MD Languages: Spanish, Chinese, Burmese Provider ID: 1352193 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No Tampa Heart and Vascular Associates Khadim, Ghazanfar MD 6101 Webb Rd Ste 206 Provider ID: 456632 Tampa, FL 33615 Gender: Male (813) 884-0897 Florida Heart Institute Fax: (813) 903-8132 310 W Alexander St 12 Yrs/130 Yrs Plant City, FL 33563 St Josephs Hospital (813) 780-6687 Languages: Spanish, Italian Fax: (813) 788-6554 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Bayfront Health Dade City Florida Hospital Zephyrhills Misiri, Juna MD South Florida Baptist Hospital Provider ID: 1126169 Languages: Spanish, Chinese, Gender: Female Burmese Bay Area Cardiology MT 1:00 AM - 5:00 PM Associates, PA W 8:00 AM - 12:00 PM 13029 Summerfield Square Dr PCMH: No Riverview, FL 33578 (813) 443-0880 Leclercq, Baudouin MD Fax: (813) 654-9032 18 Yrs/130 Yrs Provider ID: 1012893 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Vascular Action LLC 2810 W Saint Isabel St Ste 102 Misiri, Juna MD Tampa, FL 33607 Provider ID: 1126169 (813) 872-8480 Gender: Female Fax: (813) 872-8579 Bay Area Cardiology 00 Yrs/130 Yrs Associates, PA Munroe Regional Med Center 3920 Galen Ct Ocala Regional Medical Sun City Center, FL 33573 Center (813) 634-7200 West Marion Community Fax: (813) 654-9032 Hospital 18 Yrs/130 Yrs Languages: French M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Misiri, Juna MD Provider ID: 1126169 Gender: Female Bay Area Cardiology Associates, PA 635 Eichenfeld Dr Brandon, FL 33511 (813) 684-6000 Fax: (813) 654-9032 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mohmand, Asad MD Provider ID: 1261859 Gender: Male Margarita R. Cancio, MD, PA D/B/A I 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Montero, Jose MD Provider ID: 19421 Gender: Male Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8015 Fax: (813) 276-2999 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M 9:30 AM - 1:30 PM T 9:00 AM - 12:00 PM W 8:30 AM - 1:30 PM PCMH: No Obrien, Kevin MD Provider ID: 200018 Gender: Male USF Physicicans Group 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2201 16 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Ostolaza Garcia, Otto MD Provider ID: 948021 Gender: Male Internal Med Nephrology Assoc Inc 4710 N Habana Ave Ste 300 Tampa, FL 33614 (813) 873-1016 Fax: (813) 874-2813 18 Yrs/130 Yrs CRMC At Bayonet Point Florida Hospital Tampa Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Patel, Pragnesh MD Provider ID: 1415126 Gender: Male Neurobehavioral Medicine LLC 613 W MLK Jr Blvd Ste 101 Tampa, FL 33603 (813) 237-1958 Fax: (813) 237-8147 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa Community Hospital Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No Patel, Sonal MD Provider ID: 1356345 Gender: Female Florida Diabetes and Endocrine Assoc 7001 N Dale Mabry Hwy Ste 2 Tampa, FL 33614 (813) 252-9849 Fax: (813) 283-9000 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Languages: Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Internal Medicine - cont. Roy, Bipul MD Rabago Reyes, Cassandra MD Provider ID: 1428827 Gender: Female Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5470 Fax: (813) 844-1655 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Rattes, Max MD Provider ID: 1418113 Gender: Male Tgmf Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Reddivari, Venkata MD Provider ID: 1365941 Gender: Female Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 877-1277 Fax: (813) 876-7073 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM Sun 9:00 AM - 4:30 PM PCMH: No

Provider ID: 1039188 Gender: Male South Shore Cardiovascular Associat 1159 Nikki View Dr Brandon, FL 33511 (813) 661-6199 Fax: (813) 661-6334 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Bengali M-F 9:00 AM - 5:00 PM PCMH: No Sandhu, Jagdeep MD Provider ID: 360954 Gender: Male Care Plus Walkin Clinics PA 519 E Bloomingdale Ave Brandon, FL 33511 (813) 655-4100 Fax: (813) 655-1775 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Hindi, Urdu, Punjabi M-F 8:00 AM - 7:30 PM Sat-Sun 8:00 AM - 3:30 PM PCMH: No Schreibman, Tanya MD Provider ID: 286830 Gender: Female Comprehensive Care Center 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3705 12 Yrs/130 Yrs Languages: Creole M-F 9:00 AM - 5:00 PM PCMH: No

Shah, Bhumik MD Provider ID: 1414961 Gender: Male Tgmg Fcc Healthpark 5802 N 30th St Tampa, FL 33610 (813) 236-5350 Fax: (813) 234-2904 18 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM PCMH: No Sinnott, John MD Provider ID: 1282926 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 00 Yrs/130 Yrs Tampa General Hospital PCMH: No Somboonwit, Charurut MD Provider ID: 1027412 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 00 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 1:30 PM T 10:00 AM - 2:00 PM W 8:00 AM - 12:30 PM PCMH: No Somboonwit, Charurut MD Provider ID: 284169 Gender: Female Hillsborough County Health Dept 13601 N 22nd St Tampa, FL 33613 (813) 307-8058 Fax: (813) 272-7173 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM PCMH: No

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Sullebarger, John MD Provider ID: 1310245 Gender: Male Florida Medical Clinic, PA 3860 Sun City Center Blvd Sun City Center, FL 33573 (813) 633-1980 Fax: (813) 355-5104 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital MT 8:00 AM - 5:00 PM PCMH: No Sullebarger, John MD Provider ID: 1310245 Gender: Male Florida Medical Clinic, PA 4200 N Armenia Ave Ste 5 Tampa, FL 33607 (813) 284-2200 Fax: (813) 377-1006 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-W 8:00 AM - 5:00 PM PCMH: No Sullebarger, John MD Provider ID: 1310245 Gender: Male Florida Medical Clinic, PA 4210 W Linebaugh Ave Tampa, FL 33624 (813) 884-0923 Fax: (813) 377-1006 18 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital MT 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Internal Medicine - cont. Walgampaya, Dakshina MD Thiel, Derrick DO Provider ID: 523744 Gender: Male Jose R Prieto MD PA 214 Morrison Rd Ste 104 Brandon, FL 33511 (813) 681-6474 Fax: (813) 651-8473 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Florida Hospital Tampa M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3075 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-F 8:00 AM - 5:00 PM PCMH: No Velusamy, Muthusamy MD Provider ID: 1170547 Gender: Male Cardiovascular Institute of America 6328 Gunn Hwy Ste C Tampa, FL 33625 (813) 610-9510 Fax: (844) 224-0312 18 Yrs/130 Yrs Medical Center of Trinity Languages: Tamil M-F 9:00 AM - 4:00 PM PCMH: No

Provider ID: 1418206 Gender: Male Tgmg Fcc Kennedy 2501 W Kennedy Blvd Tampa, FL 33609 (813) 844-1385 Fax: (813) 254-0230 00 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM PCMH: Yes, Level 3

Zervogiannis, Panagiotis MD

Maternal Fetal Medicine

Provider ID: 1154644 Gender: Male Internal Med Nephrology Assoc Inc 2205 W Kennedy Blvd Tampa, FL 33606 (813) 579-1248 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Angel, Jeffrey MD Provider ID: 6299 Gender: Male Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital M-TH 9:00 AM - 4:00 PM PCMH: No

Interventional Cardiology

Walker, Robert Morgan MD Provider ID: 7289 Gender: Male USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7558 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Walker, Robert Morgan MD Provider ID: 7289 Gender: Male USF Physicicans Group 5802 N 30th St Tampa, FL 33610 (813) 236-5350 Fax: (813) 236-5332 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Zervogiannis, Panagiotis MD Provider ID: 1154644 Gender: Male Internal Med Nephrology Assoc Inc 4710 N Habana Ave Ste 300 Tampa, FL 33614 (813) 873-1016 Fax: (813) 874-2813 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Canedo, Mario MD Provider ID: 1341602 Angel, Jeffrey MD Gender: Male Provider ID: 6299 Tampa Heart and Vascular Gender: Male Associates 13701 Bru B Downs Blvd Ste 101 Pediatrix Medical Group 13601 Bru B Downs Blvd Ste Tampa, FL 33613 250 (813) 971-2600 Tampa, FL 33613 Fax: (813) 979-4511 (813) 971-6909 18 Yrs/130 Yrs Fax: (813) 971-6985 Tampa Community Hospital 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Brandon Regional Hospital PCMH: No Florida Hospital Tampa St Josephs Hospital Schachter, David MD M-F 9:00 AM - 5:00 PM PCMH: No Provider ID: 1036114 Gender: Male Baacke, Keri MD Healthpoint Medical Group Provider ID: 1344794 Inc Gender: Female 2814 W Virginia Ave Pediatrix Medical Group of Tampa, FL 33607 Florida (813) 875-9000 13601 Bru B Downs Blvd Ste Fax: (813) 874-3278 250 18 Yrs/130 Yrs Tampa, FL 33613 M-F 8:00 AM - 5:00 PM (813) 971-6909 PCMH: No Fax: (855) 527-5510 Tabesh, Mohammadreza MD Provider ID: 562862 Gender: Male Cardiovascular Center of Tampa PA 13801 Bru B Downs Blvd Ste 104 Tampa, FL 33613 (813) 972-5090 Fax: (813) 975-8748 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Maternal Fetal Medicine - Fines Dailey, Verlee MD Provider ID: 1068805 cont. Baacke, Keri MD Provider ID: 1344794 Gender: Female Pediatrix Medical Group of Florida 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Belogolovkin, Victoria MD Provider ID: 1282640 Gender: Female Women's Care Floirda, LLC 5 Tampa General Cir Tampa, FL 33606 (813) 644-6200 Fax: (813) 304-2428 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs M-TH 9:00 AM - 4:00 PM PCMH: No Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Female Pediatrix Medical Group 3030 W Dr MLK Blvd Ste 250 Tampa, FL 33607 (813) 870-4000 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Ste 250 Tampa, FL 33607 (813) 870-4000 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 3100 E Fletcher Ave Tampa, FL 33613 (813) 971-6000 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group of Florida 3100 E Fletcher Ave Tampa, FL 33613 (813) 971-6000 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fry III, Alland MD Provider ID: 310079 Gender: Male Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs M-TH 9:00 AM - 4:00 PM PCMH: No

Funai, Edmund MD Provider ID: 1183028 Gender: Male 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group I 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (813) 971-6985 12 Yrs/130 Yrs M-TH 8:00 AM - 4:00 PM F 8:00 AM - 12:00 PM PCMH: No

Funai, Edmund MD Provider ID: 1183028 Gender: Male 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5188 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs M-TH 9:00 AM - 4:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Ste 250 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 3100 E Fletcher Ave Tampa, FL 33613 (813) 971-6000 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kalter, Craig MD Provider ID: 6302 Gender: Male Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Maternal Fetal Medicine - Nirgudkar, Pranita MD cont. Provider ID: 1352153 Kalter, Craig MD Provider ID: 6302 Gender: Male Pediatrix Medical Group 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (813) 971-6985 12 Yrs/130 Yrs Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No Kalter, Craig MD Provider ID: 6302 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Kalter, Craig MD Provider ID: 6302 Gender: Male Pediatrix Medical Group of Florida 3100 E Fletcher Ave Tampa, FL 33613 (813) 971-6000 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Louis, Judette MD Provider ID: 391389 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 00 Yrs/130 Yrs South Florida Baptist Hospital Tampa General Hospital Languages: Creole M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Female Pediatrix Medical Group of Florida 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/130 Yrs Languages: Hindi, Marathi M-F 9:00 AM - 5:00 PM PCMH: No Nirgudkar, Pranita MD Provider ID: 1352153 Gender: Female Pediatrix Medical Group of Florida 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 00 Yrs/130 Yrs Languages: Hindi, Marathi M-F 9:00 AM - 5:00 PM PCMH: No Obican, Sarah MD Provider ID: 1103967 Gender: Female 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0679 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Obican, Sarah MD Provider ID: 1103967 Gender: Female 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Rao, Kiran MD Provider ID: 1270906 Gender: Male Womens Care Florida LLC 5 Tampa General Cir Ste 650 Tampa, FL 33606 (813) 644-6235 Fax: (813) 644-6245 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Rodriguez, Alejandro MD Provider ID: 1226422 Gender: Male USF Physician Group 13330 USF Laurel Dr 5th Fl Tampa, FL 33612 (813) 259-8500 Fax: (813) 974-7687 00 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rodriguez, Alejandro MD Provider ID: 1226422 Gender: Male USF Physician Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8623 00 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rodriguez, Alejandro MD Provider ID: 1226422 Gender: Male USF Physician Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 00 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Sloan, Chris MD Provider ID: 1099110 Gender: Male Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-TH 9:00 AM - 4:00 PM PCMH: No Sloan, Chris MD Provider ID: 1099110 Gender: Male Pediatrix Medical Group 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (855) 527-5510 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-F 8:30 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medical Group of Florida 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 3030 W Dr MLK Blvd Ste 250 Tampa, FL 33607 (813) 870-4000 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Maternal Fetal Medicine - Sanchezvalle, Amarilis MD cont. Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 3100 E Fletcher Ave Tampa, FL 33613 (813) 971-6000 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Medical Genetics Pope, Kathleen MD Provider ID: 687626 Gender: Female 2 Tampa General Cir Tampa, FL 33606 (813) 259-8772 Fax: (813) 259-8771 00 Yrs/21 Yrs Tampa General Hospital Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No Sanchezvalle, Amarilis MD Provider ID: 612086 Gender: Female USF Physicians Group 1301 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2201 Fax: (813) 259-8771 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 612086 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33603 (813) 259-8772 Fax: (813) 259-8771 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Medical Oncology

Altemose, Rand MD Provider ID: 9901 Gender: Male Florida Cancer Specialists 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs Brandon Regional Hospital Memorial Hospital of Tampa Tampa General Hospital Languages: Italian M-F 9:00 AM - 5:00 PM PCMH: No Altemose, Rand MD

Altemose, Rand MD Provider ID: 9901 Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Brandon Regional Hospital Memorial Hospital of Tampa Tampa General Hospital Languages: Italian M-F 9:00 AM - 5:00 PM PCMH: No Altemose, Rand MD Provider ID: 9901 Gender: Male Florida Cancer Specialists 13801 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-2003 Fax: (813) 979-0516 18 Yrs/130 Yrs Brandon Regional Hospital Memorial Hospital of Tampa Tampa General Hospital Languages: Italian M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 9901 Gender: Male Florida Cancer Specialists 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs Brandon Regional Hospital Memorial Hospital of Tampa Tampa General Hospital Languages: Italian M-F 9:00 AM - 5:00 PM PCMH: No Chatoor, Hafeez MD Provider ID: 9503 Gender: Male 4051 Upper Creek Dr Ste 104 Sun City Center, FL 33573 (813) 254-7227 Fax: (813) 253-0285 18 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Chatoor, Hafeez MD Provider ID: 9503 Gender: Male Florida Cancer Specialists 2111 W Swann Ave Ste 102 Tampa, FL 33606 (813) 254-7227 Fax: (813) 253-0285 18 Yrs/130 Yrs Tampa General Hospital M-TH 9:00 AM - 4:30 PM F 9:00 AM - 12:00 PM PCMH: No Chatoor, Hafeez MD Provider ID: 9503 Gender: Male Florida Cancer Specialists 604 Medical Care Dr Brandon, FL 33511 (813) 633-3955 Fax: (813) 653-2523 18 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Fink, Matthew MD Provider ID: 314168 Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Fink, Matthew MD Provider ID: 314168 Gender: Male 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Medical Oncology - cont. Gupta, Eva MD Fink, Matthew MD Provider ID: 314168 Gender: Male Florida Cancer Specialists 13801 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-2003 Fax: (813) 979-0516 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Fink, Matthew MD Provider ID: 314168 Gender: Male Florida Cancer Specialists 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Gupta, Eva MD Provider ID: 1424359 Gender: Female Florida Cancer Specialists 3000 Medical Park Dr Ste 250 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Florida Hospital Carrollwood Memorial Hospital of Tampa St Josephs Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Ignatius, Renjitha MD Lautersztain, Julio MD Provider ID: 1424359 Gender: Female Provider ID: 1248347 Provider ID: 357689 Florida Cancer Specialists Gender: Female Gender: Male 3402 W Dr Martin Luther King Florida Cancer Specialists Pl Florida Cancer Specialists, Pl Jr Blvd 3000 Medical Park Dr Unit 530 4902 N Armenia Ave Tampa, FL 33607 Tampa, FL 33616 Tampa, FL 33603 (813) 875-3950 (813) 632-6220 (813) 876-0035 Fax: (813) 872-2741 Fax: (813) 971-5893 Fax: (813) 876-2363 18 Yrs/130 Yrs 18 Yrs/110 Yrs 18 Yrs/130 Yrs Florida Hospital Carrollwood M-F 9:00 AM - 5:00 PM Memorial Hospital of Tampa Memorial Hospital of Tampa PCMH: No Languages: Spanish, French, St Josephs Hospital Portuguese Languages: Hindi Ignatius, Renjitha MD M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Provider ID: 1248347 Mendez, Pedro MD Gender: Female Gupta, Eva MD Provider ID: 12386 Florida Cancer Specialists Pl Provider ID: 1424359 Gender: Male 403 S Kings Ave Ste 100 Gender: Female Oncology Associates PA Brandon, FL 33511 Florida Cancer Specialists Pl 205 N Plant Ave (813) 982-3460 403 S Kings Ave Ste 100 Plant City, FL 33563 Fax: (813) 982-3461 Brandon, FL 33511 (813) 872-0613 18 Yrs/110 Yrs (813) 982-3460 Fax: (813) 879-2644 M-F 9:00 AM - 5:00 PM Fax: (813) 982-3461 00 Yrs/130 Yrs PCMH: No 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Carrollwood Ignatius, Renjitha MD South Florida Baptist Hospital Memorial Hospital of Tampa Tampa Community Hospital St Josephs Hospital Languages: Spanish Provider ID: 1248347 Languages: Hindi M-F 9:00 AM - 2:00 PM Gender: Female M-F 9:00 AM - 5:00 PM PCMH: No Florida Cancer Specialists Pl PCMH: No 4051 Upper Creek Dr Ste 104 Mendez, Pedro MD Sun City Center, FL 33573 Ignatius, Renjitha MD Provider ID: 12386 (813) 254-7223 Gender: Male 18 Yrs/110 Yrs Provider ID: 1248347 Oncology Associates PA M-F 9:00 AM - 5:00 PM Gender: Female 4700 N Habana Ave Ste 702 PCMH: No Florida Cancer Specialists Tampa, FL 33614 3402 W Dr MLK Blvd (813) 872-0613 Lautersztain, Julio MD Tampa, FL 33607 Fax: (813) 879-2644 (813) 875-3950 00 Yrs/130 Yrs Provider ID: 357689 Fax: (813) 876-0432 Florida Hospital Tampa Gender: Male 18 Yrs/110 Yrs South Florida Baptist Hospital Florida Cancer Specialists M-F 9:00 AM - 5:00 PM Tampa Community Hospital 3402 W Dr MLK Blvd PCMH: No Languages: Spanish Tampa, FL 33607 M-W 8:00 AM - 4:00 PM (813) 875-3950 PCMH: No Fax: (813) 872-2741 18 Yrs/130 Yrs Memorial Hospital of Tampa Languages: Spanish, French, Portuguese M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Medical Oncology - cont. Shah, Shalin DO Provider ID: 466292 Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (183) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs St Josephs Hospital Tampa Community Hospital University Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Mendez, Pedro MD Provider ID: 12386 Gender: Male Oncology Associates PA 500 Vonderburg Dr Ste 204E Brandon, FL 33511 (813) 872-0613 Fax: (813) 879-2644 00 Yrs/130 Yrs Florida Hospital Tampa South Florida Baptist Hospital Tampa Community Hospital Shah, Shalin DO Languages: Spanish Provider ID: 466292 M-F 9:00 AM - 2:00 PM Gender: Male PCMH: No 425 S Parsons Ave Ste 101 Robbins, Mark MD Brandon, FL 33511 Provider ID: A246 (813) 982-3460 Gender: Male Fax: (813) 982-3461 403 S Kings Ave Ste 100 18 Yrs/130 Yrs Brandon, FL 33511 St Josephs Hospital Tampa Community Hospital (813) 982-3460 University Hospital Fax: (813) 982-3461 M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No M 8:00 AM - 5:00 PM PCMH: No Shah, Shalin DO Provider ID: 466292 Robbins, Mark MD Gender: Male Provider ID: A246 Florida Cancer Specialists Gender: Male 3402 W Dr MLK Blvd Florida Cancer Specialists Tampa, FL 33607 4051 Upper Creek Dr Ste 104 (813) 875-3950 Sun City Center, FL 33573 Fax: (813) 872-2741 (813) 633-3955 18 Yrs/130 Yrs Fax: (813) 633-0441 St Josephs Hospital 18 Yrs/130 Yrs Tampa Community Hospital M-TH 8:00 AM - 5:00 PM University Hospital PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Sciortino, David MD Provider ID: 1330081 Gender: Male Baycare Medical Group 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 321-6589 Fax: (813) 321-6590 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Shah, Shalin DO Provider ID: 466292 Gender: Male Florida Cancer Specialists P L 13801 Bru B Downs Blvd Unit 106 Tampa, FL 33613 (813) 977-2003 Fax: (813) 979-0516 18 Yrs/130 Yrs St Josephs Hospital Tampa Community Hospital University Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Weaver, Robert MD Provider ID: 341682 Gender: Male 3000 Medical Park Dr Ste 530 Tampa, FL 33613 (813) 632-6220 Fax: (813) 971-5893 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Weaver, Robert MD Provider ID: 341682 Gender: Male Florida Cancer Specialists 13801 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-2003 Fax: (813) 979-0516 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Weaver, Robert MD Provider ID: 341682 Gender: Male Florida Cancer Specialists 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

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Weaver, Robert MD Provider ID: 341682 Gender: Male Hematology-Oncology Specialists of 2 Columbia Dr Tampa, FL 33606 (813) 974-3133 Fax: (813) 876-2363 18 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Zayas, Egberto MD Provider ID: 186497 Gender: Male 4301 N Habana Ave Ste 1 Tampa, FL 33607 (813) 875-2300 Fax: (813) 876-5661 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Neonatal Perinatal Medicine Ashmeade, Terri MD Provider ID: 167219 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/03 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Balakrishnan, Maya MD Provider ID: 573237 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-3437 Fax: (813) 844-1671 00 Yrs/12 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Neonatal Perinatal Medicine - cont.

Foster, Cherie MD Provider ID: 523213 Gender: Female Fant, Michael MD Pediatrix Medical Group of Florida Provider ID: 506925 3030 W Dr MLK Blvd Gender: Male University Med Svcs Assoc Inc Tampa, FL 33607 (813) 872-2924 2 Tampa General Cir 5th Fl Fax: (855) 527-5510 Tampa, FL 33606 00 Yrs/18 Yrs (813) 259-8812 Mease Countryside Hospital Fax: (813) 259-8810 PCMH: No 00 Yrs/12 Yrs Tampa General Hospital Haubner, Laura MD M-F 8:00 AM - 5:00 PM Provider ID: 167215 PCMH: No Gender: Female USF Physicicans Group Fant, Michael MD 2 Tampa General Cir 2nd Fl Provider ID: 506925 Tampa, FL 33606 Gender: Male (813) 844-7224 University Medical Service Fax: (813) 259-8810 Assoc 00 Yrs/03 Yrs 1 Tampa General Cir M-F 8:00 AM - 5:00 PM Tampa, FL 33606 PCMH: No (305) 243-4546 00 Yrs/12 Yrs Ho, Thao DO Tampa General Hospital Provider ID: 1226408 M-F 9:00 AM - 5:00 PM Gender: Female PCMH: No USF Physicians Group Ferry, Jenelle MD 1 Tampa General Cir Tampa, FL 33606 Provider ID: 607323 (813) 844-3547 Gender: Female Fax: (813) 844-1671 Pediatrix Medical Group of Florida 00 Yrs/18 Yrs 3030 W Dr MLK Blvd M-F 9:00 AM - 5:00 PM Tampa, FL 33607 PCMH: No (813) 872-2924 Houin, Satya MD Fax: (855) 527-5510 Provider ID: 987154 00 Yrs/18 Yrs Gender: Female PCMH: No Pediatrix Medical Group of Flores Torres, Jaime MD Florida 3030 W Dr MLK Blvd Tampa, FL 33607 Provider ID: 819187 (813) 870-4000 Gender: Male Fax: (855) 527-5510 USF Physicians Group 00 Yrs/18 Yrs 1 Tampa General Cir PCMH: No Tampa, FL 33606 (813) 844-3437 Fax: (813) 844-1671 00 Yrs/01 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Maheshwari, Akhil MD Provider ID: 981608 Gender: Male USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-3437 Fax: (813) 844-1671 00 Yrs/130 Yrs Tampa General Hospital Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Martinasek, Dushan MD Provider ID: 209600 Gender: Male Pediatrix Medical Group of Florida 3030 W ML King Jr Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No Parilla, Erin MD Provider ID: 462020 Gender: Female Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No Rabenstein, Eric DO Provider ID: 993036 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No

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Sheridan, Richard MD Provider ID: 417949 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No Solomon, Kenneth MD Provider ID: 973231 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No Vargas, Alfonso MD Provider ID: 618069 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No Wyble, Lance MD Provider ID: 12938 Gender: Male Pediatrix Medical Group of Florida 3030 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Nephrology Bassil, Claude MD Provider ID: 978763 Gender: Male USF Physicians Group 13330 USF Laurel Dr 6th Fl Tampa, FL 33612 (813) 974-4115 Fax: (813) 974-7581 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Caintic, Alberto MD Provider ID: 1189802 Gender: Male Alberto B Caintic, MD 10920 Sheldon Rd Tampa, FL 33626 (813) 792-0770 Fax: (813) 854-2117 18 Yrs/110 Yrs St Josephs Hospital Tampa General Hospital Languages: Tagalog M-F 8:00 AM - 5:00 PM PCMH: No

Durr, Jacques MD Provider ID: 167230 Gender: Male 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-4115 18 Yrs/130 Yrs Languages: French, Italian, German M-F 8:00 AM - 5:00 PM PCMH: No Goel, Naveen MD Provider ID: 950512 Gender: Male American Access Care of Orlando 12666 Telecom Dr Tampa, FL 33637 (813) 972-4700 Fax: (813) 972-4705 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Hernandez, Cecilio MD Provider ID: 5546 Gender: Male 4102 N Macdill Ave Tampa, FL 33607 (813) 870-3979 Fax: (813) 877-1609 18 Yrs/130 Yrs Florida Hospital Tampa Memorial Hospital of Tampa Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No

Castillo, Orlando MD Provider ID: 130 Gender: Male 2810 W Saint Isabel St Ste 101 Tampa, FL 33607 (813) 873-7479 Fax: (813) 877-6324 16 Yrs/130 Yrs Florida Hospital Tampa South Florida Baptist Hospital Tampa General Hospital Iqbal, Saima MD Languages: Spanish Provider ID: 1196223 M-F 9:00 AM - 5:00 PM Gender: Female PCMH: No Tampa Kidney Associates Pl 320 W Fletcher Ave Ste 101 Doumit, Elias MD Tampa, FL 33612 Provider ID: 400753 (813) 775-2352 Gender: Male Fax: (813) 775-2353 USF Physicicans Group 18 Yrs/130 Yrs 2 Tampa General Cir Fl 3 St Josephs Hospital Tampa, FL 33606 M-F 8:30 AM - 4:30 PM (813) 974-4115 PCMH: No Fax: (813) 250-2533 18 Yrs/130 Yrs Languages: French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

Leclercq, Baudouin MD

Navarro, Jesus MD Provider ID: 25836 Gender: Male Provider ID: 1012893 Internal Medicine & Gender: Male Nephrology Assoc Vascular Action LLC 4710 N Habana Ave Ste 300 2810 W Saint Isabel St Ste 102 Tampa, FL 33614 Tampa, FL 33607 (813) 873-1016 (813) 872-8480 Fax: (813) 874-2813 Fax: (813) 872-8579 18 Yrs/130 Yrs 00 Yrs/130 Yrs Munroe Regional Med Center St Josephs Hospital Tampa General Hospital Ocala Regional Medical M-F 9:00 AM - 5:00 PM Center West Marion Community PCMH: No Hospital Ostolaza Garcia, Otto MD Languages: French M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 948021 Gender: Male Lopez Del Valle, Ramon MD Internal Med Nephrology Provider ID: 14651 Assoc Inc Gender: Male 4710 N Habana Ave Ste 300 USF Physicicans Group Tampa, FL 33614 12901 Bruce B Downs Blvd (813) 873-1016 Tampa, FL 33612 Fax: (813) 874-2813 (813) 974-4115 18 Yrs/130 Yrs Fax: (813) 974-7581 CRMC At Bayonet Point 00 Yrs/130 Yrs Florida Hospital Tampa PCMH: No Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM Mathew, Ajay DO PCMH: No Provider ID: 1352386 Gender: Male Ramirez, German MD Florida Medical Clinic PA Provider ID: 28565 12500 N Dale Mabry Hwy Gender: Male Tampa, FL 33618 Tampa Bay Nephrology (813) 782-3727 Associates Fax: (813) 355-5051 4705 N Armenia Ave Ste A 18 Yrs/110 Yrs Tampa, FL 33603 Florida Hospital Tampa (813) 353-8775 Florida Hospital Zephyrhills Fax: (813) 353-3956 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Tampa General Hospital Languages: Spanish Mathew, Ajay DO M-F 9:00 AM - 5:00 PM Provider ID: 1352386 PCMH: No Gender: Male Florida Medical Clinic PA 14320 Bruce B Downs Blvd Tampa, FL 33613 (813) 782-3727 Fax: (813) 355-5051 18 Yrs/110 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Nephrology - cont. Reddivari, Venkata MD Provider ID: 1365941 Gender: Female Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 877-1277 Fax: (813) 876-7073 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM Sun 9:00 AM - 4:30 PM PCMH: No Rodriguez, Fernando MD Provider ID: 1331 Gender: Male 6101 Webb Rd Ste 311 Tampa, FL 33615 (813) 886-7112 Fax: (813) 882-4260 18 Yrs/130 Yrs Florida Hospital Tampa Memorial Hospital of Tampa Tampa Community Hospital Languages: Spanish M-TH 9:00 AM - 5:00 PM PCMH: No Serrano, Gustavo MD Provider ID: 188717 Gender: Male 5101 N Armenia Ave Tampa, FL 33603 (813) 870-6477 Fax: (813) 870-6567 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital M-F 8:00 AM - 4:30 PM PCMH: No

Shah, Jayesh MD Provider ID: 128 Gender: Male Jayesh S Shah MD 1426 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 935-0222 Fax: (813) 877-6324 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:30 PM PCMH: No Varkala, Sreelatha MD Provider ID: 996235 Gender: Female All Kidney Care PA 4543 S Manhattan Ave Ste 103 Tampa, FL 33611 (813) 831-8888 Fax: (813) 831-6292 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Vasudeva, Indi MD Provider ID: 1356310 Gender: Female Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 18 Yrs/130 Yrs St Josephs Hospital University Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Vasudeva, Indi MD Provider ID: 402855 Gender: Female Indi Vasudeva Services Inc 4218 W Linebaugh Ave Tampa, FL 33624 (813) 961-6633 Fax: (813) 961-7733 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No

Neurology Bazargan, Sadaf MD Provider ID: 223798 Gender: Female Pearl Institute 17551 N Dale Mabry Hwy Lutz, FL 33548 (813) 454-4044 Fax: (813) 265-3937 12 Yrs/130 Yrs Languages: Spanish, Persian Farsi M-F 8:00 AM - 5:00 PM PCMH: No Benbadis, Selim MD Provider ID: 26685 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-9478 Fax: (813) 259-0858 18 Yrs/130 Yrs Tampa General Hospital Languages: French M-F 9:00 AM - 5:00 PM PCMH: No Benbadis, Selim MD Provider ID: 26685 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-0858 18 Yrs/130 Yrs Tampa General Hospital Languages: French PCMH: No

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Berges, Eddy MD Provider ID: 9896 Gender: Male 2706 W Saint Isabel St Ste A Tampa, FL 33607 (813) 870-3665 Fax: (813) 870-3668 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa Community Hospital Languages: Spanish M-F 9:00 AM - 4:30 PM PCMH: No Bitar, Hassan MD Provider ID: 190089 Gender: Male Saleh Healthcare Institute Florida 1771 S Kings Ave Brandon, FL 33511 (813) 684-5880 Fax: (813) 200-8420 00 Yrs/130 Yrs Brandon Regional Hospital Largo Medical Center Mease Hospital Dunedin Languages: Hindi, Arabic M-F 9:00 AM - 5:00 PM PCMH: No Borra, Sujatha MD Provider ID: 228858 Gender: Female 13333 N 56th St Tampa, FL 33617 (813) 983-0894 Fax: (813) 983-0956 18 Yrs/130 Yrs Florida Hospital Tampa Languages: Telugu M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Neurology - cont. Burgin, William MD Provider ID: 636082 Gender: Male USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-8551 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Burke, Deborah MD Provider ID: 318037 Gender: Female USF Physicians Group 4001 E Fletcher Ave Fl 6 Tampa, FL 33613 (813) 396-0751 Fax: (813) 905-9829 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Chichkova, Rossita MD Provider ID: 293674 Gender: Female USF Physicicans Group 2 Tampa General Cir 7th Fl Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-8551 00 Yrs/130 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No Csere, Anne DO Provider ID: 1162050 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-9478 Fax: (813) 259-8551 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Csere, Anne DO Provider ID: 1162050 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-8551 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Flores, Noemi MD Provider ID: 978706 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-8551 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Decastro, Maria MD Provider ID: 511977 Gender: Female USF Physicians Group 13330 USF Laurel Dr 5th Fl Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-7138 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Frontera, Alfred MD Provider ID: 523902 Gender: Male USF Physicians Group 13220 USF Laurel Dr Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-7590 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Decker, David MD Provider ID: 766251 Gender: Male Fhpg Neurology of Tampa 3100 E Fletcher Ave Tampa, FL 33613 (813) 615-7075 Fax: (813) 615-7416 00 Yrs/130 Yrs Florida Hospital Heartland M-F 9:00 AM - 5:00 PM PCMH: No Eliazer, Raj MD Provider ID: 305886 Gender: Male Healthpoint Medical Group Inc 2727 W Dr MLK Blvd Ste 700 Tampa, FL 33607 (813) 321-1429 Fax: (813) 321-1431 18 Yrs/130 Yrs Bay Medical Center St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Frontera, Alfred MD Provider ID: 523902 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-8551 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gipson, Amos MD Provider ID: 167359 Gender: Male USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 396-9478 Fax: (813) 259-8551 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Gooch, Clifton MD Provider ID: 330768 Gender: Male USF Physicicans Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-7138 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gooch, Clifton MD Provider ID: 330768 Gender: Male USF Physicicans Group 2 Tampa General Cir 5th Fl Tampa, FL 33606 (813) 250-2183 Fax: (813) 259-8861 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Griffin, Denise MD Provider ID: 4774 Gender: Female Neurological Care Center PA 6101 Webb Rd Ste 210 Tampa, FL 33615 (813) 249-0922 Fax: (813) 886-3903 05 Yrs/130 Yrs Florida Hospital Carrollwood Tampa Community Hospital Tampa General Hospital M-TH 8:30 AM - 3:00 PM F 9:00 AM - 12:00 PM PCMH: No Hauser, Robert Alan MD Provider ID: 7114 Gender: Male USF Physicicans Group 5 Tampa General Cir Ste 410 Tampa, FL 33606 (813) 844-4455 Fax: (813) 844-4456 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Neurology - cont. Hurst, Rebecca MD Provider ID: 1109484 Gender: Female 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 259-8551 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Kamat, Shrinath MD Provider ID: 9246 Gender: Male Bay Area Neurology Associates 2908 W Waters Ave Ste 102 Tampa, FL 33614 (813) 931-9294 Fax: (813) 936-0053 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Jimenez Sanders, Rebecca MD Maldonado, Janice MD Provider ID: 1109485 Gender: Female USF Physicians Group 6 Tampa General Cir Tampa, FL 33606 (813) 844-7900 Fax: (813) 844-4082 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kalidas, Kavita MD Provider ID: 558209 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 905-9962 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No Kalidas, Kavita MD Provider ID: 558209 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 905-9962 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1162052 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7590 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Maldonado, Janice MD Provider ID: 1162052 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 974-7590 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Patidar, Bhavin MD Provider ID: 1368378 Gender: Male Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 18 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Sahoo, Sanjiv MD Provider ID: 787151 Gender: Male 2727 W Dr MLK Blvd Ste 700 Tampa, FL 33607 (813) 321-1429 Fax: (813) 321-1431 18 Yrs/130 Yrs St Josephs Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Saleh, Mohamad MD Provider ID: 642792 Gender: Male Saleh Healthcare Institute Florida 1771 S Kings Ave Brandon, FL 33511 (813) 684-5880 Fax: (813) 662-2550 00 Yrs/130 Yrs Oak Hill Hospital M-F 9:00 AM - 5:00 PM PCMH: No Sanchez-Ramos, Juan MD Provider ID: 12940 Gender: Male USF Physicians Group - IPA 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-8032 00 Yrs/130 Yrs Tampa General Hospital University Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sanchez-Ramos, Juan MD Provider ID: 12940 Gender: Male USF Physicians Group - IPA 2A Columbia Dr 3rd Fl Tampa, FL 33606 (813) 396-9478 Fax: (813) 974-8032 00 Yrs/130 Yrs Tampa General Hospital University Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Shriver, Mary DO Provider ID: 4772 Gender: Female Neurological Care Center Lpa 6101 Webb Rd Ste 210 Tampa, FL 33615 (813) 249-0922 Fax: (813) 886-3903 05 Yrs/130 Yrs Florida Hospital Carrollwood Tampa Community Hospital Tampa General Hospital M-TH 8:30 AM - 3:00 PM F 9:00 AM - 12:00 PM PCMH: No Stephens, Hera MD Provider ID: 637672 Gender: Female 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-9478 Fax: (813) 905-9962 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Suradi, Alexis MD Provider ID: 1241669 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-3478 Fax: (813) 974-7590 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Suradi, Alexis MD Provider ID: 1241669 Gender: Female USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 396-9478 Fax: (813) 251-8551 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Neurology - cont. Suradi, Yazan MD Provider ID: 1282708 Gender: Female USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 396-3478 Fax: (813) 974-7590 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Suradi, Yazan MD Provider ID: 1282708 Gender: Female USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 396-9478 Fax: (813) 251-8551 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Velez Camacho, Hector MD Provider ID: 1344842 Gender: Male Florida Medical Clinic, PA 13801 Bru B Downs Blvd Ste 401 Tampa, FL 33613 (813) 971-8811 Fax: (813) 971-6951 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Vu, Tuan MD Provider ID: 572715 Gender: Male USF Physicicans Group 13330 Laurel Dr Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-7590 18 Yrs/130 Yrs Languages: Vietnamese M-F 9:00 AM - 5:00 PM PCMH: No

Vu, Tuan MD Provider ID: 572715 Gender: Male USF Physicicans Group 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 905-9891 18 Yrs/130 Yrs Languages: Vietnamese M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 190379 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-8577 Fax: (813) 259-0858 00 Yrs/21 Yrs Mease Hospital Dunedin University Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Neuromuscular Medicine Vu, Tuan MD Provider ID: 572715 Gender: Male USF Physicicans Group 13330 Laurel Dr Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-7590 18 Yrs/130 Yrs Languages: Vietnamese M-F 9:00 AM - 5:00 PM PCMH: No Vu, Tuan MD Provider ID: 572715 Gender: Male USF Physicicans Group 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 905-9891 18 Yrs/130 Yrs Languages: Vietnamese M-F 9:00 AM - 5:00 PM PCMH: No

Neuroradiology Degala, Sree MD Provider ID: 1242888 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8845 Fax: (813) 250-2156 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lefler, James MD Provider ID: 657148 Gender: Male Medical Group of Tampa Bay Orthopae 3100 E Fletcher Ave Tampa, FL 33613 (813) 615-7075 Fax: (813) 615-7416 00 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-TH 8:00 AM - 4:30 PM F 8:00 AM - 12:00 PM PCMH: No

Neurosurgery Agazzi, Siviero MD Provider ID: 301631 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs Languages: Spanish, Italian, German M-F 8:00 AM - 5:00 PM PCMH: No Balis, Gene MD Provider ID: 1095355 Gender: Male 2 Tampa General Cir Tampa, FL 33606 (813) 259-0965 Fax: (813) 259-0558 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Deukmedjian, Armen MD Provider ID: 978123 Gender: Male USF Physicians Group 3000 Medical Park Dr Ste 310 Tampa, FL 33613 (813) 396-9936 Fax: (813) 558-1065 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Elhammady, Mohamed MD Provider ID: 1095353 Gender: Male Baycare Medical Group 2727 W Dr MLK Blvd Ste 460 Tampa, FL 33607 (813) 879-4328 Fax: (813) 443-8152 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Freeman, Thomas MD Provider ID: 7088 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0944 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gonzales Portillo, Gabriel MD Provider ID: 305188 Gender: Male Baycare Medical Group 2727 W MLK Jr Blvd Ste 460 Tampa, FL 33607 (813) 879-4328 Fax: (813) 443-8152 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Neurosurgery - cont. Greenberg, Mark MD Provider ID: 274451 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0889 Fax: (813) 259-0886 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Jain, Surbhi MD Provider ID: 802251 Gender: Female 19105 N US Hwy 41 Ste 300 Lutz, FL 33549 (352) 340-5921 00 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa PCMH: No Kan, Peter Tze Man MD Provider ID: 669181 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0965 Fax: (813) 259-0858 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No King, Michael MD Provider ID: 15578 Gender: Male Neuro-Spinal Associates PA 3909 Galen Ct Ste 104 Sun City Center, FL 33573 (941) 794-3118 00 Yrs/130 Yrs Blake Medical Center Doctors Hospital Sarasota Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Liu, Shih MD Provider ID: 226225 Gender: Female USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Ren, Zeguang MD Provider ID: 1059320 Gender: Male 2 Tampa General Cir Fl 3 Tampa, FL 33606 (813) 259-0979 Fax: (813) 259-0858 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Mokin, Maxim MD Provider ID: 964253 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0965 Fax: (813) 259-0858 00 Yrs/130 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No

Sack, Jayson MD Provider ID: 1340796 Gender: Male Tampa General Medical Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-3980 Fax: (813) 449-8068 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Olivera, Raul MD Provider ID: 704610 Gender: Male 2 Tampa General Cir Tampa, FL 33606 (813) 259-8571 Fax: (813) 259-0858 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Sack, Jayson MD Provider ID: 1340796 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-0858 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Olivera, Raul MD Provider ID: 704610 Gender: Male USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-8571 Fax: (813) 259-0858 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Smith, Donald MD Provider ID: 7269 Gender: Male USF Physicicans Group 2 Tampa General Cir 7th Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Tiesi, James MD Provider ID: 7811 Gender: Male 4051 Upper Creek Dr Ste 100 Sun City Center, FL 33573 (941) 794-3118 00 Yrs/130 Yrs Columbia South Bay Hospital Doctors Hospital Sarasota Lakewood Ranch Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Tiesi, James MD Provider ID: 7811 Gender: Male Neuro Spinal Associates PA 3909 Galen Ct Ste 104 Sun City Center, FL 33573 (941) 794-3118 00 Yrs/130 Yrs Columbia South Bay Hospital Doctors Hospital Sarasota Lakewood Ranch Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Uribe, Juan MD Provider ID: 410562 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Neurosurgery - cont. Valdivia Valdivia, Juan MD Provider ID: 1064139 Gender: Male Baycare Medical Group 2727 W MLK Jr Blvd Ste 406 Tampa, FL 33607 (813) 879-4328 Fax: (813) 443-8152 18 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, French, Portuguese M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Vale, Fernando MD Provider ID: 15607 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Van Loveren, Harry MD Provider ID: 201226 Gender: Male USF Physicians Group 2 Tampa General Cir Fl 3 Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Obstetrics Armas, Ignacio MD Provider ID: 3191 Gender: Male OB GYN Associates 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Armas, Ignacio MD Provider ID: 3191 Gender: Male OB GYN Associates 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish MWTHF 9:00 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Armas, Ignacio MD Provider ID: 3191 Gender: Male OB GYN Associates 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Armas, Ignacio MD Provider ID: 3191 Gender: Male OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Arnold, Heidi MD Provider ID: 19921 Gender: Female OB GYN Assoc 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Arnold, Heidi MD Provider ID: 19921 Gender: Female OB GYN Assoc 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8663 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Arnold, Heidi MD Provider ID: 19921 Gender: Female OB GYN Assoc 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Arnold, Heidi MD Provider ID: 19921 Gender: Female OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Baron, James MD Provider ID: 25140 Gender: Male OB GYN Associates 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Baron, James MD Provider ID: 25140 Gender: Male OB GYN Associates 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Baron, James MD Provider ID: 25140 Gender: Male OB GYN Associates 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics - cont. Baron, James MD Provider ID: 25140 Gender: Male OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chamorro Roberts, Zayda MD Provider ID: 463987 Gender: Female OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chamorro Roberts, Zayda MD Provider ID: 463987 Gender: Female Tampa Bay Womens Hlthcare Alliance 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Chamorro Roberts, Zayda MD Den-Haese, Greg MD Provider ID: 463987 Gender: Female Tampa Bay Womens Hlthcare Alliance 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Chamorro Roberts, Zayda MD Provider ID: 463987 Gender: Female Tampa Bay Womens Hlthcare Alliance 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Den-Haese, Greg MD Provider ID: 299600 Gender: Male Womens Care Florida 103 Southern Oaks Dr Plant City, FL 33563 (813) 754-7561 Fax: (813) 754-5489 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 299600 Gender: Male Womens Care Florida 13123 Kings Lake Dr Ste 102 Gibsonton, FL 33534 (813) 574-1350 Fax: (813) 574-1360 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Den-Haese, Greg MD Provider ID: 299600 Gender: Male Womens Care Florida 5470 Lithia Pinecrest Rd Lithia, FL 33547 (813) 699-1006 Fax: (813) 699-1012 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Den-Haese, Greg MD Provider ID: 299600 Gender: Male Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Fernandez-Boratti, Maruja MD Provider ID: 173143 Gender: Female Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa South Florida Baptist Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Fernandez-Boratti, Maruja MD Provider ID: 173143 Gender: Female Womens Care Florida LLC 103 Southern Oaks Dr Plant City, FL 33566 (813) 754-7561 Fax: (813) 754-5489 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa South Florida Baptist Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Fernandez-Boratti, Maruja MD Provider ID: 173143 Gender: Female Womens Care Florida LLC 13123 Kings Lake Dr Ste 102 Gibsonton, FL 33534 (866) 418-3489 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa South Florida Baptist Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics - cont. Fernandez-Boratti, Maruja MD

Granger, Steven MD Provider ID: 436323 Gender: Male Womens Care Florida 103 Southern Oaks Dr Plant City, FL 33563 (813) 754-7561 Fax: (813) 754-5489 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 173143 Gender: Female Womens Care Florida LLC 5470 Lithia Pinecrest Rd Lithia, FL 33547 (813) 699-1006 Fax: (813) 699-1012 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa South Florida Baptist Hospital Languages: Spanish Granger, Steven MD M-F 9:00 AM - 5:00 PM PCMH: No Provider ID: 436323 Gender: Male Gooden, Natasha MD Womens Care Florida 13123 Kings Lake Dr Unit 102 Provider ID: 979313 Gibsonton, FL 33534 Gender: Female (813) 574-1350 Womens Care Florida LLC Fax: (813) 574-1360 3268 Cove Bend Dr 12 Yrs/130 Yrs Tampa, FL 33613 Brandon Regional Hospital (813) 971-4555 Languages: Spanish Fax: (813) 972-3782 M-F 8:00 AM - 5:00 PM 12 Yrs/130 Yrs PCMH: No Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM Granger, Steven MD F 7:30 AM - 4:00 PM PCMH: No Provider ID: 436323 Gender: Male Gooden, Natasha MD Womens Care Florida 5470 Lithia Pinecrest Rd Provider ID: 979313 Lithia, FL 33547 Gender: Female (813) 699-1006 Womens Care Florida LLC Fax: (813) 699-1012 4150 N Armenia Ave Ste 200 12 Yrs/130 Yrs Tampa, FL 33607 Brandon Regional Hospital (813) 876-0914 Languages: Spanish Fax: (813) 876-9198 M-F 8:00 AM - 5:00 PM 12 Yrs/130 Yrs PCMH: No Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Granger, Steven MD Provider ID: 436323 Gender: Male Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Greenberg, Steven MD Provider ID: 18767 Gender: Male 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Hinson Knipple, Lindsay MD Provider ID: 964450 Gender: Female Womens Care Florida LLC 2818 W Virginia Ave Tampa, FL 33607 (813) 872-8551 Fax: (813) 871-3708 12 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Hinson Knipple, Lindsay MD Provider ID: 964450 Gender: Female Womens Care Florida LLC 5 Tampa General Cir Tampa, FL 33606 (813) 644-6200 Fax: (813) 304-2427 12 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Hinson Knipple, Lindsay MD Provider ID: 964450 Gender: Female Womens Care Florida LLC 727 W Fletcher Ave Tampa, FL 33612 (813) 908-2229 Fax: (813) 963-7045 12 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Irani, Jennifer MD Provider ID: 969460 Gender: Female Womens Care Florida LLC 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Irani, Jennifer MD Provider ID: 969460 Gender: Female Womens Care Florida LLC 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Jones, Allyson MD Provider ID: 299509 Gender: Female OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics - cont. Jones, Allyson MD Provider ID: 299509 Gender: Female Tampa Bay Womens Care 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jones, Allyson MD Provider ID: 299509 Gender: Female Tampa Bay Womens Care 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Jones, Allyson MD Provider ID: 299509 Gender: Female Tampa Bay Womens Care 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Jones, Galen MD Provider ID: 18768 Gender: Male Insignia Care For Women 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Lopez Troy, Jennifer MD Provider ID: 947058 Gender: Female Womens Care Florida 13123 Kings Lake Dr Unit 102 Gibsonton, FL 33534 (813) 574-1350 Fax: (813) 574-1360 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Miller, Tracey MD Provider ID: 984992 Gender: Female Womens Care Florida LLC 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Lopez Troy, Jennifer MD

Newton, William MD

Jones, Galen MD Provider ID: 18768 Gender: Male Insignia Care For Women 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Provider ID: 947058 Gender: Female Womens Care Florida 5470 Lithia Pinecrest Rd Lithia, FL 33547 (813) 699-1006 Fax: (813) 699-1012 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Lopez Troy, Jennifer MD Provider ID: 947058 Gender: Female Womens Care Florida 103 Southern Oaks Dr Plant City, FL 33563 (813) 754-7581 Fax: (813) 754-5489 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Lopez Troy, Jennifer MD Provider ID: 947058 Gender: Female Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Miller, Tracey MD Provider ID: 984992 Gender: Female Womens Care Florida LLC 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

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Provider ID: 18766 Gender: Male Womens Care Florida 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Newton, William MD Provider ID: 18766 Gender: Male Womens Care Florida 3743 Maryweather Ln Tampa, FL 33607 (813) 973-0398 Fax: (813) 907-7608 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics - cont. Newton, William MD Provider ID: 18766 Gender: Male Womens Care Florida 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Patel, Niraj MD Provider ID: 542049 Gender: Male Womens Care Florida LLC 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Languages: Hindi, Gujarati M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Patel, Niraj MD Provider ID: 542049 Gender: Male Womens Care Florida LLC 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Languages: Hindi, Gujarati M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Pitt, Catherine MD Provider ID: 165232 Gender: Female Womens Care Florida LLC 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Pitt, Catherine MD Provider ID: 165232 Gender: Female Womens Care Florida LLC 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Pitt, Catherine MD Provider ID: 165232 Gender: Female Womens Care Florida LLC 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Von Thron, James MD Provider ID: 18759 Gender: Male Womens Care Florida LLC 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-8865 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No Von Thron, James MD

Pitt, Catherine MD Provider ID: 165232 Gender: Female Womens Care Florida LLC 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 18759 Gender: Male Womens Care Florida LLC 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Watkins, Antoinina MD Provider ID: 271801 Gender: Female 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Watkins, Antoinina MD Provider ID: 271801 Gender: Female 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Watkins, Antoinina MD Provider ID: 271801 Gender: Female 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Watkins, Antoinina MD Provider ID: 271801 Gender: Female OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Whitehead, Keith MD Provider ID: 10667 Gender: Male Womens Care Florida 103 Southern Oaks Dr Plant City, FL 33563 (813) 754-7561 Fax: (813) 754-5489 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics - cont. Whitehead, Keith MD Provider ID: 10667 Gender: Male Womens Care Florida 13123 Kings Lake Dr Ste 102 Gibsonton, FL 33534 (813) 574-1350 Fax: (813) 574-1360 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Wilkerson, Wallace MD Provider ID: 18758 Gender: Male Womens Care Florida LLC 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Wilkerson, Wallace MD

Whitehead, Keith MD Provider ID: 10667 Gender: Male Womens Care Florida 5470 Lithia Pinecrest Rd Lithia, FL 33547 (813) 699-1006 Fax: (813) 699-1012 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Whitehead, Keith MD Provider ID: 10667 Gender: Male Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 18758 Gender: Male Womens Care Florida LLC 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Obstetrics/Gynecology Abdel-Aziz, Mohamed MD Provider ID: 1600 Gender: Male 620 Eichenfeld Dr Brandon, FL 33511 (813) 654-3200 Fax: (813) 653-0232 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Tampa General Hospital Languages: Arabic M-TH 9:00 AM - 5:00 PM F 9:00 AM - 1:00 PM PCMH: No

Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 2550 W Martin Luther King Jr Blvd Ste C Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

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Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 2701 W Martin Luther King Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Arkin, Steven MD cont. Provider ID: 1051116 Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2273 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Amis, Jacqueline MD Provider ID: 1226407 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 974-4280 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Amis, Jacqueline MD Provider ID: 1226407 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Amis, Jacqueline MD Provider ID: 1226407 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male Steven Arkin MD 1913 W MLK Jr Blvd Tampa, FL 33607 (813) 376-3790 Fax: (813) 232-5904 12 Yrs/130 Yrs MT 9:00 AM - 4:00 PM PCMH: No Baker, Marisa MD Provider ID: 244659 Gender: Female 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Baker, Marisa MD Provider ID: 244659 Gender: Female USF Physicians Group 13330 USF Laurel Dr 5th Fl Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Baker, Marisa MD Provider ID: 244659 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Baker, Marisa MD Provider ID: 244659 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 259-8500 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Baldwin, Melisha MD Provider ID: 655231 Gender: Female Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Baldwin, Melisha MD Provider ID: 655231 Gender: Female Tampa Obstetrics PA 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Baldwin, Melisha MD Provider ID: 655231 Gender: Female Tampa Obstetrics PA 2701 W Martin Luther King Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

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Baldwin, Melisha MD Provider ID: 655231 Gender: Female Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Baldwin, Melisha MD Provider ID: 655231 Gender: Female Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Bassaly, Renee DO Provider ID: 636083 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 396-2487 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Bassaly, Renee DO Provider ID: 636083 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Betancourt, Fernando MD cont.

Bruder, Karen MD Provider ID: 179024 Gender: Female Provider ID: 916905 Belogolovkin, Victoria MD USF Physicians Group Gender: Male All Womens Health Center of 12901 Bruce B Downs Blvd Tampa I Tampa, FL 33612 Provider ID: 1282640 3330 W Kennedy Blvd (813) 974-2201 Gender: Female Tampa, FL 33609 00 Yrs/130 Yrs Women's Care Floirda, LLC (813) 874-0505 Tampa General Hospital 5 Tampa General Cir Fax: (813) 376-7233 M-F 8:00 AM - 5:00 PM Tampa, FL 33606 12 Yrs/130 Yrs PCMH: No (813) 644-6200 Languages: Spanish Fax: (813) 304-2428 Bruder, Karen MD M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs Provider ID: 179024 PCMH: No Languages: Spanish Gender: Female M-F 8:30 AM - 4:30 PM Brown, Amy MD USF Physicians Group PCMH: No Provider ID: 1419346 5802 N 30th St Gender: Female Tampa, FL 33610 Betancourt, Fernando MD USF Physicians Group (813) 236-5100 13330 USF Laurel Dr 5th Fl Fax: (813) 236-5222 Provider ID: 808702 Tampa, FL 33612 00 Yrs/130 Yrs Gender: Male (813) 259-8500 Tampa General Hospital All Women's Health Center of Fax: (813) 974-7687 M-F 8:00 AM - 5:00 PM Tampa 00 Yrs/130 Yrs PCMH: No 3330 W Kennedy Blvd Tampa General Hospital Tampa, FL 33609 Bruder, Karen MD M 8:00 AM - 5:00 PM (813) 874-0505 Provider ID: 357270 TWTHF 9:00 AM - 5:00 PM Fax: (813) 876-7233 Gender: Female PCMH: No 12 Yrs/130 Yrs Womens Health Care Lee Memorial Hospital Brown, Amy MD 4 Columbia Dr Ste 240 Languages: Spanish Provider ID: 1419346 Tampa, FL 33606 M-F 9:00 AM - 5:00 PM Gender: Female (813) 258-3309 PCMH: No USF Physicians Group Fax: (813) 251-4454 2 Tampa General CR 4th Fl 00 Yrs/130 Yrs Betancourt, Fernando MD Tampa, FL 33606 Tampa General Hospital (813) 259-8500 M-F 8:00 AM - 5:00 PM Provider ID: 907093 Fax: (813) 259-8623 PCMH: No Gender: Male 00 Yrs/130 Yrs All Womens Health Center of Cain, Mary MD Tampa General Hospital North Provider ID: 678053 M-F 8:00 AM 5:00 PM 14498 University Cove Pl Gender: Female PCMH: No Tampa, FL 33613 2 Tampa General Cir 4th Fl (813) 978-1919 Brown, Amy MD Tampa, FL 33606 Fax: (813) 978-1919 Provider ID: 1419346 (813) 259-8500 12 Yrs/130 Yrs Gender: Female Fax: (813) 259-0827 Languages: Spanish USF Physicians Group 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM 5802 N 30th St 5th Fl St Josephs Hospital PCMH: No Tampa, FL 33610 M-F 8:00 AM - 5:00 PM (813) 236-5100 PCMH: No Fax: (813) 238-1385 00 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 5:00 PM TWTHF 9:00 AM - 5:00 PM PCMH: No

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Caselnova, Petra MD Provider ID: 1143543 Gender: Female Women's Care Florida LLC 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Caselnova, Petra MD Provider ID: 1143543 Gender: Female Women's Care Florida LLC 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Caselnova, Petra MD Provider ID: 1143543 Gender: Female Women's Care Florida, LLC 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Cazes, Elliot MD Provider ID: 26474 Gender: Male New Tampa OB/GYN 14424 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-2757 Fax: (813) 977-6639 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Colalillo, Maryanne MD cont. Champion, Natasha MD

Provider ID: 1142493 Gender: Female Women's Care Floirda LLC 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 443203 Gender: Female Womens Health and Wellness 13148 Vail Ridge Dr Riverview, FL 33579 (813) 571-2777 Fax: (813) 571-2888 00 Yrs/130 Yrs Brandon Regional Hospital Colalillo, Maryanne MD M-F 8:30 AM - 5:00 PM PCMH: No Provider ID: 1142493 Champion, Natasha MD Gender: Female Women's Care Floirda LLC 16301 Fishhawk Blvd Ste 102 Provider ID: 443203 Lithia, FL 33547 Gender: Female Womens Health and Wellness (813) 530-4180 Fax: (813) 530-4181 815 S Parsons Ave 12 Yrs/130 Yrs Brandon, FL 33511 Brandon Regional Hospital (813) 571-2777 M-F 8:00 AM - 5:00 PM Fax: (813) 571-2888 PCMH: No 00 Yrs/130 Yrs Brandon Regional Hospital Colalillo, Maryanne MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 1142493 Colalillo, Maryanne MD Gender: Female Women's Care Florida, LLC 116 Parsons Park Dr Provider ID: 1142493 Brandon, FL 33511 Gender: Female (813) 681-6625 Women's Care Floirda LLC Fax: (813) 684-6043 13149 Elk Mountain Dr 12 Yrs/130 Yrs Riverview, FL 33579 Brandon Regional Hospital (813) 675-8326 M-F 8:00 AM - 5:00 PM Fax: (813) 675-8336 PCMH: No 12 Yrs/130 Yrs Brandon Regional Hospital Connery, Sheila MD M-F 8:00 AM - 5:00 PM Provider ID: 364319 PCMH: No Gender: Female USF Physicians Group 2 Tampa General Cir Fl 6 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Cox, Carol MD Provider ID: 199952 Gender: Female USF Physicians Group 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Davis, Mark MD Provider ID: 1200231 Gender: Male Premier OB/GYN of Tampa, LLP 2727 W Dr MLK Blvd Ste 630 Tampa, FL 33607 (813) 876-6000 Fax: (813) 876-0590 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:00 PM PCMH: No

Edwards, Eric MD Provider ID: 1356319 Gender: Male Tampa Obstetrics PA Exodus Womens 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 413-8563 16 Yrs/130 Yrs Florida Hospital Orlando Orlando Regional Medical Center M-F 8:00 AM - 5:30 PM PCMH: No Ericsson, Dawn MD Provider ID: 1295816 Gender: Female Women's Health Hospitalists 6901 Simmons Loop Riverview, FL 33578 (813) 286-0033 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Disalvo, Heidi DO Provider ID: 1043446 Ericsson, Dawn MD Gender: Female Womens Health and Wellness Provider ID: 540647 Gender: Female 13148 Vail Ridge Dr 1513 W Busch Blvd Riverview, FL 33579 Tampa, FL 33612 (813) 571-2777 (813) 654-2229 Fax: (813) 571-2888 Fax: (813) 654-1384 00 Yrs/130 Yrs 05 Yrs/130 Yrs Brandon Regional Hospital Brandon Regional Hospital M-F 8:30 AM - 4:30 PM St Josephs Hospital PCMH: No M-F 9:00 AM - 5:00 PM Disalvo, Heidi DO PCMH: No Provider ID: 1043446 Ericsson, Dawn MD Gender: Female Womens Health and Wellness Provider ID: 540647 Gender: Female 815 S Parsons Ave Exodus Women's Center Brandon, FL 33511 14710 Bruce B Downs Blvd (813) 571-2777 Tampa, FL 33613 Fax: (813) 571-2888 (813) 684-2229 00 Yrs/130 Yrs Fax: (813) 654-1384 Brandon Regional Hospital 05 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Brandon Regional Hospital PCMH: No St Josephs Hospital M-F 8:00 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 196

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Felski, Emil DO cont. Provider ID: 1229396 Ericsson, Dawn MD Provider ID: 540647 Gender: Female Exodus Women's Center 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 05 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:30 PM PCMH: No Ericsson, Dawn MD Provider ID: 540647 Gender: Female Exodus Women's Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 05 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:30 PM PCMH: No Fanarjian, Nicole MD Provider ID: 985158 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM PCMH: No

Gender: Male Planned Parenthood of Southwest and 8068 N 56th St Tampa, FL 33617 (407) 677-1234 Fax: (407) 677-1001 12 Yrs/130 Yrs M-F 8:45 AM - 4:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Figueroa Rivera, Nitza MD Provider ID: 1146908 Gender: Female Brandon Community Health Center 710 Oakfield Dr Ste 120 Brandon, FL 33510 (813) 423-7101 Fax: (813) 423-7102 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Figueroa Rivera, Nitza MD

Funai, Edmund MD Provider ID: 1183028 Gender: Male 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Funai, Edmund MD Provider ID: 1183028 Gender: Male 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5188 21 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gomez, Daniel MD Provider ID: 1109488 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 974-4280 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1146908 Gender: Female Palm River Community Health Greene, Kristie MD Center Provider ID: 1279592 7728 Palm River Rd Gender: Female Tampa, FL 33619 USF Physicians Group (813) 630-3600 2 Tampa General Cir 4th Fl Fax: (813) 620-1614 Tampa, FL 33606 12 Yrs/130 Yrs (813) 259-8500 Brandon Regional Hospital Fax: (813) 259-8582 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Tampa General Hospital M-F 9:00 AM - 5:00 PM Florida Dept of Health In PCMH: No Hillsborough C Provider ID: 489561 Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8060 Fax: (813) 276-2999 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Hardy-Hunter, Eleanine MD Provider ID: 965935 Gender: Female Florida Woman Care LLC 3203 W Tampa Bay Blvd Tampa, FL 33607 (813) 872-4401 Fax: (813) 872-4814 12 Yrs/130 Yrs Tampa Community Hospital Languages: Spanish M-TH 8:15 AM - 5:00 PM F 8:15 AM - 4:00 PM PCMH: No Hart, Stuart MD Provider ID: 362012 Gender: Male USF Physicicans Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Hechtman, Jill MD Provider ID: 274423 Gender: Female 1513 W Busch Blvd Tampa, FL 33612 (813) 654-2229 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No Hechtman, Jill MD Provider ID: 274423 Gender: Female Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Hechtman, Jill MD cont. Provider ID: 274805 Hechtman, Jill MD Provider ID: 274423 Gender: Female Exodus Womens Center 2701 W MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Hechtman, Jill MD Provider ID: 274423 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No Hechtman, Jill MD Provider ID: 274805 Gender: Female Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Gender: Female Tampa Obstetrics PA 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Hechtman, Jill MD Provider ID: 274805 Gender: Female Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Hernandez, Lazaro MD Provider ID: 18189 Gender: Male Hernandez Lazaro MD 2309 W MLK Blvd Ste 1 Tampa, FL 33607 (813) 879-2778 Fax: (813) 877-6761 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Italian MW 9:00 AM - 5:00 PM T 9:00 AM - 1:00 PM PCMH: No Hochberg, Lauri MD Provider ID: 176573 Gender: Female USF Physicicans Group 5 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Hechtman, Jill MD Provider ID: 274805 Gender: Female Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Holmstrom, Shelly MD

Henne, Melinda MD

Holmstrom, Shelly MD

Provider ID: 1365578 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-0692 Fax: (813) 259-0882 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Holmstrom, Shelly MD Provider ID: 1149616 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Holmstrom, Shelly MD Provider ID: 1149616 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7600 Fax: (813) 349-7661 00 Yrs/130 Yrs MWTHF 7:45 AM - 5:00 PM T 7:45 AM - 7:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Holmstrom, Shelly MD

Provider ID: 1149616 Gender: Female Brandon Community Health Center 710 Oakfield Dr Brandon, FL 33510 (813) 423-7101 Fax: (813) 423-7102 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1149616 Gender: Female Oakfield Community Health Center 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 280-4328 Fax: (813) 498-2823 00 Yrs/130 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

www.wellcare.com/Florida | 198

Provider ID: 1149616 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Holmstrom, Shelly MD Provider ID: 1149616 Gender: Female Suncoast Mobile Medical Bus 14254 State Rd 574 Dover, FL 33527 (813) 312-1558 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Holstrom, Shelly MD cont. Provider ID: 246560

Jackson, Darwin MD

Jones, Malcolm MD Provider ID: 916707 Gender: Female Gender: Male Provider ID: 916885 Holmstrom, Shelly MD USF Physicicans Group All Womens Health Gender: Male 2 Tampa General Cir 4th Fl All Womens Health Center of 14498 University Cove Pl Tampa, FL 33606 Tampa I Tampa, FL 33613 Provider ID: 1149616 (813) 259-8500 3330 W Kennedy Blvd (813) 978-1919 Gender: Female Fax: (813) 259-8593 Tampa, FL 33609 Fax: (813) 978-1899 Tom Lee Community Health 00 Yrs/130 Yrs (813) 874-0505 12 Yrs/130 Yrs Center Tampa General Hospital Fax: (813) 876-7233 M-F 9:00 AM - 5:00 PM 14254 SR 574 Languages: German 12 Yrs/130 Yrs PCMH: No Dover, FL 33527 M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM (813) 349-7700 Kamath, Maya MD PCMH: No PCMH: No Fax: (813) 349-7761 Provider ID: 1129646 00 Yrs/130 Yrs Johnson II, Howard MD Imudia, Anthony MD Gender: Female MWTHF 8:00 AM - 5:00 PM Provider ID: 4068 Provider ID: 789831 Womens Care Florida T 8:00 AM - 7:00 PM Gender: Male Gender: Male 103 Southern Oaks Dr PCMH: No Bay Area OB/GYN PA USF Physicians Group Plant City, FL 33563 Holmstrom, Shelly MD 2 Tampa General Cir Ste 4000 13801 Bruce B Downs Blvd (813) 754-7561 Tampa, FL 33613 Tampa, FL 33606 Fax: (813) 754-5489 (813) 975-9788 (813) 259-8500 12 Yrs/130 Yrs Provider ID: 1149616 Fax: (813) 971-9716 Fax: (813) 259-0827 Brandon Regional Hospital Gender: Female 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Wimauma Community Health 00 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Center M-F 9:00 AM - 5:00 PM PCMH: No 5121 State Rd 674 PCMH: No Kamath, Maya MD Wimauma, FL 33598 Jackson, Darwin MD Provider ID: 1129646 (813) 349-7880 Johnson II, Howard MD Gender: Female Fax: (813) 633-2669 Provider ID: 211469 Womens Care Florida Provider ID: 450510 00 Yrs/130 Yrs Gender: Male 13123 Kings Lake Dr Gender: Male M-F 8:00 AM - 5:00 PM Gibsonton, FL 33534 All Womens Health Center of Bay Area OB-GYN, PA PCMH: No 13801 Bru B Downs Blvd Ste Tampa (813) 574-1350 201 Holstrom, Shelly MD 3330 W Kennedy Blvd Fax: (813) 574-1360 Tampa, FL 33613 Tampa, FL 33609 12 Yrs/130 Yrs Provider ID: 246560 (813) 975-9788 (813) 874-0505 Brandon Regional Hospital Gender: Female Fax: (813) 971-9716 Fax: (813) 876-7233 M-F 8:30 AM - 5:00 PM USF Physicians Group 12 Yrs/130 Yrs 12 Yrs/130 Yrs PCMH: No 13330 USF Laurel Dr Florida Hospital Tampa M-F 9:00 AM - 5:00 PM Tampa, FL 33612 Tampa General Hospital Kamath, Maya MD PCMH: No (813) 259-8500 MT 9:00 AM 5:00 PM Provider ID: 1129646 Fax: (813) 259-8593 PCMH: No Jackson, Darwin MD Gender: Female 00 Yrs/130 Yrs Womens Care Florida Tampa General Hospital Jones, Malcolm MD 5470 Lithia Pinecrest Rd Provider ID: 916711 Languages: German Provider ID: 805176 Lithia, FL 33547 Gender: Male M-F 8:00 AM - 5:00 PM Gender: Male (813) 699-1006 All Womens Health PCMH: No All Womens Health Center of Fax: (813) 699-1012 14498 University Cove Pl Tampa 12 Yrs/130 Yrs Tampa, FL 33613 3330 W Kennedy Blvd Brandon Regional Hospital (813) 978-1919 Tampa, FL 33609 M-F 8:30 AM - 5:00 PM Fax: (813) 978-1899 (813) 874-0505 PCMH: No 12 Yrs/130 Yrs Fax: (813) 376-7233 M-F 9:00 AM - 5:00 PM 12 Yrs/130 Yrs PCMH: No M-F 8:30 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 199

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Levine, Paul MD cont. Provider ID: 1627 Kamath, Maya MD Provider ID: 1129646 Gender: Female Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:30 AM - 5:00 PM PCMH: No Keefe, David MD Provider ID: 301689 Gender: Male USF Physicicans Group 2 Tampa General Cir 4RH Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Khulpateea, Beman MD Provider ID: 1162051 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lamoutte, Carlos MD

Gender: Male 1513 W Busch Blvd Tampa, FL 33612 (813) 654-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Levine, Paul MD Provider ID: 1627 Gender: Male Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Levine, Paul MD Provider ID: 1627 Gender: Male Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No

Levine, Paul MD Provider ID: 1627 Gender: Male Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No

Levine, Paul MD Provider ID: 2539 Gender: Male Tampa Obstetrics PA 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:30 PM PCMH: No

Levine, Paul MD Provider ID: 2539 Gender: Male Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:30 PM PCMH: No

Levine, Paul MD Provider ID: 2539 Gender: Male Tampa Obstetrics PA 404 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:30 PM PCMH: No

Levine, Paul MD Provider ID: 2539 Gender: Male Tampa Obstetrics PA 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:30 PM PCMH: No

Levine, Paul MD Provider ID: 2539 Gender: Male Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:30 PM PCMH: No

Provider ID: 1192609 Gender: Male 1601 W Timberlane Dr Ste 600 Plant City, FL 33566 (813) 321-6677 Fax: (813) 719-3060 18 Yrs/130 Yrs South Florida Baptist Hospital M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 200

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Louis, Judette MD cont. Provider ID: 391389 Llinas Messeguer, Jose MD Provider ID: 1204983 Gender: Male Exodus Women's 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs MT 8:00 AM - 5:00 PM WTHF 9:00 AM - 5:00 PM PCMH: No Llinas Messeguer, Jose MD Provider ID: 1205002 Gender: Male Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No Lockwood, Charles MD Provider ID: 978487 Gender: Male USF Physicians Group 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lockwood, Charles MD Provider ID: 978487 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5188 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Mallick, Sobiah MD Provider ID: 1199089 Gender: Female Gender: Female USF Physicians Group Tampa Obstetrics PA 2 Tampa General Cir 4th Fl 1513 W Busch Blvd Tampa, FL 33606 Tampa, FL 33612 (813) 259-8500 (813) 684-2229 Fax: (813) 259-8582 Fax: (813) 654-1384 00 Yrs/130 Yrs 12 Yrs/130 Yrs South Florida Baptist Hospital M-F 8:00 AM - 5:30 PM Tampa General Hospital PCMH: No Languages: Creole Mallick, Sobiah MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 1199089 Gender: Female Mallick, Sobiah MD Tampa Obstetrics PA Provider ID: 1160685 2550 W Martin Luther Ste C Gender: Female Tampa, FL 33607 Exodus Womens Center Inc (813) 684-2229 2701 W MLK Jr Blvd Fax: (813) 654-1384 Tampa, FL 33607 12 Yrs/130 Yrs (813) 684-2229 M-F 8:00 AM - 5:30 PM Fax: (813) 654-1384 PCMH: No 12 Yrs/130 Yrs Mallick, Sobiah MD M-F 8:00 AM - 5:30 PM PCMH: No Provider ID: 1199089 Gender: Female Mallick, Sobiah MD Tampa Obstetrics PA Provider ID: 1160685 2701 W MLK Jr Blvd Gender: Female Tampa, FL 33607 Exodus Womens Center Inc (813) 684-2229 401 Oakfield Dr Fax: (813) 654-1384 Brandon, FL 33511 12 Yrs/130 Yrs (813) 684-2229 M-F 8:00 AM - 5:30 PM Fax: (813) 654-1384 PCMH: No 12 Yrs/130 Yrs Mallick, Sobiah MD M-F 8:00 AM - 5:30 PM PCMH: No Provider ID: 1199089 Gender: Female Mallick, Sobiah MD Tampa Obstetrics PA Provider ID: 1199089 401 Oakfield Dr Gender: Female Brandon, FL 33511 Tampa Obstetrics PA (813) 684-2229 14710 Bruce B Downs Blvd Fax: (813) 654-1384 Tampa, FL 33607 12 Yrs/130 Yrs (813) 684-2229 M-F 8:00 AM - 5:30 PM Fax: (813) 654-1384 PCMH: No 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 201

Mallick, Sobiah MD Provider ID: 1199089 Gender: Female Tampa Obstetrics PA 4503 N 22nd St Tampa, FL 33610 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No Mallick, Sobiah MD Provider ID: 1199089 Gender: Female Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-TH 8:00 AM - 5:30 PM F 9:00 AM - 5:30 PM PCMH: No Mallick, Sobiah MD Provider ID: 1199089 Gender: Female Tampa Obstetrics PA 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No Martinez, Luciano MD Provider ID: 1200236 Gender: Male Premier OB/GYN of Tampa 2727 W Dr MLK Blvd Ste 630 Tampa, FL 33607 (813) 876-6000 Fax: (813) 876-0590 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Mikhail, Emad MD cont. Provider ID: 688597 McAfee, Khirstin DO Provider ID: 1200224 Gender: Female Premier OB/GYN of Tampa 2727 W Dr MLK Blvd Ste 630 Tampa, FL 33607 (813) 876-6000 Fax: (813) 876-0590 12 Yrs/130 Yrs St Josephs Hospital M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:00 PM PCMH: No Mikhail, Emad MD Provider ID: 688597 Gender: Male 1 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mikhail, Emad MD Provider ID: 688597 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mikhail, Emad MD Provider ID: 688597 Gender: Male 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Male 5802 N 30th St Tampa, FL 33610 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mondaca, Astrid MD Provider ID: 1154638 Gender: Female Women's Care Florida LLC 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mondaca, Astrid MD Provider ID: 1154638 Gender: Female Women's Care Florida LLC 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mondaca, Astrid MD Provider ID: 1154638 Gender: Female Women's Care Florida LLC 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Mondaca, Astrid MD Provider ID: 1154638 Gender: Female Women's Care Florida, LLC 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 6:00 PM PCMH: No

Nagella, Sarasija MD Provider ID: 1138371 Gender: Female Women's Care Florida LLC 5470 Lithia Pinecrest Rd Lithia, FL 33547 (813) 699-1006 Fax: (813) 699-1012 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Montano, Jolene MD

Nagella, Sarasija MD Provider ID: 1138371 Gender: Female Women's Care Florida LLC 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 1324965 Gender: Female Florida Woman Care LLC 3100 E Fletcher Ave Tampa, FL 33613 (800) 967-2289 Fax: (855) 462-9736 00 Yrs/130 Yrs M-TH 8:30 AM - 4:30 PM F 8:30 AM - 12:00 PM PCMH: No Nagella, Sarasija MD Provider ID: 1138371 Gender: Female Women's Care Florida LLC 103 Southern Oaks Dr Plant City, FL 33563 (813) 754-7561 Fax: (813) 754-5489 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Nagella, Sarasija MD Provider ID: 1138371 Gender: Female Women's Care Florida LLC 13123 Kings Lake Dr Gibsonton, FL 33534 (813) 574-1350 Fax: (813) 574-1360 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 202

Obican, Sarah MD Provider ID: 1103967 Gender: Female 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0679 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Obican, Sarah MD Provider ID: 1103967 Gender: Female 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Oshodi, Temitope MD cont. Provider ID: 1141164 Odibo, Anthony MD Provider ID: 984269 Gender: Male USF Physicians Group 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Odibo, Anthony MD Provider ID: 984269 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5188 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ortiz, Edwin MD Provider ID: 783354 Gender: Male Planned Parenthood of SW and Centra 8068 N 56th St Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish MT 9:00 AM - 6:00 PM W 8:00 AM - 5:00 PM THF 9:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Sun 9:00 AM - 12:00 PM PCMH: No

Gender: Female Women's Care Florida LLC 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Oshodi, Temitope MD Provider ID: 1141164 Gender: Female Women's Care Florida LLC 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Oshodi, Temitope MD Provider ID: 1141164 Gender: Female Women's Care Florida LLC 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Oshodi, Temitope MD Provider ID: 1141164 Gender: Female Women's Care Florida LLC 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Palmer, James MD Provider ID: 467625 Gender: Male University Medical Svc Associates 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Palmer, James MD Provider ID: 467625 Gender: Male University Medical Svc Associates 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Parisi, Valerie MD Provider ID: 1365590 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Patel, Niraj MD Provider ID: 1162093 Gender: Female Florida Medical Clinic, PA 12500 N Dale Mabry Hwy Ste D Tampa, FL 33618 (813) 284-2229 Fax: (813) 377-1681 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Patel, Urmila MD Provider ID: 233172 Gender: Female 1513 W Busch Blvd Tampa, FL 33612 (813) 654-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Patel, Urmila MD Provider ID: 233172 Gender: Female Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:30 AM - 5:30 PM PCMH: No Patel, Urmila MD Provider ID: 233172 Gender: Female Exodus Womens Center 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Patel, Urmila MD Provider ID: 233172 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Patel, Urmila MD cont. Provider ID: 240842 Patel, Urmila MD Provider ID: 240842 Gender: Female Tampa Obstetrics 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Patel, Urmila MD Provider ID: 240842 Gender: Female Tampa Obstetrics 514 Sugar Creek Dr Plant City, FL 33563 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Patel, Urmila MD Provider ID: 240842 Gender: Female Tampa Obstetrics Inc 1513 W Busch Blvd Tampa, FL 33612 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Patel, Urmila MD Provider ID: 240842 Gender: Female Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No

Gender: Female Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Pena, Reshelle MD Provider ID: 1169511 Gender: Female Women's Care Florida 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 973-3782 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 4:30 PM PCMH: No Pena, Reshelle MD Provider ID: 1169511 Gender: Female Women's Care Florida 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 4:30 PM PCMH: No Pile, Nadia MD Provider ID: 813723 Gender: Female Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2229 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Pile, Nadia MD Provider ID: 813723 Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Pile, Nadia MD Provider ID: 813723 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Prabhakaran, Sujatha MD Provider ID: 796079 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish, Arabic, Bengali, Armenian M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM PCMH: No

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Quinones, Eugenio MD Provider ID: 1192604 Gender: Male 1601 W Timberlane Dr Ste 600 Plant City, FL 33566 (813) 321-6677 Fax: (813) 719-3060 18 Yrs/130 Yrs South Florida Baptist Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rao, Kiran MD Provider ID: 1270906 Gender: Male Womens Care Florida LLC 5 Tampa General Cir Ste 650 Tampa, FL 33606 (813) 644-6235 Fax: (813) 644-6245 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Rapkin, David MD Provider ID: 789833 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8623 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Rapkin, David MD Provider ID: 789833 Gender: Male USF Physicians Group 214 Morrison Rd Brandon, FL 33511 (813) 844-4300 Fax: (813) 844-1909 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Riddell, Scott MD cont. Provider ID: 678068 Rapkin, David MD Provider ID: 789833 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 844-4500 Fax: (813) 238-1385 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Rapkin, Rachel MD Provider ID: 789834 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-8582 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Riddell, Scott MD Provider ID: 678068 Gender: Male 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Romero, Stephanie MD Provider ID: 964944 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 18 Yrs/130 Yrs St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rapkin, Rachel MD Provider ID: 789834 Gender: Female USF Physicians Group 2 Tampa General Cir Ste 4000 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Romero, Stephanie MD Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 964944 Gender: Female Rapkin, Rachel MD USF Physicians Group Provider ID: 789834 5802 N 30th St Gender: Female Tampa, FL 33610 USF Physicians Group (813) 236-5100 5802 N 30th St Fax: (813) 236-5188 Tampa, FL 33610 18 Yrs/130 Yrs (813) 236-5100 St Josephs Hospital Fax: (813) 236-5188 Languages: Spanish 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Tampa General Hospital PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No

Rosa, Hector MD Provider ID: 817797 Gender: Male Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM PCMH: No Rotunda-Patino, Mariel DO

Rutherford, Thomas MD Provider ID: 1282707 Gender: Female USF Delegated Grp 1 Tampa General Cir Tampa, FL 33606 (813) 844-3952 Fax: (813) 844-5882 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rutherford, Thomas MD Provider ID: 1282707 Gender: Female USF Physicians Group 3 Tampa General Cir Tampa, FL 33606 (813) 844-3952 Fax: (813) 844-5882 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 964456 Gender: Female Womens Health and Wellness 13148 Vail Ridge Dr Riverview, FL 33579 (813) 571-2777 Fax: (813) 571-2888 00 Yrs/130 Yrs Sappenfield, Elisabeth MD Brandon Regional Hospital Languages: Spanish Provider ID: 1419355 M-F 8:30 AM - 5:00 PM Gender: Female PCMH: No Baycare Medical Group 2 Tampa General CR 4th Fl Rotunda-Patino, Mariel DO Tampa, FL 33606 (813) 259-8500 Provider ID: 964456 Fax: (813) 259-8623 Gender: Female 00 Yrs/130 Yrs Womens Health and Wellness Tampa General Hospital 815 S Parsons Ave M-F 8:00 AM - 5:00 PM Brandon, FL 33511 PCMH: No (813) 571-2777 Fax: (813) 571-2888 Sappenfield, Elisabeth MD 00 Yrs/130 Yrs Brandon Regional Hospital Provider ID: 1419355 Languages: Spanish Gender: Female M-F 8:30 AM - 5:00 PM USF Physicians Group PCMH: No 13330 USF Laurel Dr 5th Fl Tampa, FL 33612 (813) 259-8500 Fax: (813) 974-7687 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Shafii, Sohrab MD cont. Provider ID: 656 Sappenfield, Elisabeth MD Provider ID: 1419355 Gender: Female USF Physicians Group 5802 N 30th St 5th Fl Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Shafii, Sohrab MD Provider ID: 656 Gender: Male Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No Shafii, Sohrab MD Provider ID: 656 Gender: Male Tampa Obstetrics PA 1513 W Busch Blvd Tampa, FL 33612 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No

Gender: Male Tampa Obstetrics PA 2550 W Dr MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No Shafii, Sohrab MD Provider ID: 656 Gender: Male Tampa Obstetrics PA 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No Shafii, Sohrab MD Provider ID: 656 Gender: Male Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No Shafii, Sohrab MD Provider ID: 656 Gender: Male Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No

Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 2701 W MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 1513 W Busch Blvd Tampa, FL 33612 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 2550 W MLK Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

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Sijin, Odalis MD Provider ID: 1289509 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Smith, Karimah MD cont. Provider ID: 1168743 Silver- Hochberg, Lauri MD Provider ID: 175850 Gender: Female USF Physicicans Group 2A Columbia Dr 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Silver- Hochberg, Lauri MD Provider ID: 175850 Gender: Female USF Physicicans Group 4 Columbia Dr Ste 529 Tampa, FL 33606 (813) 259-8585 Fax: (813) 259-8582 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sloan, Chris MD Provider ID: 1099110 Gender: Male Florida Perinatal Associates 6901 Simmons Loop Ste 208 Riverview, FL 33578 (813) 971-8625 Fax: (855) 527-5510 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-TH 9:00 AM - 4:00 PM PCMH: No Sloan, Chris MD Provider ID: 1099110 Gender: Male Pediatrix Medical Group 13601 Bru B Downs Blvd Ste 250 Tampa, FL 33613 (813) 971-6909 Fax: (855) 527-5510 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Florida Hospital Tampa M-F 8:30 AM - 5:00 PM PCMH: No

Gender: Female Women's Care Florida 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No Smith, Karimah MD Provider ID: 1168743 Gender: Female Women's Care Florida 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No Smith, Karimah MD Provider ID: 1168743 Gender: Female Women's Care Florida 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No Smith, Karimah MD Provider ID: 1168743 Gender: Female Women's Care Florida 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No

Spellacy, William MD Provider ID: 357259 Gender: Male 4 Columbia Dr Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 00 Yrs/130 Yrs University Hospital Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1108675 Gender: Female Exodus Womens Center Inc 14710 Bruce B Downs Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No

Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 14710 Bruce B Downs Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Spencer, Debbie MD Provider ID: 1108675 Gender: Female Exodus Womens Center Inc 2701 W MLK Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No

Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 2550 W Martin Luther King Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Spencer, Debbie MD Provider ID: 1108675 Gender: Female Exodus Womens Center Inc 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No

Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 2701 W MLK Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 207

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Sporn, Paul MD cont. Provider ID: 1198713 Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 4503 N 22nd St Tampa, FL 33610 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Sporn, Paul MD Provider ID: 1198713 Gender: Male Premier OB/GYN of Tampa 6911 Pistol Range Rd Ste 102B Tampa, FL 33635 (813) 814-9719 Fax: (813) 814-9835 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:00 PM PCMH: No

Gender: Male Premier OB/GYN of Tampa, LLP 2727 W Dr MLK Blvd Ste 630 Tampa, FL 33607 (813) 876-6000 Fax: (813) 876-0590 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:00 PM PCMH: No Stine, Jessica MD Provider ID: 1134421 Gender: Female Womens Care Florida LLC 4213 N Gomez Ave Tampa, FL 33607 (813) 644-4910 Fax: (813) 644-4912 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stine, Jessica MD Provider ID: 1134421 Gender: Female Womens Care Florida LLC 5 Tampa General Cir Tampa, FL 33606 (813) 644-6200 Fax: (813) 304-2428 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stine, Jessica MD Provider ID: 1134421 Gender: Female Womens Care Florida LLC 602 Vonderburg Dr Ste 101 Brandon, FL 33511 (813) 530-4950 Fax: (813) 530-4951 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No

Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 2550 W Dr MLK Blvd Ste C Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No

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Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 401 Oakfield Dr Brandon, FL 33511 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Suarez, Adriana MD Provider ID: 1254509 Gender: Female Tampa Obstetrics, PA 514 Sugar Creek Dr Plant City, FL 33563 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Tramont, John MD cont. Provider ID: 1088173

Wagner, Stephen MD

Gender: Male Provider ID: 1308270 Ta, Alyssa MD 5802 N 30th St Gender: Male Tampa, FL 33610 Provider ID: 354787 Exodus Womens Center (813) 236-5100 Gender: Female 401 Oakfield Dr Fax: (813) 236-5188 Health Point Medical Group Brandon, FL 33511 1601 W Timberlane Dr Ste 400 00 Yrs/130 Yrs (813) 654-2273 M-F 8:00 AM - 5:00 PM Plant City, FL 33566 Fax: (813) 654-1384 PCMH: No (813) 321-6677 12 Yrs/130 Yrs Fax: (813) 321-1877 Languages: French, German, Uzbay, Lisa MD Dutch 18 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM South Florida Baptist Hospital Provider ID: 1322780 Gender: Female St Josephs Hospital PCMH: No Women's Health Hospitalists, Languages: Vietnamese LLC Walter, Andrew MD M-F 9:00 AM - 5:00 PM 6901 Simmons Loop Provider ID: 805175 PCMH: No Riverview, FL 33578 Gender: Male Teefey, Patrick MD (813) 286-0033 Exodus Womens Center Fax: (813) 282-1806 Provider ID: 789836 401 Oakfield Dr 12 Yrs/130 Yrs Gender: Male Brandon, FL 33511 M-F 8:00 AM - 5:00 PM USF Physicians Group (813) 684-2229 2 Tampa General Cir Ste 4000 PCMH: No Fax: (813) 654-1384 Tampa, FL 33606 00 Yrs/130 Yrs Uzbay, Lisa MD (813) 259-8500 Tampa Bay Surgery Center Provider ID: 1322780 Fax: (813) 259-0827 M-F 8:00 AM - 5:30 PM Gender: Female 00 Yrs/130 Yrs PCMH: No Womens Care Florida LLC M-F 8:00 AM - 5:00 PM 5002 W Lemon St Walter, Andrew MD PCMH: No Tampa, FL 33609 Provider ID: 805175 Tramont, John MD (813) 286-0033 Gender: Male Fax: (813) 282-1806 Provider ID: 1088173 Exodus Womens Center Inc 12 Yrs/130 Yrs Gender: Male 1513 W Busch Blvd M-F 8:00 AM - 5:00 PM 13330 USF Laurel Dr Tampa, FL 33612 PCMH: No Tampa, FL 33612 (813) 684-2229 (813) 259-8500 Fax: (813) 654-1384 Verdeja Perez, Ana MD Fax: (813) 259-0827 00 Yrs/130 Yrs 00 Yrs/130 Yrs Tampa Bay Surgery Center Provider ID: 1192607 M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Gender: Female PCMH: No PCMH: No 1601 W Timberlane Dr Ste 400 Tramont, John MD Washington, Gina MD Plant City, FL 33566 Provider ID: 1088173 (813) 321-6677 Provider ID: 911915 Gender: Male Fax: (813) 719-3060 Gender: Female 2 Tampa General Cir 4th Fl 18 Yrs/130 Yrs Tampa Obstetrics/Exodus Womens Center Tampa, FL 33606 M-F 9:00 AM - 5:00 PM 14710 Bruce B Downs Blvd (813) 259-8500 PCMH: No Tampa, FL 33613 Fax: (813) 259-0827 Von Thron, James MD (813) 654-2273 00 Yrs/130 Yrs Provider ID: 212660 Fax: (813) 654-1384 M-F 8:00 AM - 5:00 PM Gender: Male 12 Yrs/130 Yrs PCMH: No 2123 W M L King Jr Blvd Brandon Regional Hospital Tampa, FL 33607 M-F 8:30 AM - 5:00 PM (813) 876-0914 PCMH: No Fax: (813) 876-9198 00 Yrs/130 Yrs PCMH: No

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Washington, Gina MD Provider ID: 911915 Gender: Female Tampa Obstetrics/Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:30 AM - 5:00 PM PCMH: No Washington, Gina MD Provider ID: 911915 Gender: Female Tampa Obstetrics/Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:30 AM - 5:00 PM PCMH: No Waterman II, Philip MD Provider ID: 686208 Gender: Male Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs Lee Memorial Hospital M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 10:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Obstetrics/Gynecology - Yankowitz, Jerome MD cont. Provider ID: 609495

Zweibach, Stephen MD

Anderson, Bruce OD Provider ID: 1353043 Gender: Male Gender: Male Provider ID: 13571 Wattenbarger, John MD USF Physicians Group USF Physicians Group Gender: Male 5802 N 30th St Womens Health and Wellness 13127 USF Magnolia Dr Tampa, FL 33610 Tampa, FL 33612 13148 Vail Ridge Dr Provider ID: 1299251 (813) 236-5100 (813) 974-3820 Riverview, FL 33579 Gender: Male Fax: (813) 236-5188 Fax: (813) 974-5621 (813) 571-2777 Shriners Hospitals For 00 Yrs/130 Yrs 00 Yrs/130 Yrs Children Fax: (813) 571-2888 South Florida Baptist Hospital 00 Yrs/130 Yrs Tampa General Hospital 12502 USF Pine Dr USF Endoscopy & Surgery M-F 8:00 AM - 5:00 PM Tampa, FL 33612 Brandon Regional Hospital Center Lakeland Reg Medical Center PCMH: No (813) 975-7130 Winter Haven Hospital South Florida Baptist Hospital Fax: (813) 975-7129 M-F 8:00 AM - 5:00 PM Anthony, Charles MD M-F 9:00 AM - 5:00 PM 00 Yrs/18 Yrs PCMH: No Provider ID: TPV1518278142-0 Shriners Hospital For Children PCMH: No Gender: Male Nc Yelverton Jr, Robert MD Zweibach, Stephen MD Eye Associates of Manatee Languages: Spanish LLP PCMH: No Provider ID: 19916 3894 Sun City Center Blvd Provider ID: 13571 Gender: Male Yankowitz, Jerome MD Sun City Center, FL 33573 Gender: Male Women's Care Florida LLC Womens Health and Wellness (813) 634-2020 2818 W Virginia Ave Fax: (813) 633-9009 815 S Parsons Ave Provider ID: 609495 Tampa, FL 33607 12 Yrs/99 Yrs Brandon, FL 33511 Gender: Male (813) 872-8551 No Hospital Privileges(813) 571-2777 USF Physicians Group Fax: (813) 871-3708 Covering Arrangem Fax: (813) 571-2888 13330 USF Laurel Dr 12 Yrs/130 Yrs Languages: Spanish, Arabic 00 Yrs/130 Yrs Tampa, FL 33612 St Josephs Hospital M 1:00 AM - 5:00 PM Brandon Regional Hospital (813) 259-8500 Tampa General Hospital TWTHF 8:00 AM - 5:00 PM Lakeland Reg Medical Center Fax: (813) 259-8582 M-F 9:00 AM 5:00 PM South Florida Baptist Hospital PCMH: No 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM South Florida Baptist Hospital PCMH: No Berger, Todd MD PCMH: No USF Endoscopy & Surgery Yelverton Jr, Robert MD Provider ID: TPV1205836418-0 Center Ophthalmology Gender: Male Winter Haven Hospital Provider ID: 19916 Eye Associates of Manatee M-F 8:00 AM - 5:00 PM Ahn, Byung-Joon MD LLP Gender: Male PCMH: No 3894 Sun City Center Blvd Womens Care Florida LLC Provider ID: TPV1649492711-0 Yankowitz, Jerome MD Sun City Center, FL 33573 5 Tampa General Cir Gender: Male (813) 634-2020 Tampa, FL 33606 Eye Associates of Manatee LLP Fax: (813) 633-9009 (813) 644-6200 Provider ID: 609495 3894 Sun City Center Blvd 18 Yrs/99 Yrs Fax: (813) 304-2427 Gender: Male Sun City Center, FL 33573 Northside Hospital 12 Yrs/130 Yrs USF Physicians Group (813) 634-2020 Languages: Spanish, Arabic St Josephs Hospital 2 Tampa General Cir Tampa General Hospital Fax: (813) 633-9009 M 1:00 AM - 5:00 PM Tampa, FL 33606 M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs TWTHF 8:00 AM - 5:00 PM (813) 259-8500 PCMH: No No Hospital PrivilegesPCMH: No Fax: (813) 259-8582 Covering Arrangem 00 Yrs/130 Yrs Languages: Spanish, Arabic South Florida Baptist Hospital M 1:00 AM - 5:00 PM USF Endoscopy & Surgery TWTHF 8:00 AM - 5:00 PM Center Winter Haven Hospital PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 210

Last update 08/14/2017

Specialty Physicians Hillsborough Ophthalmology - cont. Bhaleeya, Swetangi MD Provider ID: 1353044 Gender: Female USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Curtis, Margo MD Provider ID: 1353076 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Diakonis, Vasilios MD Provider ID: TPV1902234172-0 Gender: Male The Eye Physicians of Pinellas PA 501 N Howard Ave Ste 100 Tampa, FL 33606 (727) 581-8706 Fax: (727) 588-2447 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

El-Jabali, Fayssal DO Foster, John MD Provider ID: TPV1629199096-0 Provider ID: TPV1396920906-0 Gender: Male Gender: Male Newsom Eye Laser Center Inc Eye Associates of Manatee LLP 13904 N Dale Mabry Hwy Ste 200 3894 Sun City Center Blvd Tampa, FL 33618 Sun City Center, FL 33573 (813) 908-2020 (813) 634-2020 Fax: (813) 968-6175 Fax: (813) 633-9009 18 Yrs/99 Yrs 04 Yrs/99 Yrs No Hospital PrivilegesBlake Medical Center Covering Arrangem Languages: Spanish, Arabic Languages: Spanish, Arabic M 1:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No PCMH: No

Drucker, Mitchell MD

El-Jabali, Fayssal DO Fouraker, Bradley MD Provider ID: TPV1629199096-0 Provider ID: TPV1467445866-0 Gender: Male Gender: Male Newsom Eye Laser Center Inc Gregory L Henderson MD 3115 Swann Ave FACS Inc Tampa, FL 33609 403 Vonderburg Dr Ste 101 (813) 908-2020 Brandon, FL 33511 Fax: (813) 968-6175 (813) 681-1122 18 Yrs/99 Yrs Fax: (813) 684-4924 No Hospital Privileges00 Yrs/99 Yrs Covering Arrangem Tampa General Healthcare Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No PCMH: No

Provider ID: 1353048 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Davis, Jeffrey MD Provider ID: TPV1275795775-0 Edelman, Robert MD Gender: Male Provider ID: TPV1790783553-0 Espana, Edgar MD Manatee-Sarasota Eye Clinic Provider ID: 1353050 Gender: Male 1515 Sun City Center Plz Gender: Male Manatee-Sarasota Eye Clinic Sun City Center, FL 33573 USF Physicians Group 1515 Sun City Center Plz (941) 748-1818 13127 USF Magnolia Dr Sun City Center, FL 33573 Fax: (941) 746-1055 Tampa, FL 33612 (941) 748-1818 00 Yrs/18 Yrs (813) 974-3820 Manatee Memorial Hospital & Fax: (941) 746-1055 Fax: (813) 974-5621 00 Yrs/18 Yrs Health Syste Manatee Memorial Hospital & 12 Yrs/130 Yrs Languages: Spanish Tampa General Hospital Health Syste M-F 8:00 AM - 5:00 PM Languages: Spanish Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Friedman, Scott MD Provider ID: TPV1497842314-0 Gender: Male Eye Associates of Manatee LLP 3894 Sun City Center Blvd Sun City Center, FL 33573 (813) 634-2020 Fax: (813) 633-9009 00 Yrs/99 Yrs Winter Haven Hospital Languages: Spanish, Arabic M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Ophthalmology - cont. Gamell, Lisa MD Provider ID: 1353061 Gender: Female USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gstalder, Roger MD Provider ID: 1353064 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Henderson Sr, Gregory MD Provider ID: TPV1427055227-0 Gender: Male Gregory L Henderson MD FACS Inc 403 Vonderburg Dr Ste 101 Brandon, FL 33511 (813) 681-1122 Fax: (813) 684-4924 00 Yrs/99 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Guggino, Giacomo MD Provider ID: TPV1093757585-0 Garruto, Bryan MD Ho, Janie MD Gender: Male Provider ID: TPV1710902911-0 Provider ID: TPV1710961487-0 Giacomo S Guggino MD PA Gender: Male Gender: Female 3109 W Swann Ave Newsom Eye Laser Center Inc Tampa, FL 33609 The Eye Physicians of Pinellas PA 13904 N Dale Mabry Hwy Ste (813) 876-1400 200 501 N Howard Ave Ste 100 Fax: (813) 876-1600 Tampa, FL 33618 Tampa, FL 33606 00 Yrs/99 Yrs (813) 908-2020 (727) 581-8706 St Josephs Hospital Fax: (813) 968-6175 Fax: (727) 588-2447 Languages: Spanish 00 Yrs/99 Yrs 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish, Arabic No Hospital PrivilegesPCMH: No Covering Arrangem M-F 8:00 AM - 5:00 PM Languages: French, Romanian PCMH: No Hector, Richard MD M-F 8:00 AM - 5:00 PM Provider ID: TPV1073511077-0 Garruto, Bryan MD PCMH: No Gender: Male Provider ID: TPV1710902911-0 Eye Associates of Manatee Kasper, Jeffrey MD Gender: Male LLP Provider ID: TPV1912907122-0 Newsom Eye Laser Center Inc 3894 Sun City Center Blvd Gender: Male 3115 Swann Ave Sun City Center, FL 33573 Eye Associates of Manatee Tampa, FL 33609 (813) 634-2020 LLP (813) 908-2020 Fax: (813) 633-9009 3894 Sun City Center Blvd Fax: (813) 968-6175 18 Yrs/99 Yrs 00 Yrs/99 Yrs Manatee Memorial Hospital & Sun City Center, FL 33573 (813) 634-2020 Languages: Spanish, Arabic Health Syste Fax: (813) 633-9009 M-F 8:00 AM - 5:00 PM Languages: Spanish, Arabic 18 Yrs/99 Yrs PCMH: No M 1:00 AM - 5:00 PM Northside Hospital TWTHF 8:00 AM - 5:00 PM Groden, Lewis MD Languages: Spanish, Arabic PCMH: No M 1:00 AM - 5:00 PM Provider ID: 1353063 TWTHF 8:00 AM - 5:00 PM Gender: Male PCMH: No USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 212

Levitt, Michael MD Provider ID: TPV1720074974-0 Gender: Male Florida Pediatric Associates LLC 4900 N Habana Ave Tampa, FL 33614 (813) 233-2020 Fax: (813) 877-6839 18 Yrs/99 Yrs St Josephs Hospital Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No Levy-Clarke, Grace MD Provider ID: TPV1437342847-0 Gender: Female Gregory L Henderson MD FACS Inc 135 W Robertson St Brandon, FL 33511 (813) 685-0001 Fax: (813) 685-0008 06 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Levy-Clarke, Grace MD Provider ID: TPV1437342847-0 Gender: Female Gregory L Henderson MD FACS Inc 403 Vonderburg Dr Ste 101 Brandon, FL 33511 (813) 681-1122 Fax: (813) 684-4924 06 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Madow, Brian MD Provider ID: 1353067 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-6723 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Ophthalmology - cont. Mali, Joshua MD Provider ID: TPV1124261375-0 Gender: Male Eye Associates of Manatee LLP 3894 Sun City Center Blvd Sun City Center, FL 33573 (813) 634-2020 Fax: (813) 633-9009 01 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Arabic M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Mendelblatt, Frank MD Provider ID: 1340787 Gender: Male Tampa General Medical Group 5802 N 30th St Tampa, FL 33610 (813) 236-5200 Fax: (813) 236-5222 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Misch, David MD Provider ID: TPV1992775571-0 Gender: Male Vitreous and Retina Consultants 2002 Alexander St Plant City, FL 33563 (863) 297-5400 Fax: (863) 595-4515 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Perez Gonzalez Deapodaca, Newsom, Thomas MD Provider ID: TPV1851386395-0 Jose MD Provider ID: TPV1326282013-0 Gender: Male Newsom Eye Laser Center Inc Gender: Male Antonio Prado MD PA 3115 Swann Ave 7522 N Himes Ave Tampa, FL 33609 Tampa, FL 33614 (813) 908-2020 (813) 931-0500 Fax: (813) 968-6175 Fax: (813) 935-4055 06 Yrs/99 Yrs 12 Yrs/99 Yrs Florida Hospital No Hospital PrivilegesNo Hospital PrivilegesCovering Arrangem Covering Arrangem Languages: Spanish, Arabic Languages: Spanish, Hindi, Telugu M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 4:30 PM PCMH: No Nakanishi, Linda MD PCMH: No Pavan, Peter MD Provider ID: 1353069 Perich, Larry DO Provider ID: 1353071 Gender: Female Provider ID: TPV1891724019-0 Gender: Male USF Physicians Group Gender: Male USF Physicians Group 13127 USF Magnolia Dr Larry M Perich DO PA 13127 USF Magnolia Dr Tampa, FL 33612 11809 N Dale Mabry Hwy Tampa, FL 33612 (813) 974-3820 Tampa, FL 33618 (813) 974-3820 Fax: (813) 974-5621 (813) 963-2020 Fax: (813) 974-6723 00 Yrs/130 Yrs Fax: (813) 265-2842 00 Yrs/130 Yrs Tampa General Hospital 07 Yrs/99 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Languages: Spanish M-F 8:00 AM 5:00 PM PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Newsom, Thomas MD PCMH: No Provider ID: TPV1851386395-0 Perez Gonzalez Deapodaca, Jose MD Plous, Oren MD Gender: Male Provider ID: TPV1467422659-0 Newsom Eye Laser Center Inc Provider ID: TPV1326282013-0 Gender: Male Gender: Male 13904 N Dale Mabry Hwy Ste Antonio Prado MD PA Tampa Bay Retina PA 200 206 Buckingham Pl Ste 102 7522 N Himes Ave Tampa, FL 33618 Brandon, FL 33511 Tampa, FL 33614 (813) 908-2020 (813) 653-2020 (941) 312-2769 Fax: (813) 968-6175 Fax: (813) 653-2205 Fax: (866) 426-2169 06 Yrs/99 Yrs 12 Yrs/99 Yrs 12 Yrs/99 Yrs Florida Hospital No Hospital PrivilegesNo Hospital PrivilegesMease Countryside Hospital Covering Arrangem Covering Arrangem Morton Plant Hospital Winter Haven Hospital Languages: Spanish, Arabic Languages: Spanish, Telugu M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 4:30 PM PCMH: No PCMH: No PCMH: No Moon, Suk MD Provider ID: TPV1477524130-0 Gender: Male Vitreous and Retina Consultants 2002 Alexander St Plant City, FL 33563 (863) 297-5400 Fax: (863) 595-4515 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 213

Last update 08/14/2017

Specialty Physicians Hillsborough Ophthalmology - cont. Prado, Antonio MD Provider ID: TPV1790783769-0 Gender: Male Antonio Prado MD PA 7522 N Himes Ave Tampa, FL 33614 (813) 931-0500 Fax: (813) 935-4055 18 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Hindi, Telugu M-F 8:00 AM - 4:30 PM PCMH: No Prado, Antonio MD Provider ID: TPV1790783769-0 Gender: Male Antonio Prado MD PA 206 Buckingham Pl Ste 102 Brandon, FL 33511 (813) 653-2020 Fax: (813) 653-2205 18 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Telugu M-F 8:00 AM - 4:30 PM PCMH: No Randolph, John MD Provider ID: TPV1164621330-0 Gender: Male Vitreous and Retina Consultants 2002 Alexander St Plant City, FL 33563 (863) 297-5400 Fax: (863) 595-4515 06 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Richards, David MD Provider ID: 1353073 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Rosanelli, Edward MD Provider ID: TPV1336115153-0 Gender: Male E George Rosanelli Jr MD 4129 N Armenia Ave Ste A Tampa, FL 33607 (813) 875-3884 Fax: (813) 878-2355 18 Yrs/99 Yrs Palms of Pasadena Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Shane, Anita MD Srivastava, Vinita MD Provider ID: TPV1992998207-0 Provider ID: TPV1720370034-0 Gender: Female Gender: Female Manatee-Sarasota Eye Clinic Newsom Eye Laser Center Inc 1515 Sun City Center Plz 3115 Swann Ave Sun City Center, FL 33573 Tampa, FL 33609 (941) 748-1818 (813) 908-2020 Fax: (941) 746-1055 Fax: (813) 968-6175 00 Yrs/18 Yrs 15 Yrs/99 Yrs Lakewood Ranch Medical Eskenazi Hospital Center 8330 Lakew Indiana University Med Manatee Memorial Hospital & Center Health Syste Languages: Spanish, Arabic Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Slonim, Charles MD Provider ID: 1353074 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Optician

Cef Vision Inc Provider ID: TPV1740204148-0 2128 Jim Redman Pkwy Plant City, FL 33563 (813) 752-3320 Fax: (813) 759-6595 00 Yrs/99 Yrs Languages: Spanish MTH 9:00 AM - 7:00 PM TF 9:00 AM - 5:00 PM WSat 9:00 AM - 1:00 PM PCMH: No

Shah, Geeta MD Provider ID: TPV1568487205-0 Gender: Female Eagle Optical Co Srivastava, Vinita MD Larry M Perich DO PA Provider ID: TPV1578747309-0 Provider ID: TPV1720370034-0 11809 N Dale Mabry Hwy 1410 E Fletcher Ave Gender: Female Tampa, FL 33618 Tampa, FL 33612 Newsom Eye Laser Center Inc (813) 963-2020 (813) 977-4801 13904 N Dale Mabry Hwy Ste Fax: (813) 265-2842 Fax: (813) 979-4572 200 05 Yrs/99 Yrs 00 Yrs/99 Yrs Tampa, FL 33618 No Hospital PrivilegesM-F 8:00 AM - 5:00 PM (813) 908-2020 Covering Arrangem PCMH: No Fax: (813) 968-6175 Languages: Spanish 15 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Eye Doctors Optical Outlets Eskenazi Hospital PCMH: No PA Indiana University Med Provider ID: TPV1114012689-0 Center 5607 Johns Rd Languages: Spanish, Arabic Tampa, FL 33634 M-F 8:00 AM - 5:00 PM (813) 885-3937 PCMH: No Fax: (813) 880-8375 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 214

Last update 08/14/2017

Specialty Physicians Hillsborough Optician - cont. Eye Doctors Optical Outlets PA Provider ID: TPV1255522165-0 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 00 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1275723538-0 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1376734772-0 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 00 Yrs/99 Yrs MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1487845707-0 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0471 Fax: (813) 464-2763 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Eye Doctors Optical Outlets PA Provider ID: TPV1740515105-0 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (407) 374-1757 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1861682106-0 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Visionworks Inc Optimart Inc Provider ID: TPV1861600488-0 Provider ID: TPV1801173968-0 700 S Dale Mabry Hwy 3830 State Rd 674 Ste 105 Tampa, FL 33609 Sun City, FL 33573 (813) 872-8587 (813) 634-6155 Fax: (813) 871-5460 Fax: (816) 634-6236 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Visionworks Inc Provider ID: TPV1245517085-0 8150 Citrus Park Towne Center Mall Ste 1100 Tampa, FL 33625 (813) 920-6824 Fax: (813) 926-6619 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Visionworks Inc Provider ID: TPV1265719231-0 14901 N Dale Mabry Hwy Tampa, FL 33618 Eye Doctors Optical Outlets (813) 960-8318 PA Provider ID: TPV1902097306-0 Fax: (813) 265-8872 00 Yrs/99 Yrs 915 E Bloomingdale Ave M-F 8:00 AM - 5:00 PM Brandon, FL 33511 PCMH: No (813) 661-1930 Fax: (813) 436-8467 Visionworks Inc 00 Yrs/99 Yrs Provider ID: TPV1437436748-0 M-F 9:00 AM - 6:00 PM 2001 E Fowler Ave Sat 9:00 AM - 4:00 PM Tampa, FL 33612 PCMH: No (813) 972-5728 Fax: (813) 977-7544 Eye Doctors Optical Outlets 00 Yrs/99 Yrs PA M-F 8:00 AM - 5:00 PM Provider ID: TPV1982894325-0 PCMH: No 3920A W Hillsborough Ave Tampa, FL 33614 Visionworks Inc (813) 870-2273 Provider ID: TPV1447537386-0 Fax: (813) 283-4859 655 Brandon Town Center 00 Yrs/99 Yrs Brandon, FL 33511 M-F 9:00 AM - 6:00 PM (813) 651-0113 Sat 9:00 AM - 3:00 PM Fax: (813) 651-0964 PCMH: No 00 Yrs/99 Yrs For Eyes Optical Co of Coconut Grove Inc Provider ID: TPV1861545501-0 2201 E Fowler Ave Ste B Tampa, FL 33612 (813) 978-1035 Fax: (813) 972-1954 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

MTWTHFSat 10:00 AM - 9:00 PM PCMH: No

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Optometry Adler, Shepard OD Provider ID: TPV1366403974-0 Gender: Male Professional Eyecare Consultants PA 2201 E Fowler Ave Ste B Tampa, FL 33612 (813) 972-1573 Fax: (813) 862-0563 05 Yrs/99 Yrs MTTHF 10:00 AM - 5:00 PM W 11:00 AM - 7:00 PM Sat 10:00 AM - 3:00 PM PCMH: No Alvarez, Dennis OD Provider ID: TPV1477637791-0 Gender: Male Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Anderson, Bruce OD Provider ID: 1353043 Gender: Male USF Physicians Group 13127 USF Magnolia Dr Tampa, FL 33612 (813) 974-3820 Fax: (813) 974-5621 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Anderson, Clinton OD Provider ID: TPV1326034349-0 Gender: Male Clinton Anderson Inc 945 E Brandon Blvd Brandon, FL 33511 (813) 662-3937 Fax: (813) 662-5367 05 Yrs/99 Yrs MWTHF 9:00 AM - 6:00 PM T 9:00 AM - 7:00 PM Sat 8:30 AM - 2:30 PM PCMH: No Anderson, Clinton OD Provider ID: TPV1326034349-1 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Austin, Bradley OD Provider ID: TPV1235544750-0 Gender: Male Treyefecta Vision Holdings LLC 14901 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-8958 Fax: (813) 908-6883 00 Yrs/99 Yrs M-F 9:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 12:00 AM - 5:00 PM PCMH: No

Barrido, Kevin OD Berdeal, Rogelio OD Provider ID: TPV1205895604-0 Provider ID: TPV1336205624-0 Gender: Male Gender: Male Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA 1510 E Fowler Ave 1510 E Fowler Ave Tampa, FL 33612 Tampa, FL 33612 (813) 971-0472 (813) 971-0472 Fax: (813) 464-2763 Fax: (813) 464-2763 01 Yrs/99 Yrs 06 Yrs/99 Yrs Languages: Spanish, Languages: Spanish, Vietnamese Vietnamese M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM Sat 9:00 AM - 4:00 PM PCMH: No PCMH: No

Berdeal, Rogelio OD Provider ID: TPV1336205624-0 Gender: Male Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Barrido, Kevin OD Berdeal, Rogelio OD Provider ID: TPV1205895604-0 Provider ID: TPV1336205624-0 Gender: Male Gender: Male Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA 3202 W Kennedy Blvd Ste 1 227-B Brandon Towne Center Dr Tampa, FL 33609 Brandon, FL 33511 (813) 872-6063 (813) 685-1935 Fax: (813) 347-9879 Fax: (813) 283-4866 01 Yrs/99 Yrs 06 Yrs/99 Yrs Languages: Spanish, Vietnamese Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM MT 9:00 AM - 8:00 PM Sat 9:00 AM - 3:00 PM WTHF 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM Berdeal, Rogelio OD PCMH: No Provider ID: TPV1336205624-0 Berdeal, Rogelio OD Gender: Male Provider ID: TPV1336205624-0 Eye Doctors Optical Outlets PA Gender: Male 14390 N Dale Mabry Hwy Eye Doctors Optical Outlets PA Tampa, FL 33618 3202 W Kennedy Blvd Ste 1 (813) 962-1799 Tampa, FL 33609 Fax: (813) 283-4668 (813) 872-6063 06 Yrs/99 Yrs Fax: (813) 347-9879 Languages: Spanish, Vietnamese 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Spanish, Vietnamese Sat 9:00 AM - 3:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 3:00 PM PCMH: No

Berdeal, Rogelio OD Provider ID: TPV1336205624-0 Gender: Male Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 216

Berdeal, Rogelio OD Provider ID: TPV1336205624-0 Gender: Male Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Berdeal, Rogelio OD Provider ID: TPV1336205624-0 Gender: Male Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 06 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Berdeal, Rogelio OD Provider ID: TPV1336205624-0 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 06 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Berdeal, Rogelio OD Provider ID: TPV1336205624-1 Gender: Male Tampa Bay Optical Inc 4710 N Habana Ave Ste 204 Tampa, FL 33602 (813) 877-2400 Fax: (813) 877-2402 06 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Bernatsky, Sylvia OD Provider ID: TPV1205917465-0 Gender: Female Bernatsky Wilson PA 700 S Dale Mabry Hwy Tampa, FL 33609 (813) 877-4935 Fax: (813) 871-5460 05 Yrs/99 Yrs MTWTHFSat 9:00 AM - 7:30 PM PCMH: No Bernatsky, Sylvia OD Provider ID: TPV1205917465-0 Gender: Female Wilson Bernatsky PA 655 Brandon Town Center Brandon, FL 33511 (813) 681-1036 Fax: (813) 651-0718 05 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM Sun 11:00 AM - 3:00 PM PCMH: No Buffano, Roxanne OD Provider ID: TPV1275765265-1 Gender: Female Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Buzzett, Jennifer OD Provider ID: TPV1316989627-0 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Buzzett, Jennifer OD Provider ID: TPV1316989627-0 Gender: Female Jennifer J Buzzett OD 3802 Britton Plz Ste A Tampa, FL 33611 (813) 837-0077 Fax: (813) 839-8509 05 Yrs/99 Yrs M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Carlson, Ruben OD Provider ID: TPV1881658565-0 Gender: Male Central Florida Eye Care Associates Inc 5201 E Busch Blvd Tampa, FL 33617 (813) 979-2929 Fax: (813) 979-9479 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Clough, Scott OD Provider ID: TPV1326042375-0 Gender: Male Vision Specialty Associates PA 3830 State Rd 674 Ste 105 Sun City, FL 33573 (813) 634-6155 Fax: (813) 634-6236 06 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM PCMH: No Cochran, John OD Provider ID: TPV1538168836-1 Gender: Male Bernatsky Wilson PA 700 S Dale Mabry Hwy Tampa, FL 33609 (813) 877-4935 Fax: (813) 871-5460 05 Yrs/99 Yrs MTWTHFSat 9:00 AM - 7:30 PM PCMH: No

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Custred, Jeffrey OD Provider ID: TPV1669411021-0 Gender: Male Jeffrey Custred OD 2128 Jim Redman Pkwy Plant City, FL 33563 (813) 752-3320 Fax: (813) 759-6595 05 Yrs/99 Yrs MTH 9:00 AM - 7:00 PM TF 9:00 AM - 5:00 PM W 9:00 AM - 1:00 PM Sat 9:00 AM - 12:30 PM PCMH: No Cuva, Philip OD Provider ID: TPV1407960073-0 Gender: Male Antonio Prado MD PA 206 Buckingham Pl Ste 102 Brandon, FL 33511 (813) 653-2020 Fax: (813) 653-2205 09 Yrs/99 Yrs Languages: Spanish, Telugu M-F 8:00 AM - 4:30 PM PCMH: No Cuva, Philip OD Provider ID: TPV1407960073-0 Gender: Male Antonio Prado MD PA 7522 N Himes Ave Tampa, FL 33614 (813) 931-0500 Fax: (813) 935-4055 09 Yrs/99 Yrs Languages: Spanish, Hindi, Telugu M-F 8:00 AM - 4:30 PM PCMH: No Day, Paul OD Provider ID: TPV1265634224-0 Gender: Male Vision Specialty Associates PA 3830 State Rd 674 Ste 105 Sun City, FL 33573 (813) 634-6155 Fax: (813) 634-6236 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Detweiler, Edwin OD Provider ID: TPV1154303923-0 Gender: Male Eye Associates of Manatee LLP 3894 Sun City Center Blvd Sun City Center, FL 33573 (813) 634-2020 Fax: (813) 633-9009 05 Yrs/99 Yrs Languages: Spanish, Arabic M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Detweiler, Edwin OD Provider ID: TPV1154303923-0 Gender: Male Eye Associates of Manatee LLP 779 Cortaro Dr Sun City Center, FL 33573 (813) 634-2020 Fax: (813) 633-9009 05 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Dixon, Dustin OD Provider ID: TPV1245578491-1 Gender: Male Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Dominguez, Vymarys OD Provider ID: TPV1861608481-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Fazio, Eric OD Provider ID: TPV1447245246-0 Gender: Male Newsom Eye Laser Center Inc 13904 N Dale Mabry Hwy Ste 200 Tampa, FL 33618 (813) 908-2020 Fax: (813) 968-6175 05 Yrs/99 Yrs Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Fazio, Eric OD Provider ID: TPV1447245246-0 Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Male Newsom Eye Laser Center Inc Gender: Female Eye Doctors Optical Outlets 3115 Swann Ave PA Tampa, FL 33609 227-B Brandon Towne Center (813) 908-2020 Dr Fax: (813) 968-6175 Brandon, FL 33511 05 Yrs/99 Yrs (813) 685-1935 Languages: Spanish, Arabic Fax: (813) 283-4866 M-F 8:00 AM - 5:00 PM 05 Yrs/99 Yrs PCMH: No Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 218

Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Fernandez, Sonia OD Provider ID: TPV1730343534-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Ferris, Anthony OD Provider ID: TPV1457547366-0 Gender: Male Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 04 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Ferris, Anthony OD Provider ID: TPV1457547366-0 Gender: Male Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 04 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ferris, Anthony OD Provider ID: TPV1457547366-0 Gender: Male Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 04 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ferris, Anthony OD Provider ID: TPV1457547366-0 Gender: Male Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 04 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ferris, Anthony OD Provider ID: TPV1457547366-0 Gender: Male Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 04 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ferris, Anthony OD Provider ID: TPV1457547366-1 Gender: Male Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 04 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Ferris, Anthony OD Provider ID: TPV1457547366-0 Gender: Male Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 04 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No

Ferris, Anthony OD Provider ID: TPV1457547366-1 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 04 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 219

Forde, Jessica OD Provider ID: TPV1699223974-0 Gender: Female Newsom Eye Laser Center Inc 13904 N Dale Mabry Hwy Ste 200 Tampa, FL 33618 (813) 908-2020 Fax: (813) 968-6175 00 Yrs/99 Yrs Languages: Spanish, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Furman, Adam OD Provider ID: TPV1336541465-0 Gender: Male Vision Specialty Associates PA 3830 State Rd 674 Ste 105 Sun City, FL 33573 (813) 634-6155 Fax: (813) 634-6236 06 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM PCMH: No Fusselman, John OD Provider ID: TPV1083711196-0 Gender: Male Suncoast Community Health Centers Inc 14254 Martin Luther King Blvd Dover, FL 33527 (813) 349-7700 Fax: (813) 349-7761 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Fusselman, John OD Provider ID: TPV1083711196-0 Gender: Male Suncoast Community Health Centers Inc 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 938-6421 00 Yrs/99 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Fusselman, John OD Provider ID: TPV1083711196-1 Gender: Male Suncoast Community Health Centers Inc 313 S Lakewood DR Brandon, FL 33511 (813) 349-7900 Fax: (813) 938-6426 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fusselman, John OD Provider ID: TPV1083711196-1 Gender: Male Suncoast Community Health Centers Inc 7728 Palm River Rd Tampa, FL 33619 (813) 653-6100 Fax: (813) 938-6428 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gill, Jonell OD Provider ID: TPV1518952035-0 Gender: Female Clinton Anderson Inc 945 E Brandon Blvd Brandon, FL 33511 (813) 662-3937 Fax: (813) 662-5367 05 Yrs/99 Yrs MWTHF 9:00 AM - 6:00 PM T 9:00 AM - 7:00 PM Sat 8:30 AM - 2:30 PM PCMH: No Glassberg, Steven OD Provider ID: TPV1982643136-0 Gender: Male Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Goldstein, Stacey OD Provider ID: TPV1841523677-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Gres, Stephen OD Heaps, Eric OD Provider ID: TPV1962528620-0 Provider ID: TPV1154751782-0 Gender: Male Gender: Male Maxim-Eyes Optical Inc Eye Doctors Optical Outlets PA 2547 State Rd 60 E 1510 E Fowler Ave Valrico, FL 33594 Tampa, FL 33612 (813) 653-9661 (813) 971-0472 Fax: (813) 657-4334 Fax: (813) 464-2763 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish Languages: Spanish, M-W 10:00 AM - 6:00 PM Vietnamese TH 10:00 AM - 8:00 PM M-F 9:00 AM - 6:00 PM F 10:00 AM - 2:00 PM Sat 9:00 AM - 4:00 PM PCMH: No PCMH: No Haffner, George OD Gonzalez, Heidi OD Heaps, Eric OD Provider ID: TPV1316070113-0 Provider ID: TPV1003196783-0 Provider ID: TPV1154751782-0 Gender: Male Gender: Female Gender: Male Eye Doctors Optical Outlets Clinton Anderson Inc Eye Doctors Optical Outlets PA PA 945 E Brandon Blvd 1510 E Fowler Ave 6431 County Line Rd Ste 113 Brandon, FL 33511 Tampa, FL 33612 Tampa, FL 33647 (813) 662-3937 (813) 971-0472 (813) 315-3085 Fax: (813) 662-5367 Fax: (813) 464-2763 Fax: (813) 464-7783 05 Yrs/99 Yrs 05 Yrs/99 Yrs 05 Yrs/99 Yrs MWTHF 9:00 AM - 6:00 PM Languages: Spanish, Languages: Spanish, T 9:00 AM - 7:00 PM Vietnamese Vietnamese Sat 8:30 AM - 2:30 PM M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Gres, Stephen OD PCMH: No Provider ID: TPV1962528620-0 Haffner, George OD Heaps, Eric OD Gender: Male Provider ID: TPV1316070113-0 Provider ID: TPV1154751782-0 Stephen D Gres OD PA Gender: Male Gender: Male 2547 State Rd 60 E Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA Valrico, FL 33594 PA 6431 County Line Rd Ste 113 (813) 653-9661 915 E Bloomingdale Ave Tampa, FL 33647 Fax: (813) 657-4334 Brandon, FL 33511 (813) 315-3085 05 Yrs/99 Yrs (813) 661-1930 Fax: (813) 464-7783 Languages: Spanish Fax: (813) 654-8202 05 Yrs/99 Yrs M-W 10:00 AM - 6:00 PM 05 Yrs/99 Yrs Languages: Spanish, TH 10:00 AM - 8:00 PM Languages: Spanish Vietnamese F 10:00 AM - 2:00 PM M-F 9:00 AM - 6:00 PM M-F 9:00 AM 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM Sat 9:00 AM - 4:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 220

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont.

Hernandez, Madeline OD Provider ID: TPV1710907944-1 Hernandez, Madeline OD Gender: Female Provider ID: TPV1710907944-0 Eye Doctors Optical Outlets PA Gender: Female Vision Specialty Associates PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 3830 State Rd 674 Ste 105 (813) 872-6063 Sun City, FL 33573 Fax: (813) 347-9879 (813) 634-6155 07 Yrs/99 Yrs Fax: (813) 634-6236 Languages: Spanish, 07 Yrs/99 Yrs Vietnamese Languages: Spanish M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 3:00 PM Sat 9:00 AM - 6:00 PM PCMH: No PCMH: No Hernandez, Madeline OD Provider ID: TPV1710907944-1 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 07 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Hernandez, Madeline OD Provider ID: TPV1710907944-1 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 07 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Hernandez, Madeline OD Provider ID: TPV1710907944-1 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 07 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Hernandez, Madeline OD Provider ID: TPV1710907944-1 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 07 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Hernandez, Madeline OD Provider ID: TPV1710907944-2 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 07 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Hidalgo, Janet OD Provider ID: TPV1598035057-0 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Hetherington, Mark OD Hidalgo, Janet OD Provider ID: TPV1437258944-0 Provider ID: TPV1598035057-0 Gender: Male Gender: Female Vision Specialty Associates PA Eye Doctors Optical Outlets PA 3830 State Rd 674 Ste 105 3202 W Kennedy Blvd Ste 1 Sun City, FL 33573 Tampa, FL 33609 (813) 634-6155 (813) 872-6063 Fax: (813) 634-6236 Fax: (813) 347-9879 07 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish, M-F 9:00 AM - 5:00 PM Vietnamese Sat 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 3:00 PM Hidalgo, Janet OD PCMH: No Provider ID: TPV1598035057-0 Hidalgo, Janet OD Gender: Female Provider ID: TPV1598035057-0 Eye Doctors Optical Outlets Gender: Female PA Eye Doctors Optical Outlets 14390 N Dale Mabry Hwy PA Tampa, FL 33618 3920A W Hillsborough Ave (813) 962-1799 Tampa, FL 33614 Fax: (813) 283-4668 (813) 870-2273 00 Yrs/99 Yrs Fax: (813) 283-4859 Languages: Spanish, 00 Yrs/99 Yrs Vietnamese Languages: Spanish, M-F 9:00 AM - 6:00 PM Vietnamese Sat 9:00 AM - 3:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 221

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Hidalgo, Janet OD Provider ID: TPV1598035057-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Hidalgo, Janet OD Provider ID: TPV1598035057-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Hidalgo, Janet OD Provider ID: TPV1598035057-0 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 00 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Honeyblue, Shamika OD Kanicky, Luc OD Provider ID: TPV1538317219-0 Provider ID: TPV1043275175-0 Gender: Female Gender: Male Vision Specialty Associates PA Eye Doctors Optical Outlets PA 3830 State Rd 674 Ste 105 1510 E Fowler Ave Sun City, FL 33573 Tampa, FL 33612 (813) 634-6155 (813) 971-0472 Fax: (813) 634-6236 Fax: (813) 464-2763 07 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish Languages: Spanish, M-F 9:00 AM - 5:00 PM Vietnamese Sat 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM Jones, Douglas OD PCMH: No Provider ID: TPV1063587327-0 Kanicky, Luc OD Gender: Male Vision Specialty Associates PA Provider ID: TPV1043275175-0 Gender: Male 3830 State Rd 674 Ste 105 Eye Doctors Optical Outlets Sun City, FL 33573 PA (813) 634-6155 3920A W Hillsborough Ave Fax: (813) 634-6236 Tampa, FL 33614 05 Yrs/99 Yrs (813) 870-2273 Languages: Spanish Fax: (813) 283-4859 M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 6:00 PM Languages: Spanish, PCMH: No Vietnamese M-F 9:00 AM - 6:00 PM Kanicky, Jee OD Provider ID: TPV1245296599-0 Sat 9:00 AM - 3:00 PM PCMH: No Gender: Female Eye Doctors Optical Outlets Kanicky, Luc OD PA Provider ID: TPV1043275175-0 1510 E Fowler Ave Gender: Male Tampa, FL 33612 Eye Doctors Optical Outlets (813) 971-0472 PA Fax: (813) 464-2763 6431 County Line Rd Ste 113 05 Yrs/99 Yrs Tampa, FL 33647 Languages: Spanish, (813) 315-3085 Vietnamese Fax: (813) 464-7783 M-F 9:00 AM - 6:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 4:00 PM Languages: Spanish, PCMH: No Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 222

Krumbholz, Gerald OD Provider ID: TPV1982631701-0 Gender: Male Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 05 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Suncoast Community Health Centers Inc 14254 Martin Luther King Blvd Dover, FL 33527 (813) 349-7700 Fax: (813) 349-7761 05 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Suncoast Community Health Centers Inc 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 938-6421 05 Yrs/99 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM PCMH: No LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Suncoast Community Health Centers Inc 313 S Lakewood DR Brandon, FL 33511 (813) 349-7900 Fax: (813) 938-6426 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Suncoast Community Health Centers Inc 7728 Palm River Rd Tampa, FL 33619 (813) 653-6100 Fax: (813) 938-6428 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Lappano, Alfred OD Lewenson, Robert OD Long, Lori OD Provider ID: TPV1194727669-0 Provider ID: TPV1235181769-0 Provider ID: TPV1477685931-0 Gender: Male Gender: Male Gender: Female Vision Specialty Associates PA Eye Doctors Optical Outlets Eye Associates of Manatee PA LLP 3830 State Rd 674 Ste 105 6431 County Line Rd Ste 113 779 Cortaro Dr Sun City, FL 33573 Tampa, FL 33647 Sun City Center, FL 33573 (813) 634-6155 (813) 315-3085 (813) 634-2020 Fax: (813) 634-6236 Fax: (813) 464-7783 Fax: (813) 633-9009 05 Yrs/99 Yrs 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish Languages: Spanish, Languages: Spanish M-F 9:00 AM - 5:00 PM Vietnamese MTTHF 8:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM W 8:00 AM - 12:30 PM PCMH: No Sat 9:00 AM - 4:00 PM PCMH: No Lawrence, James OD PCMH: No Lopez, Viviana OD Provider ID: TPV1407849839-0 Lewenson, Robert OD Provider ID: TPV1447583950-1 Gender: Male Provider ID: TPV1235181769-0 Gender: Female Gregory L Henderson MD Gender: Male FACS Inc Myeyedr Optometry of Eye Doctors Optical Outlets Florida LLC 612 N US Hwy 41 PA 102 Henry Ave Ruskin, FL 33570 8025 Citrus Park Town Center Plant City, FL 33563 (813) 645-3831 Mall (813) 704-6090 Fax: (813) 645-4402 Tampa, FL 33625 Fax: (813) 704-6097 00 Yrs/99 Yrs (813) 792-1628 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Fax: (813) 283-4909 M-F 9:00 AM - 6:00 PM PCMH: No 05 Yrs/99 Yrs PCMH: No Languages: Spanish Lewenson, Robert OD M-F 10:30 AM - 8:30 PM Luu, Jessica OD Provider ID: TPV1235181769-0 Sat 10:00 AM 9:00 PM Provider ID: TPV1619364775-0 Gender: Male Sun 12:00 AM - 6:00 PM Gender: Female Eye Doctors Optical Outlets PCMH: No PA Eye Doctors Optical Outlets PA 5607 Johns Rd Lieb, Gregory OD 14390 N Dale Mabry Hwy Tampa, FL 33634 Provider ID: TPV1962400952-0 Tampa, FL 33618 (813) 699-1999 Gender: Female (813) 962-1799 Fax: (813) 330-0099 Antonio Prado MD PA Fax: (813) 283-4668 05 Yrs/99 Yrs 7522 N Himes Ave 05 Yrs/99 Yrs Languages: Spanish, Tampa, FL 33614 Vietnamese Languages: Spanish, (813) 931-0500 Vietnamese M-TH 9:00 AM - 6:00 PM Fax: (813) 935-4055 M-F 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM 18 Yrs/99 Yrs Sat 9:00 AM - 3:00 PM Sat 10:00 AM - 6:00 PM Languages: Spanish, Hindi, PCMH: No PCMH: No Telugu M-F 8:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 223

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Luu, Jessica OD Provider ID: TPV1619364775-0 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Luu, Jessica OD Provider ID: TPV1619364775-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Luu, Jessica OD Provider ID: TPV1619364775-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Luu, Jessica OD Provider ID: TPV1619364775-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Luu, Jessica OD Provider ID: TPV1619364775-0 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 05 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 06 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 224

Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 06 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 06 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 06 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Mann, Clare OD Provider ID: TPV1659424927-1 Gender: Female Professional Eyecare Consultants PA 2201 E Fowler Ave Ste B Tampa, FL 33612 (813) 972-1573 Fax: (813) 862-0563 06 Yrs/99 Yrs MTTHF 10:00 AM - 5:00 PM W 11:00 AM - 7:00 PM Sat 10:00 AM - 3:00 PM PCMH: No

Miller, Matthew OD Provider ID: TPV1669603130-0 Gender: Male Larry M Perich DO PA 11809 N Dale Mabry Hwy Tampa, FL 33618 (813) 963-2020 Fax: (813) 265-2842 05 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Merlino, Brian OD Eye Doctors Optical Outlets PA Provider ID: TPV1841418555-0 1510 E Fowler Ave Gender: Male Vision Specialty Associates PA Tampa, FL 33612 (813) 971-0472 3830 State Rd 674 Ste 105 Fax: (813) 464-2763 Sun City, FL 33573 05 Yrs/99 Yrs (813) 634-6155 Languages: Spanish, Fax: (813) 634-6236 Vietnamese 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Spanish Sat 9:00 AM - 4:00 PM M-F 9:00 AM - 5:00 PM PCMH: No Sat 9:00 AM - 6:00 PM PCMH: No

Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 225

Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Morrison, Caryn OD Provider ID: TPV1881601631-0 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 05 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Morrison, Caryn OD Provider ID: TPV1881601631-1 Gender: Female Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ngar, Lucie OD Provider ID: TPV1447238274-0 Gender: Female Eye Doctors Optical Outlets PA 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Murphy, Kenneth OD Provider ID: TPV1700870854-0 Ngar, Lucie OD Provider ID: TPV1447238274-0 Gender: Male Gender: Female Daniel A Palmisano OD PA Eye Doctors Optical Outlets 8150 Citrus Park Towne PA Center Mall Ste 1100 915 E Bloomingdale Ave Tampa, FL 33625 Brandon, FL 33511 (813) 920-6718 (813) 661-1930 Fax: (813) 926-6619 Fax: (813) 654-8202 18 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 10:00 AM - 6:30 PM Languages: Spanish Sat 10:00 AM - 5:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM Neal, Terry OD PCMH: No Provider ID: TPV1366445819-1 Ocasio, John OD Gender: Male Provider ID: TPV1679534911-0 Myeyedr Optometry of Gender: Male Florida LLC Eye Doctors Optical Outlets 102 Henry Ave PA Plant City, FL 33563 14390 N Dale Mabry Hwy (813) 704-6090 Tampa, FL 33618 Fax: (813) 704-6097 (813) 962-1799 06 Yrs/99 Yrs Fax: (813) 283-4668 M-F 9:00 AM - 6:00 PM 05 Yrs/99 Yrs PCMH: No Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ocasio, John OD Provider ID: TPV1679534911-0 Gender: Male Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Payne, Tessa OD Provider ID: TPV1518198027-0 Gender: Female Larry M Perich DO PA 11809 N Dale Mabry Hwy Tampa, FL 33618 (813) 963-2020 Fax: (813) 265-2842 01 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Petit, Mitchell OD Provider ID: TPV1184628547-0 Gender: Male Palmisano, Daniel OD Newsom Eye Laser Center Inc Provider ID: TPV1083670756-0 13904 N Dale Mabry Hwy Ste Gender: Male 200 Daniel A Palmisano OD PA Tampa, FL 33618 8150 Citrus Park Towne (813) 908-2020 Center Mall Ste 1100 Fax: (813) 968-6175 Tampa, FL 33625 05 Yrs/99 Yrs (813) 920-6718 Languages: Spanish, Arabic Fax: (813) 926-6619 M-F 8:00 AM - 5:00 PM 06 Yrs/99 Yrs PCMH: No M-F 10:00 AM - 6:30 PM Sat 10:00 AM - 5:00 PM Petit, Mitchell OD PCMH: No Provider ID: TPV1184628547-0 Gender: Male Parrish, Gregory OD Newsom Eye Laser Center Inc Provider ID: TPV1598759458-1 3115 Swann Ave Gender: Male Tampa, FL 33609 Myeyedr Optometry of (813) 908-2020 Florida LLC Fax: (813) 968-6175 102 Henry Ave 05 Yrs/99 Yrs Plant City, FL 33563 Languages: Spanish, Arabic (813) 704-6090 M-F 8:00 AM - 5:00 PM Fax: (813) 704-6097 PCMH: No 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Pham, Kim OD PCMH: No Provider ID: TPV1255746947-0 Gender: Female Patel, Binal OD Eye Doctors Optical Outlets Provider ID: TPV1790036325-1 PA Gender: Female 14390 N Dale Mabry Hwy Myeyedr Optometry of Tampa, FL 33618 Florida LLC (813) 962-1799 102 Henry Ave Fax: (813) 283-4668 Plant City, FL 33563 00 Yrs/99 Yrs (813) 704-6090 Languages: Spanish, Fax: (813) 704-6097 Vietnamese 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 226

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Pham, Kim OD Provider ID: TPV1255746947-0 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Pham, Kim OD Provider ID: TPV1255746947-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Pham, Kim OD Provider ID: TPV1255746947-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Pham, Kim OD Provider ID: TPV1255746947-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Pham, Kim OD Provider ID: TPV1255746947-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Pham, Kim OD Provider ID: TPV1255746947-0 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 00 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Phillips, James OD Provider ID: TPV1598759219-1 Gender: Male Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Phillips, Stephen OD Provider ID: TPV1871587592-1 Gender: Male Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

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Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Pradilla, Sergio OD Provider ID: TPV1881027811-1 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Puzzo, Melissa OD Provider ID: TPV1669760799-1 Gender: Female Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 00 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No

Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

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Ramesar, Denyse OD Provider ID: TPV1982037917-0 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 00 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Ramesar, Denyse OD Provider ID: TPV1982037917-1 Gender: Female Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Ramsay, William OD Provider ID: TPV1821093873-0 Gender: Male Larry M Perich DO PA 11809 N Dale Mabry Hwy Tampa, FL 33618 (813) 963-2020 Fax: (813) 265-2842 05 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Raney, Dennis OD Provider ID: TPV1003921974-0 Gender: Male Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Roberts, David OD Provider ID: TPV1972665883-0 Gender: Male Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Roberts, Elizabeth OD Provider ID: TPV1295722908-1 Gender: Female Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Salomon, Brad OD Provider ID: TPV1851385710-1 Gender: Male Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-1 Gender: Female Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Scamard, David OD Scamard, David OD Provider ID: TPV1790900694-0 Provider ID: TPV1790900694-0 Gender: Male Gender: Male Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA 227-B Brandon Towne Center 6431 County Line Rd Ste 113 Dr Tampa, FL 33647 Brandon, FL 33511 (813) 315-3085 (813) 685-1935 Fax: (813) 464-7783 Fax: (813) 283-4866 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish, Languages: Spanish, Vietnamese Vietnamese M-F 9:00 AM - 6:00 PM Salomon, Teresa OD MT 9:00 AM - 8:00 PM Sat 9:00 AM - 4:00 PM WTHF 9:00 AM - 6:00 PM Provider ID: TPV1891789517-1 PCMH: No Sat 9:00 AM - 4:00 PM Gender: Female Scamard, David OD PCMH: No Myeyedr Optometry of Florida LLC Provider ID: TPV1790900694-0 Scamard, David OD 102 Henry Ave Gender: Male Provider ID: TPV1790900694-0 Eye Doctors Optical Outlets Plant City, FL 33563 Gender: Male PA (813) 704-6090 Eye Doctors Optical Outlets 8025 Citrus Park Town Center Fax: (813) 704-6097 PA Mall 05 Yrs/99 Yrs 3202 W Kennedy Blvd Ste 1 Tampa, FL 33625 M-F 9:00 AM - 6:00 PM Tampa, FL 33609 (813) 792-1628 PCMH: No (813) 872-6063 Fax: (813) 283-4909 Scamard, David OD Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish Provider ID: TPV1790900694-0 05 Yrs/99 Yrs Languages: Spanish, M-F 10:30 AM - 8:30 PM Gender: Male Vietnamese Sat 10:00 AM - 9:00 PM Eye Doctors Optical Outlets M-F 9:00 AM - 6:00 PM PA Sun 12:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM 14390 N Dale Mabry Hwy PCMH: No PCMH: No Tampa, FL 33618 Schatz, Scott OD (813) 962-1799 Scamard, David OD Provider ID: TPV1154495141-0 Fax: (813) 283-4668 Provider ID: TPV1790900694-0 Gender: Male 05 Yrs/99 Yrs Gender: Male Eye Doctors Optical Outlets Languages: Spanish, Eye Doctors Optical Outlets PA Vietnamese PA 227-B Brandon Towne Center M-F 9:00 AM - 6:00 PM 3920A W Hillsborough Ave Dr Sat 9:00 AM - 3:00 PM Tampa, FL 33614 Brandon, FL 33511 PCMH: No (813) 870-2273 (813) 685-1935 Fax: (813) 283-4859 Fax: (813) 283-4866 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish, Languages: Spanish, Vietnamese Vietnamese M-F 9:00 AM - 6:00 PM MT 9:00 AM - 8:00 PM Sat 9:00 AM - 3:00 PM WTHF 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont.

Scott, Christopher OD Scott, Christopher OD Provider ID: TPV1326004953-0 Provider ID: TPV1326004953-1 Schatz, Scott OD Gender: Male Gender: Male Provider ID: TPV1154495141-0 Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA Gender: Male 227-B Brandon Towne Center 5607 Johns Rd Eye Doctors Optical Outlets Dr PA Tampa, FL 33634 Brandon, FL 33511 915 E Bloomingdale Ave (813) 699-1999 (813) 685-1935 Brandon, FL 33511 Fax: (813) 330-0099 Fax: (813) 283-4866 (813) 661-1930 05 Yrs/99 Yrs 05 Yrs/99 Yrs Fax: (813) 654-8202 Languages: Spanish, Languages: Spanish, Vietnamese 05 Yrs/99 Yrs Vietnamese M-TH 9:00 AM - 6:00 PM Languages: Spanish MT 9:00 AM - 8:00 PM F 9:00 AM - 5:30 PM M-F 9:00 AM - 6:00 PM WTHF 9:00 AM - 6:00 PM Sat 10:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM Sat 9:00 AM - 4:00 PM PCMH: No PCMH: No PCMH: No Scott, Christopher OD Scott, Christopher OD Scott, Christopher OD Provider ID: TPV1326004953-1 Provider ID: TPV1326004953-0 Provider ID: TPV1326004953-0 Gender: Male Gender: Male Gender: Male Eye Doctors Optical Outlets Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA PA 6431 County Line Rd Ste 113 14390 N Dale Mabry Hwy 3202 W Kennedy Blvd Ste 1 Tampa, FL 33647 Tampa, FL 33618 Tampa, FL 33609 (813) 315-3085 (813) 962-1799 (813) 872-6063 Fax: (813) 464-7783 Fax: (813) 283-4668 Fax: (813) 347-9879 05 Yrs/99 Yrs 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish, Languages: Spanish, Languages: Spanish, Vietnamese Vietnamese Vietnamese M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM Sat 9:00 AM - 3:00 PM Sat 9:00 AM - 3:00 PM PCMH: No PCMH: No PCMH: No Scott, Christopher OD Scott, Christopher OD Provider ID: TPV1326004953-1 Provider ID: TPV1326004953-0 Scott, Christopher OD Provider ID: TPV1326004953-0 Gender: Male Gender: Male Gender: Male Eye Doctors Optical Outlets Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA PA 8025 Citrus Park Town Center 1510 E Fowler Ave 3936 Vogel Rd Mall Tampa, FL 33612 Tampa, FL 33614 Tampa, FL 33625 (813) 971-0472 (813) 870-2273 (813) 792-1628 Fax: (813) 464-2763 Fax: (813) 283-4859 Fax: (813) 283-4909 05 Yrs/99 Yrs 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish, Languages: Spanish Languages: Spanish Vietnamese M-F 9:00 AM - 6:00 PM M-F 10:30 AM - 8:30 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM Sat 10:00 AM - 9:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Sun 12:00 AM - 6:00 PM PCMH: No PCMH: No

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Scott, Christopher OD Provider ID: TPV1326004953-1 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Smith, Kevin OD Provider ID: TPV1518945179-0 Gender: Male Dr Kevin L Smith OD and Associates Inc 4117 W Henderson Blvd Tampa, FL 33629 (813) 207-8984 Fax: (813) 207-8954 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM PCMH: No Smith, Kevin OD Provider ID: TPV1518945179-0 Gender: Male Eye Doctors Optical Outlets PA 227-B Brandon Towne Center Dr Brandon, FL 33511 (813) 685-1935 Fax: (813) 283-4866 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 9:00 AM - 8:00 PM WTHF 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Smith, Kevin OD Provider ID: TPV1518945179-0 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Sterling, Peggy OD Provider ID: TPV1427105410-0 Gender: Female Peggy J Sterling OD 7037 US Hwy 301 S Riverview, FL 33578 (813) 677-0229 Fax: (813) 677-0137 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sudbury, Glenn OD Provider ID: TPV1861572992-0 Gender: Male Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Thai, Pauline OD Provider ID: TPV1871808097-1 Gender: Female Myeyedr Optometry of Florida LLC 102 Henry Ave Plant City, FL 33563 (813) 704-6090 Fax: (813) 704-6097 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Ton, Kim-Oanh OD Tyler, Eric OD Provider ID: TPV1770982704-0 Provider ID: TPV1285652826-0 Gender: Female Gender: Male Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA 5607 Johns Rd 8025 Citrus Park Town Center Mall Tampa, FL 33634 Tampa, FL 33625 (813) 699-1999 (813) 792-1628 Fax: (813) 330-0099 Fax: (813) 283-4909 05 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Vietnamese Languages: Spanish M-TH 9:00 AM - 6:00 PM M-F 10:30 AM - 8:30 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 9:00 PM Sat 10:00 AM - 6:00 PM Sun 12:00 AM - 6:00 PM PCMH: No PCMH: No

Vo, Mai OD Provider ID: TPV1952779514-0 Gender: Female Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Tran, Baotram OD Provider ID: TPV1295920643-0 Gender: Female Professional Eyecare Consultants PA 2201 E Fowler Ave Ste B Tampa, FL 33612 (813) 972-1573 Fax: (813) 862-0563 05 Yrs/99 Yrs MTTHF 10:00 AM - 5:00 PM W 11:00 AM - 7:00 PM Sat 10:00 AM - 3:00 PM PCMH: No

Tyler, Eric OD Provider ID: TPV1285652826-0 Gender: Male Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Vo, Mai OD Provider ID: TPV1952779514-0 Gender: Female Eye Doctors Optical Outlets PA 3202 W Kennedy Blvd Ste 1 Tampa, FL 33609 (813) 872-6063 Fax: (813) 347-9879 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Tyler, Eric OD Provider ID: TPV1285652826-0 Gender: Male Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Vo, Mai OD Provider ID: TPV1952779514-0 Gender: Female Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Vo, Mai OD Provider ID: TPV1952779514-0 Gender: Female Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont. Vo, Mai OD Provider ID: TPV1952779514-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Vo, Mai OD Provider ID: TPV1952779514-0 Gender: Female Eye Doctors Optical Outlets PA 6431 County Line Rd Ste 113 Tampa, FL 33647 (813) 315-3085 Fax: (813) 464-7783 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Vo, Mai OD Provider ID: TPV1952779514-1 Gender: Female Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 05 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Vo, Mai OD Provider ID: TPV1952779514-1 Gender: Female Eye Doctors Optical Outlets PA 915 E Bloomingdale Ave Brandon, FL 33511 (813) 661-1930 Fax: (813) 654-8202 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Vu, Bonnie OD Provider ID: TPV1972919595-0 Gender: Female Eye Doctors Optical Outlets PA 5607 Johns Rd Tampa, FL 33634 (813) 699-1999 Fax: (813) 330-0099 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:30 PM Sat 10:00 AM - 6:00 PM PCMH: No Walker, Stacey OD Provider ID: TPV1801088976-0 Gender: Female Stacey Walker OD PA 2001 E Fowler Ave Tampa, FL 33612 (813) 972-3465 Fax: (813) 977-7544 06 Yrs/99 Yrs MTTHF 9:00 AM - 6:00 PM W 9:00 AM - 4:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Weisbond, Steven OD Provider ID: TPV1457390148-0 Gender: Male Eye Doctors Optical Outlets PA 3920A W Hillsborough Ave Tampa, FL 33614 (813) 870-2273 Fax: (813) 283-4859 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Woolwine, Joshua OD Provider ID: TPV1215389754-0 Gender: Male Eye Doctors Optical Outlets PA 14390 N Dale Mabry Hwy Tampa, FL 33618 (813) 962-1799 Fax: (813) 283-4668 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Williams, John OD Provider ID: TPV1205977295-0 Gender: Male Treyefecta Vision Holdings LLC 14901 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-8958 Fax: (813) 908-6883 05 Yrs/99 Yrs M-F 9:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 12:00 AM - 5:00 PM PCMH: No

Woolwine, Joshua OD Provider ID: TPV1215389754-0 Gender: Male Eye Doctors Optical Outlets PA 1510 E Fowler Ave Tampa, FL 33612 (813) 971-0472 Fax: (813) 464-2763 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Wilson, Mark OD Provider ID: TPV1407883895-0 Woolwine, Joshua OD Provider ID: TPV1215389754-0 Gender: Male Gender: Male Bernatsky Wilson PA Eye Doctors Optical Outlets 700 S Dale Mabry Hwy PA Tampa, FL 33609 6431 County Line Rd Ste 113 (813) 877-4935 Tampa, FL 33647 Fax: (813) 871-5460 (813) 315-3085 05 Yrs/99 Yrs Fax: (813) 464-7783 MTWTHFSat 9:00 AM - 7:30 05 Yrs/99 Yrs PM Languages: Spanish, PCMH: No Vietnamese Wilson, Mark OD M-F 9:00 AM - 6:00 PM Provider ID: TPV1407883895-0 Sat 9:00 AM - 4:00 PM PCMH: No Gender: Male Wilson Bernatsky PA 655 Brandon Town Center Brandon, FL 33511 (813) 681-1036 Fax: (813) 651-0718 05 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM Sun 11:00 AM - 3:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Optometry - cont.

Langston, Andrew DMD

Woolwine, Joshua OD Provider ID: TPV1215389754-0 Gender: Male Eye Doctors Optical Outlets PA 8025 Citrus Park Town Center Mall Tampa, FL 33625 (813) 792-1628 Fax: (813) 283-4909 05 Yrs/99 Yrs Languages: Spanish M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Provider ID: 1119613 Gender: Male Tampa Bay Jaw Surgery 3645 W Waters Ave Tampa, FL 33614 (813) 933-6228 Fax: (813) 933-8237 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No

Oral & Maxillofacial Surgery Ahson, Imran DMD Provider ID: 1270825 Gender: Male Florida Craniofacial Institute 4200 N Armenia Ave Ste 3 Tampa, FL 33607 (813) 870-6000 Fax: (813) 870-6015 12 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 2:00 PM PCMH: No Bowlin, Walter DDS Provider ID: TPVP128856-01 Gender: Male Walter Q Bowlin Jr DDS 3645 W Waters Ave Tampa, FL 33614 (813) 933-6228 Fax: (813) 933-8237 00 Yrs/99 Yrs PCMH: No

Ricalde, Pat DDS Provider ID: 359615 Gender: Female Florida Craniofacial Institute 4200 N Armenia Ave Ste 3 Tampa, FL 33607 (813) 870-6000 Fax: (813) 870-6015 00 Yrs/16 Yrs Languages: Spanish, Greek M-TH 8:00 AM - 5:00 PM F 8:00 AM - 2:00 PM PCMH: No

Chin, Leo DMD Provider ID: TPVP44135-07 Gender: Male Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Chin, Leo DMD Provider ID: TPVP44135-08 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Chin, Leo DMD Provider ID: TPVP44135-09 Gender: Male Chin, Leo DMD Suncoast Mobile Dental Van Provider ID: TPVP44135-06 2814 14th Ave SE Gender: Male Palm River Community Health Ruskin, FL 33570 (813) 653-6100 Center Fax: (813) 349-7596 7728 Palm River Rd 00 Yrs/99 Yrs Tampa, FL 33619 Languages: Spanish (813) 630-3635 M-F 8:00 AM - 5:00 PM Fax: (813) 620-1614 PCMH: No 00 Yrs/99 Yrs Languages: Spanish Chin, Leo DMD M-F 8:00 AM - 5:00 PM Provider ID: TPVP44135-10 PCMH: No Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Orthodontics

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Chin, Leo DMD Provider ID: TPVP44135-11 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chin, Leo DMD Provider ID: TPVP44135-12 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Guzman, Ulises DDS Provider ID: TPVP44937-24 Gender: Male Guzman Orthodontics 6907 W Waters Ave Tampa, FL 33634 (813) 887-5555 Fax: (813) 887-5556 00 Yrs/99 Yrs Languages: Spanish MW 10:00 AM - 6:00 PM T 7:00 AM - 5:00 PM TH 9:00 AM - 5:00 PM F 9:00 AM - 1:00 PM PCMH: No McDowell, Ernest DMD Provider ID: TPVP104348-05 Gender: Male Florida Orthodontic Associates 1773 W Fletcher Ave Tampa, FL 33612 (727) 442-4070 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Orthodontics - cont. McDowell, Ernest DMD Provider ID: TPVP104348-06 Gender: Male Florida Orthodontic Associates LLC 3739 Neptune St Tampa, FL 33629 (727) 442-4070 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Nelson, Stephen DMD Provider ID: TPVP44404-10 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Parsa, Mitra DDS Provider ID: TPVP126985-04 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Turke, Eric DDS Provider ID: TPVP44561-01 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Turke, Eric DDS Provider ID: TPVP44561-02 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Turke, Eric DDS Provider ID: TPVP44561-03 Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Turke, Eric DDS Provider ID: TPVP44561-04 Gender: Male Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Turke, Eric DDS Provider ID: TPVP44561-05 Gender: Male Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Turke, Eric DDS Provider ID: TPVP44561-06 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Turke, Eric DDS Provider ID: TPVP44561-07 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Orthopaedic Surgery Becker, Edward MD Provider ID: 951374 Gender: Male Orthopaedic Medical Group of Tampa 6901 Simmons Loop Ste 201 Riverview, FL 33578 (813) 684-2663 Fax: (813) 906-6100 00 Yrs/130 Yrs Memorial Hospital of Tampa South Florida Baptist Hospital Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No Buscemi, Michael DO Provider ID: 10246 Gender: Male Michael J Buscemi Jr DO PA 11809 N Dale Mabry Hwy Tampa, FL 33618 (813) 926-4010 Fax: (813) 926-5424 18 Yrs/130 Yrs Florida Hospital Carrollwood Tampa Bay Surgery Center Tampa Community Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Butler, Robert MD Provider ID: 1232209 Gender: Male Orthopedic Medical Group of Tampa B 615 Vonderburg Dr Brandon, FL 33511 (813) 684-2663 Fax: (813) 685-9178 00 Yrs/130 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Orthopaedic Surgery cont.

Chan, John MD Provider ID: 16808 Gender: Male Butler, Robert MD Orthopedic Assoc of Tampa 4612 N Habana Ave Ste 203 Provider ID: 1232209 Tampa, FL 33614 Gender: Male Orthopedic Medical Group of (813) 877-6748 Tampa B Fax: (813) 875-0359 6901 Simmons Loop 18 Yrs/130 Yrs Riverview, FL 33578 Florida Hospital Tampa St Josephs Hospital (813) 684-2663 Tampa Community Hospital Fax: (813) 330-3324 Languages: Spanish 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM Winter Haven Hospital F 8:00 AM - 4:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Cain, Richard MD Provider ID: 1026531 Gender: Male Baycare Medical Group 4211 Van Dyke Rd Ste 200 Lutz, FL 33558 (813) 264-6490 Fax: (813) 443-8143 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cain, Richard MD Provider ID: 1026531 Gender: Male Healthpoint Medical Group Inc 2727 W Dr MLK Blvd Ste 320 Tampa, FL 33607 (813) 877-6748 Fax: (813) 875-0359 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Cronen, Geoffrey MD Provider ID: 720820 Gender: Male Shriners Hospitals For Children Tam 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 Fax: (813) 975-7129 00 Yrs/21 Yrs Tampa General Hospital Languages: French PCMH: No Florschutz, Anthony MD Provider ID: 1138382 Gender: Male Baycare Medical Group 2727 W Dr MLK Blvd Ste 320 Tampa, FL 33607 (813) 877-6748 Fax: (813) 443-8154 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Garcia, Michael MD Provider ID: 510016 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7125 00 Yrs/18 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Hess, Alfred MD Provider ID: 25503 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 Fax: (813) 975-7129 00 Yrs/18 Yrs Florida Hospital Tampa Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

James, Eric MD Goldsmith, Scott MD Provider ID: 1339592 Provider ID: 448988 Gender: Male Gender: Male Baycare Medical Group Inc Orthopeadic Medical Group 2727 W Dr MLK Blvd Ste 701 615 Vonderburg Dr Tampa, FL 33607 Brandon, FL 33511 (813) 877-6748 (813) 684-2663 Fax: (813) 875-0359 Fax: (813) 685-9178 18 Yrs/130 Yrs 00 Yrs/130 Yrs South Florida Baptist Hospital M-F 9:00 AM - 5:00 PM Tampa Bay Surgery Center PCMH: No M-F 8:00 AM - 5:00 PM Jester, Adam MD PCMH: No Provider ID: 1193406 Goldsmith, Stuart MD Gender: Male Provider ID: 3287 Orthopeadic Medical Group Gender: Male 10141 Big Bend Rd Orthopeadic Medical Group Riverview, FL 33578 615 Vonderburg Dr (813) 302-2841 Brandon, FL 33511 Fax: (813) 441-1191 (813) 684-2663 00 Yrs/130 Yrs Fax: (813) 685-9178 St Josephs Hospital 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Brandon Regional Hospital PCMH: No South Florida Baptist Hospital Tampa Bay Surgery Center Jester, Adam MD Languages: Spanish Provider ID: 1193406 MTF 8:00 AM - 5:00 PM Gender: Male WTH 2:00 AM - 5:00 PM Orthopeadic Medical Group PCMH: No 420 N Plant Ave Plant City, FL 33563 Grogan, Dennis MD (813) 756-4001 Provider ID: 574682 Fax: (813) 441-1191 Gender: Male 00 Yrs/130 Yrs Shriners Hospitals For St Josephs Hospital Children M-F 9:00 AM - 5:00 PM 12502 USF Pine Dr PCMH: No Tampa, FL 33612 (813) 975-7130 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Orthopaedic Surgery cont. Jester, Adam MD Provider ID: 1193406 Gender: Male Orthopeadic Medical Group 4700 N Habana Ave Tampa, FL 33614 (813) 684-2663 Fax: (813) 877-3017 00 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Jester, Adam MD Provider ID: 1193406 Gender: Male Orthopeadic Medical Group 615 Vonderburg Dr Brandon, FL 33511 (813) 684-2663 Fax: (813) 685-9178 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Khoury, Joseph MD Provider ID: 1328647 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Leffers, David MD Provider ID: 334840 Gender: Male USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-9422 Fax: (813) 396-9495 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Maciel, Maureen MD Provider ID: 574456 Gender: Female Shriners Hospitals For Children Tam 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7129 00 Yrs/18 Yrs Tampa General Hospital PCMH: No

Nofsinger, Charles MD Provider ID: 328737 Gender: Male USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-9422 Fax: (813) 396-9495 00 Yrs/130 Yrs Languages: Russian, German, Swedish M-F 9:00 AM - 5:00 PM PCMH: No

Remaley, Delbert DO Moreno, Anthony MD Provider ID: 1078338 Provider ID: 21771 Gender: Male Gender: Male Shriners Hospitals For Shriners Hospitals For Children Children 12502 USF Pine Dr 12502 USF Pine Dr Tampa, FL 33612 Tampa, FL 33612 (813) 975-7130 (813) 281-8115 Fax: (813) 974-7129 Fax: (813) 281-8656 00 Yrs/18 Yrs 00 Yrs/18 Yrs Florida Hospital Tampa CRMC At Bayonet Point Florida Hospital North Pinellas PCMH: No Morton Plant Hospital Remaley III, Delbert DO Languages: Spanish, Italian, Greek M-F 8:00 AM - 5:00 PM Provider ID: 964074 PCMH: No Gender: Male USF Physicians Group Neustadt, Jeffrey MD 13330 USF Laurel Dr Provider ID: 17808 Tampa, FL 33612 Gender: Male (813) 974-2201 Childrens Orthopaedic and Fax: (813) 396-9495 Scoliosis 00 Yrs/130 Yrs 3440 W Dr MLK Blvd Ste 200 M-F 8:00 AM - 5:00 PM Tampa, FL 33607 PCMH: No (813) 879-2663 Fax: (813) 879-2663 Sanders, Roy MD 00 Yrs/18 Yrs Provider ID: 1272069 Bayfront Medical Center Gender: Male Johns Hopkins All Childrens Shriners Hospitals For Hospital Inc Children St Josephs Hospital 12502 USF Pine Dr Languages: Spanish Tampa, FL 33612 M-F 8:30 AM - 5:00 PM (813) 975-7130 PCMH: No 00 Yrs/130 Yrs PCMH: No

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Sando, Mark MD Provider ID: 1172728 Gender: Male Orthopaedic Medical Group of Tampa 6901 Simmons Loop Ste 201 Riverview, FL 33578 (813) 684-2663 Fax: (813) 906-6100 00 Yrs/130 Yrs South Florida Baptist Hospital Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sando, Mark MD Provider ID: 1172728 Gender: Male Orthopeadic Medical Group of Tampa 420 N Plant Ave Plant City, FL 33563 (813) 684-2663 Fax: (813) 441-1191 00 Yrs/130 Yrs South Florida Baptist Hospital Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sando, Mark MD Provider ID: 1172728 Gender: Male Orthopeadic Medical Group of Tampa 615 Vonderburg Dr Brandon, FL 33511 (813) 684-2663 Fax: (813) 685-9178 00 Yrs/130 Yrs South Florida Baptist Hospital Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No Scott, Kevin MD Provider ID: 552299 Gender: Male Scott Sports Med LLC 6918 Gunn Hwy Ste C Tampa, FL 33625 (813) 855-8450 Fax: (813) 855-7540 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Orthopaedic Surgery cont. Shereff, Michael MD Provider ID: 452181 Gender: Male USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-9422 Fax: (813) 396-9495 18 Yrs/130 Yrs Languages: French M-F 8:00 AM - 5:00 PM PCMH: No

Watson, Jeffrey MD Provider ID: 707626 Gender: Male Orthopeadic Medical Group 615 Vonderburg Dr Brandon, FL 33511 (813) 684-2663 Fax: (813) 685-9178 00 Yrs/130 Yrs South Florida Baptist Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Koehler, Nicholas MD Provider ID: 1232211 Gender: Male Nicholas Koehler, PA 6 Tampa General Cir Tampa, FL 33606 (813) 844-7900 Fax: (813) 844-4058 00 Yrs/130 Yrs MTTHF 9:00 AM - 4:00 PM W 9:00 AM - 12:00 PM PCMH: No

Pediatric Allergy & Immunology Jerez, Diana MD Provider ID: 223984 Gender: Female Florida Pediatric Associate LLC 19039 N Dale Mabry Hwy Lutz, FL 33548 (813) 948-7000 Fax: (813) 948-7008 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish M-F 8:30 AM - 4:00 PM PCMH: No

Mukalel, Jessen MD Provider ID: 1281300 Stephens, Heidi MD Gender: Male Egas, Juan MD Provider ID: 7180 Tampa Institute For Pain and Provider ID: 1404108 Spine Gender: Female Gender: Male 13140 Elk Mountain Dr Ste B USF Physicicans Group Pediatric Cardiology Access Healthcare Riverview, FL 33579 2 Tampa General Cir 3rd Fl 17807 Huntington Bow Cir Ste (813) 513-8477 Tampa, FL 33606 Arrillaga, Frances MD 101 Fax: (813) 574-7761 (813) 396-9422 Lutz, FL 33558 12 Yrs/130 Yrs Fax: (813) 250-2126 (813) 388-9405 Provider ID: 333773 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs Fax: (813) 406-4691 Gender: Female PCMH: No Tampa General Hospital 18 Yrs/130 Yrs Pediatrix Medical Group of University Hospital Rivera, Abraham MD Florida Languages: Spanish M-F 9:00 AM - 5:00 PM 15045 Bruce B Downs Blvd M-F 8:00 AM - 5:00 PM Provider ID: 1338563 PCMH: No Tampa, FL 33647 PCMH: No Gender: Male Watson, Jeffrey MD Florida Pain Relief Group PLLC (727) 322-4830 Grana, Erick MD Fax: (855) 527-5510 3450 E Fletcher Ave Ste 350 Provider ID: 212096 00 Yrs/21 Yrs Tampa, FL 33613 Provider ID: 707626 Gender: Male Brandon Regional Hospital (813) 739-7495 Gender: Male Florida Hospital Carrollwood Tampa Pain Relief Centers Fax: (813) 864-0788 Orthopaedic Medical Group Johns Hopkins All Childrens 2333 W Hillsborough Ave Ste of Tampa 18 Yrs/130 Yrs Hospital Inc 100 420 N Plant Ave Languages: Spanish Languages: Spanish Tampa, FL 33603 Plant City, FL 33563 M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM (813) 872-4492 (813) 756-4001 PCMH: No PCMH: No 00 Yrs/130 Yrs Fax: (813) 441-1191 Armenia Ambulatory Surgery Zhu, Hui MD 00 Yrs/130 Yrs Provider ID: 1338577 South Florida Baptist Hospital Center Inc St Josephs Hospital Tampa Bay Surgery Center Gender: Male Languages: Spanish M-F 8:00 AM - 5:00 PM Florida Pain Relief Group M-F 7:00 AM - 5:00 PM PCMH: No 1110 Nikki View Dr PCMH: No Brandon, FL 33511 (813) 699-4005 Fax: (813) 343-2694 18 Yrs/130 Yrs Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No

Pain Management

www.wellcare.com/Florida | 237

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Cardiology cont. Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 112 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Babu, Keshava MD Provider ID: 28839 Gender: Male Pediatric Cardiologist Specialist 303 E Robertson St Brandon, FL 33511 (813) 221-8131 Fax: (813) 221-8138 00 Yrs/21 Yrs St Josephs Hospital Tampa General Hospital Languages: Hindi, Tamil M-F 9:00 AM - 5:00 PM PCMH: No

Babu, Keshava MD Provider ID: 28839 Gender: Male Pediatric Cardiology Specialists 208 W MLK Jr Blvd Tampa, FL 33603 (813) 221-8131 Fax: (813) 221-8138 00 Yrs/21 Yrs St Josephs Hospital Tampa General Hospital Languages: Hindi, Tamil M-F 9:00 AM - 5:00 PM PCMH: No

Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5000 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Bernus, Anna MD Provider ID: 531121 Ballal, Natraj MD Gender: Female Provider ID: 22700 Pediatrix Medical Group of Gender: Male Florida Bay Pediatric Cardiology 15045 Bruce B Downs Blvd 2727 W MLK Blvd Ste 620 Tampa, FL 33647 Tampa, FL 33607 (727) 322-4830 (813) 874-1662 Fax: (855) 527-5510 Fax: (813) 879-5064 00 Yrs/21 Yrs 00 Yrs/18 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, French Mease Hospital Dunedin M-F 8:00 AM - 5:00 PM South Florida Baptist Hospital PCMH: No Languages: Spanish, Hindi, Arabic Bernus, Anna MD M-F 8:00 AM - 4:15 PM Provider ID: 531121 PCMH: No Gender: Female Pediatrix Medical Group of Ballal, Natraj MD Florida Provider ID: 22700 3003 W Dr MLK Blvd 3rd Fl Gender: Male Tampa, FL 33607 Bay Pediatric Cardiology (813) 870-4000 603 W Lumsden Rd Fax: (855) 527-5510 Brandon, FL 33511 00 Yrs/21 Yrs (813) 874-1662 Brandon Regional Hospital Fax: (813) 879-5064 Languages: Spanish, French 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Florida Hospital Tampa PCMH: No Mease Hospital Dunedin South Florida Baptist Hospital Crawford, Marguerite MD Languages: Spanish, Hindi, Arabic Provider ID: 314170 M 1:00 AM - 5:00 PM Gender: Female PCMH: No 885 S Parsons Ave Brandon, FL 33511 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

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Crawford, Marguerite MD Provider ID: 314170 Gender: Female Pediatric Physician Services Inc 12220 Bruce B Downs Blvd Tampa, FL 33612 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group 3001 W Dr Martin Luther K Tampa, FL 33607 (813) 554-8701 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Cardiology cont.

Hardin, Joel MD Provider ID: 1311775 Gender: Male Gonzalez, Javier MD Ppediatrix Medical Group of Florida 3003 W Dr MLK Blvd 3rd Fl Provider ID: 520104 Tampa, FL 33607 Gender: Male (813) 870-4000 Pediatrix Medical Group of Fax: (855) 527-5510 Florida 3003 W Dr Martin Luther King 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM Jr Blvd Fl 3 5:00 PM Tampa, FL 33607 PCMH: No (813) 870-4000 Fax: (855) 527-5510 Hardin, Joel MD 00 Yrs/21 Yrs Provider ID: 1311775 Brandon Regional Hospital Gender: Male Mease Countryside Hospital Ppediatrix Medical Group of Morton Plant North Bay Florida Hospital 427 S Parsons Ave Ste 122 Languages: Spanish Brandon, FL 33511 M-F 8:00 AM - 5:00 PM (727) 322-4830 PCMH: No Fax: (855) 527-5510 Gonzalez, Javier MD 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 5:00 PM Provider ID: 520104 PCMH: No Gender: Male Pediatrix Medical Group of Huhta, James MD Florida Provider ID: 225655 427 S Parsons Ave Ste 122 Gender: Male Brandon, FL 33511 Pediatric Cardiology (727) 322-4830 Associates Fax: (855) 527-5510 12220 Bruce B Downs Blvd 00 Yrs/21 Yrs Tampa, FL 33612 Brandon Regional Hospital (727) 892-4200 Mease Countryside Hospital Fax: (727) 502-8047 Morton Plant North Bay Hospital 00 Yrs/19 Yrs Languages: Spanish Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No

Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Hardin, Joel MD Provider ID: 1311775 Gender: Male Ppediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male 3001 W McKing Tampa, FL 33607 (813) 554-8701 Fax: (813) 870-4911 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Cardiology cont. Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lawrence, David MD

Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Martinez, Richard MD

Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatric Cardiology Associates 12220 Bruce B Downs Blvd Tampa, FL 33612 (727) 892-4200 Fax: (727) 502-8047 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McCormack, Jorge MD Provider ID: 225657 Gender: Male Surgi Kids 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5000 Fax: (727) 502-8047 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Cardiology cont. McKenna, Daniel MD Provider ID: 1344711 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 Fax: (813) 975-7129 00 Yrs/21 Yrs Morton Plant Hospital Naples Community Hospital Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD

Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD

Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD

Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Stapleton, Gary MD

Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8701 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 12220 Bruce B Downs Blvd Tampa, FL 33612 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No

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Stapleton, Gary MD Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 885 S Parsons Ave Brandon, FL 33511 (727) 767-3333 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Suh, Elsa MD Provider ID: 225664 Gender: Male Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Bayfront Health Spring Hill Johns Hopkins All Childrens Hospital Inc South Florida Baptist Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Suh, Elsa MD Provider ID: 225664 Gender: Male Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd Fl 3 Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/21 Yrs Bayfront Health Spring Hill Johns Hopkins All Childrens Hospital Inc South Florida Baptist Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Cardiology cont.

Langley, Stephen MD

Provider ID: 1087213 Suh, Elsa MD Gender: Male Provider ID: 225664 Healthpoint Medical Group Gender: Male 3003 W Dr MLK Blvd 2nd Fl Pediatrix Medical Group of Tampa, FL 33607 Florida (813) 357-0520 427 S Parsons Ave Ste 122 Fax: (813) 870-4790 Brandon, FL 33511 00 Yrs/18 Yrs (727) 322-4830 M-F 8:00 AM - 5:00 PM Fax: (855) 527-5510 PCMH: No 00 Yrs/21 Yrs Sharma, Mahesh MD Bayfront Health Spring Hill Johns Hopkins All Childrens Hospital Inc Provider ID: 1087216 South Florida Baptist Hospital Gender: Male Languages: Spanish Baycare Medical Group M-F 8:00 AM - 5:00 PM 3003 W Dr MLK Blvd 2nd Fl PCMH: No Tampa, FL 33607 (813) 357-0520 Wearden, Peter MD Fax: (813) 870-4790 00 Yrs/18 Yrs Provider ID: 955967 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Healthpoint Medical Group Inc Viegas, Melita MD 3003 W Dr MLK Blvd 2nd Fl Provider ID: 1069319 Mab Gender: Female Tampa, FL 33607 Healthpoint Medical Group (813) 357-0520 3003 W Dr MLK Blvd 2nd Fl Fax: (813) 870-4790 Mab 18 Yrs/130 Yrs Tampa, FL 33607 St Josephs Hospital (813) 357-0520 M-F 9:00 AM - 5:00 PM Fax: (813) 870-4790 PCMH: No 00 Yrs/18 Yrs Pediatric Cardiovascular Languages: French M-F 8:00 AM - 5:00 PM Surgery PCMH: No Jacobs, Jeffery MD Provider ID: 19272 Gender: Male Cardiac Surgical Associates LLP 3003 W Dr M L King Blvd Fl 2 Tampa, FL 33607 (813) 554-8343 Fax: (813) 554-8345 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Mease Hospital Dunedin St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Ear, Nose & Throat Andrews, Thomas MD Provider ID: 1246 Gender: Male Pediatric Otolaryngology 14111 State Rd 54 Odessa, FL 33556 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Andrews, Thomas MD Provider ID: 1246 Gender: Male Pediatric Otolaryngology Assoc 4726 N Habana Ave Ste 204 Tampa, FL 33614 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Andrews, Thomas MD Provider ID: 1246 Gender: Male Pediatric Otolaryngology Associates 10080 Balaye Run Dr Tampa, FL 33619 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Cressman, Wade MD Provider ID: 8265 Gender: Male Pediatric Otolaryngology 4726 N Habana Ave Ste 204 Tampa, FL 33614 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Cressman, Wade MD Provider ID: 8265 Gender: Male Pediatric Otolaryngology Associates 10080 Balaye Run Dr Tampa, FL 33619 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Trowbridge, Rose MD Provider ID: 912630 Gender: Female Pediatric Otolaryngology 10080 Balaye Run Dr Tampa, FL 33619 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Ear, Nose & Throat - cont. Trowbridge, Rose MD Provider ID: 912630 Gender: Female Pediatric Otolaryngology 4726 N Habana Ave Ste 204 Tampa, FL 33614 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head Nec 4726 N Habana Ave Ste 204 Tampa, FL 33614 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head & Nec 10080 Balaye Run Dr Tampa, FL 33619 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head & Nec 14111 State Rd 54 Odessa, FL 33556 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Declue, Terry MD Provider ID: 8064 Gender: Male Pediatric Endocrine Associates 3001 W MLK Blvd Tampa, FL 33607 (813) 554-8420 Fax: (813) 554-8377 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish, Creole MW 8:30 AM - 4:30 PM TTH 8:30 AM - 5:00 PM PCMH: No

Pediatric Endocrinology

Dougan, Grace MD Provider ID: 951635 Gender: Female Pediatric Endocrine Associates PA 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8420 Fax: (813) 554-8377 00 Yrs/21 Yrs St Josephs Hospital Languages: Spanish M-W 8:30 AM - 3:30 PM PCMH: No

Bollepalli, Sureka MD Provider ID: 1263554 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 00 Yrs/18 Yrs Tampa General Hospital PCMH: No Bollepalli, Sureka MD Provider ID: 558266 Gender: Female USF Physician Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Bollepalli, Sureka MD Provider ID: 558266 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2583 Fax: (813) 396-9678 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gomez, Danielle MD Provider ID: 1286497 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7125 00 Yrs/18 Yrs Tampa General Hospital MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

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Jorgensen, Ellen Verena MD Provider ID: 9409 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lenz, Anne MD Provider ID: 612108 Gender: Female Pediatic Endocrine Associates 3001 W MLK Blvd Medical Arts Bldg Tampa, FL 33607 (813) 554-8420 Fax: (813) 554-8377 00 Yrs/21 Yrs Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 8:30 AM - 4:00 PM PCMH: No Lin, Tsu-Hui MD Provider ID: 5142 Gender: Female Pediatric Endocrine Associates 3001 W MLK Blvd Tampa, FL 33607 (813) 554-8420 Fax: (813) 554-8377 00 Yrs/21 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Chinese M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Endocrinology cont. Rodriguez, Henry MD Provider ID: 581090 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Shah, Shuchi MD Provider ID: 536740 Gender: Female Florida Pediatic Associates LLC 15289 Amberly Dr Tampa, FL 33647 (813) 972-1067 Fax: (813) 972-1091 00 Yrs/21 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Shulman, Dorothy MD Provider ID: 9411 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Shulman, Dorothy MD Provider ID: 9411 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Gastroenterology Arasu, Thiru MD Provider ID: 4516 Gender: Male 3003 W MLK Blvd 3rd Fl Mab Tampa, FL 33607 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Arasu, Thiru MD Provider ID: 4516 Gender: Male Thiru S Arasu MD 14111 State Rd 54 Odessa, FL 33556 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Hindi MWTHF 9:00 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Arasu, Thiru MD Provider ID: 4516 Gender: Male Thiru S Arasu MD 15045 Bruce B Downs Blvd Tampa, FL 33647 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No

Beltroy Cornejo, Eduardo MD Provider ID: 1031488 Gender: Male Pediatric Gastroenterology Hepatolo 3003 W. MLK Jr Blvd 3rd Fl Medical Arts Bldg Tampa, FL 33607 (813) 870-4948 Fax: (813) 544-8044 00 Yrs/21 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Condino, Adria DO Provider ID: 429785 Gender: Female 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5063 Fax: (813) 631-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No Condino, Adria DO Provider ID: 429785 Gender: Female 3003 W MLK Blvd Tampa, FL 33607 (813) 987-2911 Fax: (813) 987-2853 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC M-F 7:00 AM - 5:30 PM PCMH: No

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Cuenca, Rosa MD Provider ID: 4495 Gender: Female Thiru S Arasu MD 10817 Bloomingdale Ave Riverview, FL 33578 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Florida Hospital Tampa St Josephs Hospital Languages: Spanish MWTHF 9:00 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Cuenca, Rosa MD Provider ID: 4495 Gender: Female Thiru S Arasu MD 15045 Bruce B Downs Blvd Tampa, FL 33647 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Cuenca, Rosa MD Provider ID: 4495 Gender: Female Thiru S Arasu MD 3003 W MLK Blvd 3rd Fl Mab Tampa, FL 33607 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Ignacio, Joseph MD Gastroenterology - cont. Dhana, Leila MD Provider ID: 207634 Gender: Female 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5063 Fax: (813) 631-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Dhana, Leila MD Provider ID: 207634 Gender: Female 14111 SR 54 Odessa, FL 33556 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Dhana, Leila MD Provider ID: 207634 Gender: Female 427 S Parsons Ave Ste 112 Brandon, FL 33511 (813) 661-2222 Fax: (727) 822-9515 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 197151 Gender: Male 14111 SR 54 Odessa, FL 33556 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Plantation General Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Ignacio, Joseph MD Provider ID: 197151 Gender: Male 5205 E Fletcher Ave Tampa, FL 33617 (813) 987-2911 Fax: (813) 987-2870 00 Yrs/130 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Plantation General Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Ignacio, Joseph MD Provider ID: 197151 Gender: Male Ped Gastroenterology Hepatology 885 S Parsons Ave Brandon, FL 33511 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/130 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Plantation General Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No

Irizarry, Karina MD Provider ID: 469781 Gender: Female 885 S Parsons Ave Brandon, FL 33511 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Kaiser, Greg MD Provider ID: 19532 Gender: Male Ped Gastroen Hepatol Nutrition 5205 E Fletcher Ave Tampa, FL 33617 (813) 987-2911 Fax: (813) 987-2870 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Irizarry, Karina MD Provider ID: 469781 Gender: Female Ped Gastroenterology Hepatology 5205 E Fletcher Ave Tampa, FL 33617 (813) 987-2911 Fax: (813) 987-2853 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC Languages: Spanish M-F 7:00 AM - 5:30 PM PCMH: No

McClenathan, Daniel MD

Kaiser, Greg MD Provider ID: 19532 Gender: Male 14111 SR 54 Odessa, FL 33556 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Provider ID: 1347 Gender: Male 14111 SR 54 Odessa, FL 33556 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Narwal, Shivinder MD Provider ID: 923120 Gender: Male Thiru S Arasu MD 205 S Moon Ave Brandon, FL 33511 (813) 324-2613 Fax: (813) 324-2614 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC M-TH 9:00 AM - 5:00 PM F 9:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Wilsey Jr, Michael MD Gastroenterology - cont. Narwal, Shivinder MD Provider ID: 923120 Gender: Male Thiru S Arasu MD 3003 W ML King Jr Blvd Tampa, FL 33607 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC M-TH 9:00 AM - 5:00 PM F 9:30 AM - 5:30 PM PCMH: No Rook, Michelle MD Provider ID: 958681 Gender: Female 3003 W Martin Lauther King Blvd Mab 3rd Fl Tampa, FL 33607 (813) 870-4948 Fax: (813) 554-8044 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Wilsey Jr, Michael MD Provider ID: 200955 Gender: Male 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5063 Fax: (813) 631-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 200955 Gender: Male Ped Gastroenterology Hepatology 3003 Martin Luther King Jr Blvd Tampa, FL 33607 (813) 987-2911 Fax: (727) 822-9515 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Michele MD Provider ID: 8416 Gender: Female 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5063 Fax: (813) 631-5062 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Michele MD Provider ID: 8416 Gender: Female 14111 SR 54 Odessa, FL 33556 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Winesett, Michele MD Provider ID: 8416 Gender: Female 5205 E Fletcher Ave Temple Terrace, FL 33617 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Genetics Ranells, Judith MD Provider ID: 12942 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Hematology/ Oncology Ayala, Irmel MD Provider ID: 2522 Gender: Female Pediatric Physician Services, Inc 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5001 Fax: (813) 631-5098 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Cockrell, Erin DO Provider ID: 695337 Gender: Female 3001 W Dr MLK Blvd 1st Fl Tampa, FL 33607 (813) 321-6820 Fax: (813) 287-6306 00 Yrs/18 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Galligan, Andrew MD Provider ID: 1109490 Gender: Male 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 396-9696 Fax: (813) 250-2101 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Grana, Nanette MD Provider ID: 451174 Gender: Female PPS Developmental/ Behavioral Ped 12220 Bruce B Downs Blvd Box 1000 Tampa, FL 33612 (727) 767-4175 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Kerr, Jody MD Provider ID: 372911 Gender: Female 12220 Bruce B Downs Blvd Tampa, FL 33612 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Hematology/ Oncology - cont. Mogul, Mark MD Provider ID: 170953 Gender: Male Healthpoint Medical Group Inc 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 321-6820 Fax: (813) 287-6306 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Obzut, Dana MD Provider ID: 301071 Gender: Female Healthpointe Medical Group 3001 W MLK Jr Blvd Tampa, FL 33607 (813) 321-6820 Fax: (813) 554-8353 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Reed, Damon MD Provider ID: 451168 Gender: Male All Children's Specialty Physicians 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5001 Fax: (813) 631-5098 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-TH 8:30 AM - 5:00 PM PCMH: No Rico, Juan MD Provider ID: 717729 Gender: Female 2 Tampa General Cir Ste 2 Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/21 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rossbach, Hans-Christoph MD Provider ID: 3315 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7125 00 Yrs/18 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc Languages: German PCMH: No Sawczyn, Kelly MD Provider ID: 397206 Gender: Female Pediatric Physician Services 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5001 Fax: (813) 631-5098 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No Stapleton, Stacie MD Provider ID: 401213 Gender: Female PPS Developmental/ Behavioral Ped 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5001 Fax: (813) 631-5098 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Infectious Disease Bergamo, Dale MD Provider ID: 364333 Gender: Male USF Physicians Group 3003 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (813) 259-8800 Fax: (813) 259-8805 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Bergamo, Dale MD Provider ID: 364333 Gender: Male USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Berman, David DO Provider ID: 173540 Gender: Male 885 S Parsons Ave Brandon, FL 33511 (727) 767-4160 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Emmanuel, Patricia Jacques MD Provider ID: 7075 Gender: Female USF Physicians Group 17 Davis Blvd Ste 200 Tampa, FL 33606 (813) 259-8800 Fax: (813) 259-8805 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Emmanuel, Patricia Jacques MD Provider ID: 7075 Gender: Female USF Physicicans Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-7715 Fax: (813) 974-5411 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Gutierrez Jaramillo, Mavel MD Provider ID: 1109501 Gender: Female 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8800 Fax: (813) 259-8805 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Messina, Allison MD Provider ID: 346501 Gender: Female Pediatric Physicians Services 885 S Parsons Ave Brandon, FL 33511 (727) 767-4160 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Rodriguez, Carina MD Provider ID: 343712 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Infectious Disease - cont. Rodriguez, Carina MD Provider ID: 554223 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8015 Fax: (813) 276-2999 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M 8:00 AM - 3:30 PM T 10:00 AM - 4:00 PM PCMH: No

Pediatric Nephrology Campos, Alfonso MD Provider ID: 7041 Gender: Male USF Physicians Group 13101 Bruce B Downs Blvd Fl 3 Tampa, FL 33612 (813) 259-8760 Fax: (813) 259-8765 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Campos, Alfonso MD Provider ID: 7041 Gender: Male USF Physicians Group 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 259-8760 Fax: (813) 259-8765 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Panzarino, Valerie MD Provider ID: 310890 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8760 Fax: (813) 259-8765 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Neurosurgery

Carey, Carolyn MD Provider ID: 173532 Gender: Female 885 S Parsons Ave Brandon, FL 33511 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Rodriguez, Luis MD Provider ID: 309778 Gender: Male Provider ID: 626399 885 S Parsons Ave Gender: Male Brandon, FL 33511 Shriners Hospitals For (727) 767-8181 Children Fax: (727) 767-8030 12502 USF Pine Dr 00 Yrs/21 Yrs Tampa, FL 33612 Bayfront Medical Center (813) 975-7130 Johns Hopkins All Childrens Fax: (813) 975-7129 Hospital Inc 00 Yrs/18 Yrs Tampa General Hospital Florida Hospital Orlando Languages: Spanish, German Shriners Hospital For Children M-F 9:00 AM - 5:00 PM Nc PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Tuite, Gerald MD Provider ID: 17798 Carey, Carolyn MD Gender: Male Provider ID: 173532 12220 Bruce B Downs Blvd Gender: Female Tampa, FL 33612 12220 Bruce B Downs Blvd (727) 767-8181 Tampa, FL 33612 Fax: (727) 767-8030 (727) 767-8181 00 Yrs/130 Yrs Fax: (727) 767-8030 Johns Hopkins All Childrens 00 Yrs/21 Yrs Hospital Inc Bayfront Medical Center Tampa General Hospital Johns Hopkins All Childrens Languages: Spanish Hospital Inc M-F 9:00 AM - 5:00 PM Tampa General Hospital PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Baumgartner, James MD

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Tuite, Gerald MD Provider ID: 17798 Gender: Male 885 S Parsons Ave Brandon, FL 33511 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Orthopaedics Beck, Scott MD Provider ID: 17806 Gender: Male Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 879-2663 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No Benfanti, Paul MD Provider ID: 587667 Gender: Male Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 879-2663 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Orthopaedics - Neustadt, Jeffrey MD cont. Provider ID: 17808 Deignan, Brian MD Provider ID: 791861 Gender: Male Healthpoint Medical Group 10141 Big Bend Rd Fl 206 Riverview, FL 33578 (813) 554-8983 Fax: (813) 443-8177 00 Yrs/18 Yrs St Josephs Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 879-2663 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Deignan, Brian MD Siambenes, David DO Provider ID: 791861 Gender: Male Provider ID: 587354 Healthpoint Medical Group 3003 W Dr MLK Blvd Mab-3rd Gender: Male Healthpoint Medical Group Fl 3003 W Dr MLK Blvd Mab 3rd Tampa, FL 33607 Fl (813) 554-8983 Tampa, FL 33607 Fax: (813) 443-8154 (813) 554-8983 00 Yrs/18 Yrs Fax: (813) 554-8992 St Josephs Hospital 00 Yrs/18 Yrs Languages: Spanish St Josephs Hospital M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Delucia, Tracey MD Warnick, Drew MD Provider ID: 1005684 Provider ID: 557201 Gender: Female Gender: Male Healthpoint Medical Group Childrens Orthopaedic and Inc Scoliosis 3003 W Dr MLK Blvd Mab 3rd 3440 W Dr MLK Blvd Ste 200 Fl Tampa, FL 33607 Tampa, FL 33607 (813) 879-2663 (813) 554-8983 Fax: (813) 879-2663 Fax: (813) 443-8177 00 Yrs/18 Yrs 00 Yrs/18 Yrs Johns Hopkins All Childrens M-F 8:00 AM - 5:00 PM Hospital Inc PCMH: No Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Orthopedic Surgery Bradley, Timothy MD Provider ID: 226054 Gender: Male Timothy M Bradley MD Pediatric Orth 602 Vonderburg Dr Ste 103 Brandon, FL 33511 (813) 720-8001 Fax: (813) 445-8168 00 Yrs/18 Yrs Brandon Regional Hospital St Josephs Hospital Languages: Spanish MF 8:00 AM - 6:00 PM TWTH 8:00 AM - 5:00 PM PCMH: No Kortright, Luis MD Provider ID: 12400 Gender: Male 4600 N Habana Ave Ste 6 Tampa, FL 33614 (813) 871-5200 Fax: (813) 871-2423 00 Yrs/18 Yrs St Josephs Hospital Languages: Spanish M-W 9:00 AM - 4:30 PM TH 12:00 AM - 4:30 PM F 9:00 AM - 12:00 PM PCMH: No Phillips, Lee MD Provider ID: 1100601 Gender: Male Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

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Raney, Ellen MD Provider ID: 590111 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7117 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Pulmonology Ajayi, Akinyemi MD Provider ID: 208937 Gender: Male Orlando Pediatric Pulmonary And Sle 16606 N Dale Mabry Hwy Ste 103 Tampa, FL 33618 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs Arnold Palmer Hospital For Children Florida Hospital Orlando M-F 9:00 AM - 5:00 PM PCMH: No Couluris, Marisa DO Provider ID: 240427 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8767 Fax: (813) 259-8770 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Couluris, Marisa DO Provider ID: 240427 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8767 Fax: (813) 259-8770 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Pulmonology cont. Couluris, Marisa DO Provider ID: 240427 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8770 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Houin, Paul MD Provider ID: 1004662 Gender: Male Pediatric Pulmonary Specialists PA 4714 N Armenia Ave Ste 201 Tampa, FL 33603 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-TH 9:00 AM - 6:00 PM PCMH: No Kuriakose, Kevin MD Provider ID: 777446 Gender: Male Orlando Pediatric Pulmonary And Sle 16606 N Dale Mabry Hwy Tampa, FL 33618 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Penugonda, Madhuri MD Provider ID: 816127 Gender: Female Orlando Pediatric Pulmonary And Sle 16606 N Dale Mabry Hwy Tampa, FL 33618 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Prpich, John MD Provider ID: 448916 Gender: Male Pediatric Pulmonary Specialists PA 10817 Bloomingdale Ave Riverview, FL 33578 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/21 Yrs St Josephs Hospital M 9:00 AM - 5:00 PM PCMH: No Prpich, John MD Provider ID: 448916 Gender: Male Pediatric Pulmonary Specialists PA 4714 N Armenia Ave Ste 201 Tampa, FL 33603 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/21 Yrs St Josephs Hospital M-TH 9:00 AM - 6:00 PM PCMH: No Rosenberg, David MD Provider ID: 1424 Gender: Male Pediatric Pulmonary Specialists PA 10817 Bloomingdale Ave Riverview, FL 33578 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Lakeland Reg Medical Center St Josephs Hospital M 9:00 AM - 5:00 PM PCMH: No

Rosenberg, David MD Coughlin, John MD Provider ID: 1424 Provider ID: 5639 Gender: Male Gender: Male Pediatric Pumonary Specialists 10080 Balaye Run Dr 4714 N Armenia Ave Ste 201 Tampa, FL 33619 Tampa, FL 33603 (813) 631-5034 (813) 870-1995 Fax: (813) 631-5061 Fax: (813) 875-1889 00 Yrs/21 Yrs 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Pediatric Surgery Center LLC Hospital Inc Odessa Lakeland Reg Medical Center St Josephs Hospital M-F 9:00 AM - 5:00 PM M-TH 9:00 AM - 6:00 PM PCMH: No PCMH: No Coughlin, John MD Sifain, Maggie MD Provider ID: 5639 Provider ID: 515650 Gender: Male Gender: Female 14111 SR 54 Orlando Pediatric Pulmonary Odessa, FL 33556 And Sle (813) 631-5034 16606 N Dale Mabry Hwy Fax: (813) 631-5061 Tampa, FL 33618 00 Yrs/21 Yrs (407) 898-2767 Brandon Regional Hospital Fax: (407) 898-9443 Florida Hospital Carrollwood Pediatric Surgery Center LLC 00 Yrs/21 Yrs Odessa Orlando Regional Medical M-F 8:30 AM - 5:00 PM Center PCMH: No Languages: Arabic M-F 8:30 AM - 5:00 PM Coughlin, John MD PCMH: No Provider ID: 5639 Pediatric Surgery Gender: Male John P. Coughlin, MD PA Chandler, Nicole MD 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5034 Provider ID: 461033 Fax: (813) 631-5061 Gender: Female 00 Yrs/21 Yrs Pediatric Physician Services Brandon Regional Hospital 885 S Parsons Ave Florida Hospital Carrollwood Brandon, FL 33511 Pediatric Surgery Center LLC (727) 767-4170 Odessa Fax: (727) 767-4346 M-F 8:30 AM - 5:00 PM 00 Yrs/21 Yrs PCMH: No Johns Hopkins All Childrens Hospital Inc Kassira, Noor MD M-F 8:00 AM - 4:00 PM Provider ID: 987932 PCMH: No Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 974-4280 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Surgery - cont. Kassira, Noor MD Provider ID: 987932 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 234-2803 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Loux, Tara MD Provider ID: 1144349 Gender: Female Baycare Medical Group Inc 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8384 Fax: (813) 443-8160 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Martinez, Luis MD Provider ID: 18793 Gender: Male Healthpoint Medical Group 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8384 Fax: (813) 443-8160 00 Yrs/18 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Paidas, Charles MD Provider ID: 269843 Gender: Male USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-0929 Fax: (813) 396-9678 00 Yrs/21 Yrs Tampa General Hospital Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No Paidas, Charles MD Provider ID: 269843 Gender: Male USF Physicians Group 2 Tampa General Cir Fl 2 Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-8862 00 Yrs/21 Yrs Tampa General Hospital Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No Pham, Tuan MD Provider ID: 585267 Gender: Male Healthpoint Medical Center 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 554-8384 Fax: (813) 443-8160 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rideout, Drew MD Provider ID: 916252 Gender: Male All Childrens Speciality Clinic 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5000 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Rideout, Drew MD Provider ID: 916252 Gender: Male All Childrens Specialty Clinic 855 S Parsons Ave Brandon, FL 33511 (813) 436-5900 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 885 S Parsons Ave Brandon, FL 33511 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No

Pediatric Urology Corbyons, Katherine MD Provider ID: 1245948 Gender: Female Children's Urology Group, Pl 4712 N Armenia Ave Ste 200 Tampa, FL 33603 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Hoover, Dennis MD Provider ID: 2812 Gender: Male Brandon At All Childrens Specialty 885 S Parsons Ave Brandon, FL 33511 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Hoover, Dennis MD Provider ID: 2812 Gender: Male Childrens Urology Group 4712 N Armenia Ave Ste 200 Tampa, FL 33603 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Kolligian, Mark MD Provider ID: 164682 Gender: Male Brandon At All Childrens Specialty 885 S Parsons Ave Brandon, FL 33511 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatric Urology - cont. Butto, Fouad MD Kolligian, Mark MD Provider ID: 164682 Gender: Male Childrens Urology Group 4712 N Armenia Ave Ste 200 Tampa, FL 33603 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Polsky, Ethan MD Provider ID: 341141 Gender: Male Brandon At All Childrens Specialty 885 S Parsons Ave Brandon, FL 33511 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Arroyo Jr, Jose MD Provider ID: 1100370 Gender: Male Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 653-6100 Fax: (813) 633-2669 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1321322 Gender: Male Pediatrix Medial Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Butto, Fouad MD Provider ID: 1321322 Gender: Male Pediatrix Medial Group of Florida 3003 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Butto, Fouad MD Provider ID: 1321322 Gender: Male Pediatrix Medial Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Carr, Silvana MD Provider ID: 672893 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8800 Fax: (813) 259-8805 00 Yrs/21 Yrs Tampa General Hospital Languages: Portuguese M-F 8:00 AM - 5:00 PM PCMH: No

Carr, Silvana MD Provider ID: 672893 Gender: Female USF Physicians Group 3003 W Dr MLK Blvd Fl 2 Tampa, FL 33607 (813) 259-8800 Fax: (813) 259-8805 00 Yrs/21 Yrs Tampa General Hospital Languages: Portuguese M-F 8:00 AM - 5:00 PM PCMH: No Couluris, Marisa DO Provider ID: 1199283 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 00 Yrs/21 Yrs Tampa General Hospital PCMH: No Dembinksi, Karolina DO Provider ID: 572796 Gender: Female University Med Svcs Assoc, Inc 2 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs Languages: Spanish, Polish M-F 8:00 AM - 5:00 PM PCMH: No Desai, Ajay DO Provider ID: 1423685 Gender: Male Desai,Ajay K;DO 400 E MLK Blvd Ste 107 Tampa, FL 33603 (813) 442-7505 Fax: (813) 769-9834 00 Yrs/21 Yrs Florida Hospital Tampa M-F 9:00 AM - 8:00 PM Sat 10:00 AM - 3:00 PM PCMH: No

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Fant, Michael MD Provider ID: 506925 Gender: Male University Med Svcs Assoc Inc 1 Tampa General Cir F 170 Tampa, FL 33606 (813) 844-3437 Fax: (813) 844-1671 00 Yrs/12 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Fant, Michael MD Provider ID: 506925 Gender: Male University Med Svcs Assoc Inc 2 Tampa General Cir 5th Fl Tampa, FL 33606 (813) 259-8812 Fax: (813) 259-8810 00 Yrs/12 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Karniski, Walt MD Provider ID: 996595 Gender: Male USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Karniski, Walt MD Provider ID: 996595 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 234-2803 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pediatrics - cont. Muniz-Verrando, Lorena MD Provider ID: 718935 Gender: Female Julia Barriga MD PA 5001 E Busch Blvd Tampa, FL 33617 (813) 984-8846 Fax: (813) 984-8827 00 Yrs/21 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 1:00 PM PCMH: No Murphy, Melinda MD Provider ID: 1282319 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7129 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital PCMH: No Pavan, Mary MD Provider ID: 1186178 Gender: Female USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-0602 Fax: (813) 558-1343 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Rampersad, Avind MD Provider ID: 1341932 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 281-8115 Fax: (813) 281-8656 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Rico, Juan MD Provider ID: 717729 Gender: Female 2 Tampa General Cir Ste 2 Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/21 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Carina MD Provider ID: 554223 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8015 Fax: (813) 276-2999 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M 8:00 AM - 3:30 PM T 10:00 AM - 4:00 PM PCMH: No

Shulman, Dorothy MD Provider ID: 1119388 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 00 Yrs/18 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pedodontics

Black, Harrison DMD Provider ID: TPVP157241-03 Gender: Male Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Alfano, David DDS Provider ID: TPVP96480-01 Gender: Male David P Alfano DDS 14037 N Dale Mabry Hwy Tampa, FL 33618 (813) 968-5743 Fax: (813) 264-4231 00 Yrs/99 Yrs M-TH 7:30 AM - 5:00 PM PCMH: No

Black, Harrison DMD Provider ID: TPVP157241-04 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Black, Harrison DMD Provider ID: TPVP157241-01 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Black, Harrison DMD Provider ID: TPVP157241-05 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Black, Harrison DMD Provider ID: TPVP157241-02 Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Black, Harrison DMD Provider ID: TPVP157241-06 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Pedodontics - cont. Black, Harrison DMD Provider ID: TPVP157241-07 Gender: Male Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Bui, Loananh DDS Provider ID: TPVP120562-19 Gender: Female Great Expressions Dental Centers 1060 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 931-4000 Fax: (813) 932-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Bui, Loananh DDS Provider ID: TPVP120562-20 Gender: Female Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-21 Gender: Female Great Expressions Dental Centers 1006 N Florida Ave Tampa, FL 33602 (813) 223-3266 Fax: (813) 221-6402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-26 Gender: Female Great Expressions Dental Centers 5101 E Busch Blvd Ste 13 Tampa, FL 33617 (813) 988-1167 Fax: (813) 985-7302 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cortes, Lourdes DMD Provider ID: TPVP43286-01 Gender: Female Wang and Cortes Dental 4014 W Estrella St Ste A Tampa, FL 33629 (813) 253-3679 Fax: (888) 405-7247 00 Yrs/99 Yrs Languages: Spanish MTTH 8:00 AM - 5:00 PM WF 9:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-22 Gender: Female Great Expressions Dental Centers 10924 Cross Creek Blvd Tampa, FL 33647 (813) 982-1777 Fax: (813) 986-6230 00 Yrs/99 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-27 Gender: Female Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-23 Gender: Female Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-28 Gender: Female Great Expressions Dental Centers 15148 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-0106 Fax: (813) 265-8126 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Edwards, Jenny DMD Provider ID: TPVP149782-03 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-25 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

Busciglio, Dana DMD Provider ID: TPVP165343-01 Gender: Female Great Expressions Dental Centers 10924 Cross Creek Blvd Tampa, FL 33647 (813) 982-1777 Fax: (813) 986-6230 00 Yrs/99 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No

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Falemban, Mounika DDS Provider ID: TPVP45061-01 Gender: Female Kidzone Dentistry 13039 Summerfield Square Dr Riverview, FL 33578 (813) 677-3047 Fax: (813) 649-6376 00 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM PCMH: No Gonzalez, William DMD Provider ID: TPVP144831-01 Gender: Male Pediatric Dental Center 1540 S Dale Mabry Hwy Tampa, FL 33629 (813) 254-8457 Fax: (813) 258-5090 00 Yrs/99 Yrs Languages: Spanish M-TH 8:30 AM - 5:00 PM F 8:30 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pedodontics - cont. Gyles, Richard DDS Provider ID: TPVP132893-01 Gender: Male Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gyles, Richard DDS Provider ID: TPVP132893-05 Gender: Male Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gyles, Richard DDS Provider ID: TPVP132893-02 Gender: Male Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Gyles, Richard DDS Provider ID: TPVP132893-06 Gender: Male Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gyles, Richard DDS Provider ID: TPVP132893-03 Gender: Male Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gyles, Richard DDS Provider ID: TPVP132893-07 Gender: Male Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Gyles, Richard DDS Provider ID: TPVP132893-04 Gender: Male Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Iyer, Priyanka DDS Provider ID: TPVP159376-01 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Iyer, Priyanka DDS Provider ID: TPVP159376-02 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Iyer, Priyanka DDS Provider ID: TPVP159376-03 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Iyer, Priyanka DDS Provider ID: TPVP159376-06 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Iyer, Priyanka DDS Provider ID: TPVP159376-07 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Iyer, Priyanka DDS Jafarnia, Bahareh DDS Provider ID: TPVP159376-04 Provider ID: TPVP45042-01 Gender: Female Gender: Female Palm River Community Health Great Expressions Dental Center Centers 7728 Palm River Rd 1060 W Busch Blvd Ste 105 Tampa, FL 33619 Tampa, FL 33612 (813) 630-3635 (813) 931-4000 Fax: (813) 620-1614 Fax: (813) 932-1728 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Iyer, Priyanka DDS Provider ID: TPVP159376-05 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

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Jafarnia, Bahareh DDS Provider ID: TPVP45042-02 Gender: Female Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pedodontics - cont. Jafarnia, Bahareh DDS Provider ID: TPVP45042-03 Gender: Female Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jafarnia, Bahareh DDS Provider ID: TPVP45042-05 Gender: Female Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Jafarnia, Bahareh DDS Provider ID: TPVP45042-06 Gender: Female Great Expressions Dental Centers 15148 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-0106 Fax: (813) 265-8126 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lasanta, Denisse DMD Provider ID: TPVP130428-02 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No Lasanta, Denisse DMD Provider ID: TPVP130428-03 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lasanta, Denisse DMD Provider ID: TPVP130428-04 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lasanta, Denisse DMD Provider ID: TPVP130428-05 Gender: Female Lasanta, Denisse DMD Tom Lee Community Health Provider ID: TPVP130428-01 Center Gender: Female 14254 Martin Luther King Blvd Palm River Community Health SR 574 Center Dover, FL 33527 7728 Palm River Rd (813) 349-7736 Tampa, FL 33619 Fax: (813) 349-7561 (813) 630-3635 00 Yrs/99 Yrs Fax: (813) 620-1614 Languages: Spanish 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

Lasanta, Denisse DMD Provider ID: TPVP130428-06 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lasanta, Denisse DMD Provider ID: TPVP130428-07 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lee, Sara DMD Provider ID: TPVP156988-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

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Makram, Christina DDS Provider ID: TPVP165156-02 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-01 Gender: Female Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-03 Gender: Female Great Expressions Dental Centers 5658 Fishhawk Crossing Blvd Lithia, FL 33547 (813) 490-1982 Fax: (813) 689-5908 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pedodontics - cont. Naoom, Jennifer DDS Provider ID: TPVP102299-04 Gender: Female Great Expressions Dental Centers 15148 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-0106 Fax: (813) 265-8126 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-06 Gender: Female Great Expressions Dental Centers 1060 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 931-4000 Fax: (813) 932-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-07 Gender: Female Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-08 Gender: Female Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-09 Gender: Female Great Expressions Dental Centers 6552 Gunn Hwy Tampa, FL 33625 (813) 963-0307 Fax: (813) 400-1335 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-14 Gender: Female Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-10 Gender: Female Great Expressions Dental Centers 3806 W Linebaugh Ave Tampa, FL 33618 (813) 960-0917 Fax: (813) 264-6105 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-16 Gender: Female Great Expressions Dental Centers 4333 W Bay To Bay Blvd Tampa, FL 33629 (813) 837-5147 Fax: (813) 839-2185 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-11 Gender: Female Great Expressions Dental Centers 825 W Martin Luther King Blvd Tampa, FL 33603 (813) 237-1982 Fax: (813) 232-4394 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-12 Gender: Female Great Expressions Dental Centers 10924 Cross Creek Blvd Tampa, FL 33647 (813) 982-1777 Fax: (813) 986-6230 00 Yrs/99 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-17 Gender: Female Great Expressions Dental Centers 5101 E Busch Blvd Ste 13 Tampa, FL 33617 (813) 988-1167 Fax: (813) 985-7302 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Newcity, Amanda DDS Provider ID: TPVP145785-05 Gender: Female Smile Design Lithia 3442 Lithia Pinecrest Rd Valrico, FL 33596 (813) 662-1111 Fax: (888) 582-0179 00 Yrs/99 Yrs MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No

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Newcity, Amanda DDS Provider ID: TPVP145785-16 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7635 Fax: (813) 938-6423 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Newcity, Amanda DDS Provider ID: TPVP145785-17 Gender: Female Suncoast Mobile Dental Van 2814 14th Ave SE Ruskin, FL 33570 (813) 653-6100 Fax: (813) 349-7596 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Newcity, Amanda DDS Provider ID: TPVP145785-18 Gender: Female Tom Lee Community Health Center 14254 Martin Luther King Blvd SR 574 Dover, FL 33527 (813) 349-7736 Fax: (813) 349-7561 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Newcity, Amanda DDS Provider ID: TPVP145785-19 Gender: Female Palm River Community Health Center 7728 Palm River Rd Tampa, FL 33619 (813) 630-3635 Fax: (813) 620-1614 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pedodontics - cont.

Pinero Correa, Rosario DDS

Newcity, Amanda DDS Provider ID: TPVP145785-20 Gender: Female Brandon Community Health Centers 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7907 Fax: (813) 685-9111 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPV27901-07 Gender: Female Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Newcity, Amanda DDS Provider ID: TPVP145785-21 Gender: Female Oakfield Community Dental Care 710 Oakfield Dr Ste 105 Brandon, FL 33511 (813) 689-4782 Fax: (813) 684-1579 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Newcity, Amanda DDS Provider ID: TPVP145785-22 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7588 Fax: (813) 349-7890 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rosen, David DMD Provider ID: TPVP102277-01 Gender: Male Great Expressions Dental Centers 10845 Bloomingdale Ave Riverview, FL 33578 (813) 662-6100 Fax: (813) 662-6861 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rosen, David DMD Provider ID: TPVP102277-02 Gender: Male Great Expressions Dental Centers 13146 US Hwy 301 S Riverview, FL 33578 (813) 672-9575 Fax: (813) 671-7508 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rosen, David DMD Provider ID: TPVP102277-04 Gender: Male Great Expressions Dental Centers 2468 W Brandon Blvd Brandon, FL 33511 (813) 654-6700 Fax: (813) 654-7824 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rosen, David DMD Provider ID: TPVP102277-09 Gender: Male Great Expressions Dental Centers 15148 N Dale Mabry Hwy Tampa, FL 33618 (813) 960-0106 Fax: (813) 265-8126 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Rosen, David DMD Provider ID: TPVP102277-06 Gender: Male Great Expressions Dental Centers 5658 Fishhawk Crossing Blvd Lithia, FL 33547 (813) 490-1982 Fax: (813) 689-5908 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No

Ruelf, Michael DDS Provider ID: TPVP43013-01 Gender: Male Michael J Ruelf DDS 1308 W Fletcher Ave Tampa, FL 33612 (813) 264-6000 Fax: (813) 963-7056 00 Yrs/99 Yrs Languages: Spanish MTH 8:00 AM - 4:00 PM TW 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Rosen, David DMD Provider ID: TPVP102277-07 Gender: Male Great Expressions Dental Centers 1060 W Busch Blvd Ste 105 Tampa, FL 33612 (813) 931-4000 Fax: (813) 932-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Sierra, Frank DMD Provider ID: TPVP128803-01 Gender: Male Frank J Sierra DMD PA 6323 Memorial Hwy Ste 131 Tampa, FL 33615 (813) 889-0780 Fax: (813) 885-2642 00 Yrs/99 Yrs Languages: Spanish M-W 8:30 AM - 5:00 PM PCMH: No

Rosen, David DMD Provider ID: TPVP102277-08 Gender: Male Great Expressions Dental Centers 13022 Racetrack Rd Ste 101 Tampa, FL 33626 (813) 814-1868 Fax: (813) 855-8709 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Pedodontics - cont. Sirage, Mohamed DMD Provider ID: TPVP125300-11 Gender: Male Brandon Mall Dental PA 675 Brandon Town Center Mall Brandon, FL 33511 (813) 681-8600 Fax: (813) 681-7400 00 Yrs/99 Yrs Languages: Russian M 10:00 AM - 4:00 PM TTHSat 10:00 AM - 5:00 PM W 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No Theogene, Dorothy DDS Provider ID: TPVP134951-13 Gender: Female Smile Design Riverview 11693 Boyette Rd Riverview, FL 33569 (813) 672-2066 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Theogene, Dorothy DDS Provider ID: TPVP134951-14 Gender: Female Smile Design Westchase 12113 W Linebaugh Ave Tampa, FL 33626 (813) 854-1933 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish M 10:00 AM - 7:00 PM T 8:00 AM - 5:00 PM WF 8:00 AM - 4:00 PM TH 9:00 AM - 6:00 PM PCMH: No

Theogene, Dorothy DDS Provider ID: TPVP134951-15 Gender: Female Smile Design Lithia 3442 Lithia Pinecrest Rd Valrico, FL 33596 (813) 662-1111 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish MWTHF 8:30 AM - 5:00 PM T 10:00 AM - 7:00 PM PCMH: No Theogene, Dorothy DDS

Theogene, Dorothy DDS Provider ID: TPVP134951-23 Gender: Female Smile Design Fletcher 4446 E Fletcher Ave Ste F Tampa, FL 33613 (813) 910-2345 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish M 10:00 AM - 7:00 PM T 8:00 AM - 4:00 PM WTHF 8:00 AM - 5:00 PM PCMH: No Theogene, Dorothy DDS

Provider ID: TPVP134951-17 Gender: Female Smile Design 5306 Van Dyke Rd Lutz, FL 33558 (813) 960-3300 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish MF 8:00 AM - 4:00 PM T 9:00 AM - 6:00 PM WTH 8:00 AM - 5:00 PM PCMH: No Theogene, Dorothy DDS Provider ID: TPVP134951-20 Gender: Female Smile Design Tampa Palms 16021 Tampa Palms Blvd W Tampa, FL 33647 (813) 866-1100 00 Yrs/99 Yrs Languages: Spanish M 10:00 AM - 7:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

Provider ID: TPVP134951-25 Gender: Female Smile Design Citrus Park 13246 N Dale Mabry Hwy Tampa, FL 33618 (813) 926-6776 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM TTH 8:30 AM - 5:30 PM W 10:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Young, Kera DDS Provider ID: TPVP42668-01 Gender: Female Young Smiles Pediatric Dentistry and Spa PA 13131 Kings Lake Dr Ste 104 Gibsonton, FL 33534 (813) 829-9075 Fax: (813) 236-9007 00 Yrs/99 Yrs Languages: Spanish MTTH 8:00 AM - 5:00 PM W 9:00 AM - 6:00 PM PCMH: No

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Periodontics Bardsley, Norman DDS Provider ID: TPVP66204-16 Gender: Male Greenberg Dental Orthodontics 9618 US Hwy 301 S Riverview, FL 33578 (813) 867-7062 Fax: (813) 867-7281 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Physical Medicine & Rehabilitation Abel, Naomi MD Provider ID: 28264 Gender: Female USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0894 Fax: (813) 259-0886 00 Yrs/130 Yrs Tampa General Hospital University Hospital M-F 8:00 AM - 5:00 PM PCMH: No Epting, Stephanie DO Provider ID: 1227938 Gender: Female Advanced Pain Management, Inc. 426 W Brandon Blvd Ste 202 Brandon, FL 33511 (813) 388-2948 Fax: (813) 388-6827 00 Yrs/130 Yrs Languages: French, Creole M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Physical Medicine & Rehabilitation - cont. Jassal, Navdeep MD Provider ID: 1136254 Gender: Male Advanced Pain Management Inc 426 W Brandon Blvd Brandon, FL 33511 (813) 388-2948 Fax: (813) 388-6827 18 Yrs/130 Yrs M-F 7:30 AM - 4:30 PM PCMH: No Patel, Arpit DO Provider ID: 1217416 Gender: Male Advanced Pain Management Inc 426 W Brandon Blvd Brandon, FL 33511 (813) 388-2948 Fax: (813) 388-6827 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Radecki, Richard MD Provider ID: 1232038 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 00 Yrs/18 Yrs Languages: Spanish PCMH: No Zaffer, Syed MD Provider ID: 1160796 Gender: Male Skilled Physiatrists PA 5004 E Fowler Ave Ste C 214 Tampa, FL 33617 (630) 935-2438 Fax: (813) 968-5200 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Plastic & Reconstructive Harrington, Michael MD Surgery Cruse, C Wayne MD Provider ID: 7058 Gender: Male USF Physicians Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-8482 Fax: (813) 745-7192 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Cruse, C Wayne MD Provider ID: 7058 Gender: Male USF Physicians Group 6 Tampa General Cir Tampa, FL 33606 (813) 844-7656 Fax: (813) 844-4082 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Dayicioglu, Deniz MD Provider ID: 575773 Gender: Female USF Physicians Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-3980 Fax: (813) 745-5650 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, German, Turkish M-F 8:00 AM - 5:00 PM PCMH: No Dayicioglu, Deniz MD Provider ID: 575773 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 844-8416 Fax: (813) 844-1947 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish, German, Turkish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 678063 Gender: Female 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-8482 Fax: (813) 745-7192 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Harrington, Michael MD Provider ID: 678063 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 974-4280 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Harrington, Michael MD Provider ID: 678063 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5250 Fax: (813) 236-5220 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Miller, Monica MD Provider ID: 1324963 Gender: Female Advanced Hand And Plastic Surgery C 4600 N Habana Ave Ste 22 Tampa, FL 33614 (813) 866-4626 Fax: (813) 972-8866 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM PCMH: No

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Panetta, Nicholas MD Provider ID: 1108170 Gender: Male 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-4673 Fax: (813) 745-6855 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Panetta, Nicholas MD Provider ID: 1108170 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 905-9901 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Panetta, Nicholas MD Provider ID: 1108170 Gender: Male 2 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 974-4280 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Pribaz, Julian MD Provider ID: 1340791 Gender: Male Tampa General Medical Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 844-8989 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Plastic & Reconstructive Auguste, David DPM Surgery - cont. Provider ID: 1170534 Pribaz, Julian MD Provider ID: 1340791 Gender: Male USF Physicians Group 10920 McKinley Dr Tampa, FL 33612 (888) 663-3488 Fax: (813) 745-5650 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Ruas, Ernesto MD Provider ID: 17809 Gender: Male Pediatric Physician Services Inc 603 S Blvd Tampa, FL 33606 (813) 259-1550 Fax: (813) 258-1287 00 Yrs/21 Yrs St Anthonys Physicians Surgery M-F 9:00 AM - 5:00 PM PCMH: No

Podiatry Auguste, David DPM Provider ID: 1170534 Gender: Male Ankle and Foot Associates 2007 W Swann Ave Tampa, FL 33606 (813) 985-2811 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital M 7:00 AM - 11:30 PM T 8:00 AM - 11:30 PM W 1:00 AM - 5:00 PM TH 8:00 AM - 5:00 PM F 8:30 AM - 5:00 PM PCMH: No

Gender: Male Ankle and Foot Associates 232 Bullard Pkwy Tampa, FL 33617 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital MTHF 8:30 AM - 5:00 PM T 7:00 AM - 5:00 PM W 8:00 AM - 5:00 PM PCMH: No Auguste, David DPM Provider ID: 1170534 Gender: Male Ankle and Foot Associates 500 Vonderburg Dr East Tower Ste 105 Brandon, FL 33511 (813) 985-2811 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital MTTH 8:00 AM - 5:00 PM W 7:00 AM - 11:30 PM F 8:30 AM - 5:00 PM PCMH: No Beltranwalshe, Maria DPM

Brennan, Todd DPM Provider ID: 930791 Gender: Male Healthy Feet Podiatry 13801 Bruce B Downs Blvd Ste 205 Tampa, FL 33613 (813) 971-4678 Fax: (813) 978-8564 00 Yrs/130 Yrs MT 8:00 AM - 5:00 PM PCMH: No Brennan, Todd DPM Provider ID: 930791 Gender: Male Healthy Feet Podiatry 2919 W Swann Ave Ste 203 Tampa, FL 33609 (813) 875-0555 Fax: (866) 313-3106 00 Yrs/130 Yrs M 8:00 AM - 5:00 PM PCMH: No Cruz, Jairo DPM Provider ID: 1364306 Gender: Male Healthy Feet Podiatry 13801 Bruce B Downs Blvd Ste 205 Tampa, FL 33613 (813) 971-4678 Fax: (813) 978-8564 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1426116 Gender: Female Robert J Valins, DPM, PA/Total 936 Cypress Village Blvd Ste B Diaz, Nannette DPM Sun City Center, FL 33573 Provider ID: 396293 (813) 788-3600 Gender: Female Fax: (813) 788-7010 Nannette Diaz DPM PA 02 Yrs/130 Yrs 3355 W Bearss Ave M-F 9:00 AM - 4:00 PM Tampa, FL 33618 PCMH: No (813) 960-1517 Fax: (813) 962-3278 00 Yrs/130 Yrs Plantation General Hospital Tampa Bay Surgery Center Tampa Community Hospital Languages: Spanish M-W 9:00 AM - 5:00 PM TH 9:00 AM - 12:00 PM PCMH: No

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Ebsworth, Gloried DPM Provider ID: 811254 Gender: Female Advanced Foot Ankle Specialists 206 Buckingham Pl Ste 101 Brandon, FL 33511 (813) 571-2977 Fax: (813) 654-9545 00 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Memorial Hospital of Tampa Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Georges, Lena DPM Provider ID: 1326749 Gender: Female Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Girling, Martin DPM Provider ID: 28867 Gender: Male Specialist Doctors Group 210 N Alexander St Ste A Plant City, FL 33563 (813) 754-3668 Fax: (813) 752-0093 00 Yrs/130 Yrs South Florida Baptist Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Herrin, Eric DPM Provider ID: 1259215 Gender: Male Prevmed Podiatry Group, PC 4511 N Himes Ave Ste 200 Tampa, FL 33614 (317) 886-6639 Fax: (888) 547-0377 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Podiatry - cont. Johnson, Brandi DPM Provider ID: 318192 Gender: Female Advanced Foot Ankle Specialists 206 Buckingham Pl Ste 101 Brandon, FL 33511 (813) 571-2977 Fax: (813) 654-9545 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Memorial Hospital of Tampa Languages: Spanish M 8:00 AM - 5:00 PM TWTH 9:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Kaplan, Stanley DPM Provider ID: 2880 Gender: Male Stanley M Kaplan DPM PA 3704 W Euclid Ave Tampa, FL 33629 (813) 831-4118 Fax: (813) 889-0378 00 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Tampa Bay Surgery Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Kaplan, Stanley DPM Provider ID: 2880 Gender: Male Stanley M Kaplan DPM PA 4202 W Waters Ave Ste 6 Tampa, FL 33614 (813) 887-5511 Fax: (813) 889-0378 00 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Tampa Bay Surgery Center Languages: Spanish MW 10:00 AM - 4:30 PM T 10:00 AM - 2:00 PM TH 10:00 AM - 12:00 PM PCMH: No

Krawetz, Leo DPM Provider ID: 552834 Gender: Male Healthy Feet Podiatry 13801 Bruce B Downs Blvd Ste 205 Tampa, FL 33613 (813) 971-4678 Fax: (813) 978-8564 00 Yrs/130 Yrs Languages: Spanish MT 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM PCMH: No

Levin, Stephen DPM Provider ID: 454716 Gender: Male Stephen F Levin DPM PA 3704 W Euclid Ave Tampa, FL 33629 (813) 973-3535 Fax: (813) 907-2963 00 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Marsh, Naomi DPM Provider ID: 174221 Gender: Female Kussel and Associates 1302 W Swann Ave Tampa, FL 33606 (813) 250-3668 Fax: (813) 250-1515 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Loebell, James DPM

Nguyen, Thanh Binh DPM

Krawetz, Leo DPM Provider ID: 552834 Gender: Male Healthy Feet Podiatry 2919 W Swann Ave Ste 203 Tampa, FL 33609 (813) 875-0555 Fax: (866) 313-3106 00 Yrs/130 Yrs Languages: Spanish MT 8:00 AM - 5:00 PM PCMH: No

Provider ID: 152718 Gender: Male Ankle and Foot Associates 2007 W Swann Ave Tampa, FL 33606 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs M 8:00 AM - 11:00 PM T 1:00 AM - 4:30 PM W 8:00 AM - 5:00 PM PCMH: No

Kussel, Fred DPM Provider ID: 1345980 Gender: Male Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Loebell, James DPM Provider ID: 152718 Gender: Male Ankle and Foot Associates 232 Bullard Pkwy Tampa, FL 33617 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs MTH 8:30 AM - 5:00 PM T 7:00 AM - 5:00 PM W 9:00 AM - 5:00 PM PCMH: No

Leitner, Mark DPM Provider ID: 152685 Gender: Male Advanced Foot Ankle Specialists 206 Buckingham Pl Ste 101 Brandon, FL 33511 (813) 571-2977 Fax: (813) 654-9545 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa MTHF 8:00 AM - 5:00 PM TW 9:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Loebell, James DPM Provider ID: 152718 Gender: Male Ankle and Foot Associates 500 Vonderburg Dr Ste 105 Brandon, FL 33511 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs MTH 8:30 AM - 5:00 PM T 7:00 AM - 11:00 PM W 9:00 AM - 5:00 PM PCMH: No

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Provider ID: 1352215 Gender: Male Healthy Feet Podiatry 13801 Bruce B Downs Blvd Ste 205 Tampa, FL 33613 (813) 971-4678 Fax: (813) 978-8564 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Thanh Binh DPM Provider ID: 1352215 Gender: Male Healthy Feet Podiatry 2919 W Swann Ave Ste 203 Tampa, FL 33609 (813) 875-0555 Fax: (813) 313-3106 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Parsons, Lisa DPM Provider ID: 986646 Gender: Female Kussel Associates Inc 1302 W Swann Ave Tampa, FL 33606 (813) 250-3668 Fax: (813) 250-1515 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Podiatry - cont. Port, Martin DPM Provider ID: 194466 Gender: Male Stephen F Levin DPM PA 3704 W Euclid Ave Tampa, FL 33629 (813) 973-3535 Fax: (813) 907-2963 00 Yrs/130 Yrs Languages: Spanish M 8:30 AM - 12:00 PM T 1:00 AM - 4:30 PM PCMH: No Richter, Paul DPM Provider ID: 14282 Gender: Male Family Poditary Group of Tampa 7926 W Hillsborough Ave Ste G Tampa, FL 33615 (813) 886-9180 Fax: (813) 888-9093 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa Community Hospital Languages: Spanish MW 8:00 AM - 4:00 PM TTH 9:00 AM - 3:00 PM F 8:00 AM - 2:30 PM Sat 8:00 AM - 12:00 PM PCMH: No Shama, Stanley DPM Provider ID: 2514 Gender: Male Ankle and Foot Assoc. 232 Bullard Pkwy Temple Ter, FL 33617 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs Florida Hospital Tampa Tampa Bay Surgery Center Tampa General Hospital MTH 8:30 AM - 5:00 PM T 7:00 AM - 5:00 PM W 9:00 AM - 5:00 PM PCMH: No

Shama, Stanley DPM Provider ID: 2514 Gender: Male Ankle and Foot Associates 2007 W Swann Ave Tampa, FL 33606 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs Florida Hospital Tampa Tampa Bay Surgery Center Tampa General Hospital M 8:00 AM - 11:30 PM T 1:00 AM - 5:00 PM W 8:00 AM - 5:00 PM PCMH: No Shama, Stanley DPM Provider ID: 2514 Gender: Male Ankle and Foot Associates 500 Vonderburg Dr Ste 105 Brandon, FL 33511 (813) 985-2811 Fax: (813) 985-3045 00 Yrs/130 Yrs Florida Hospital Tampa Tampa Bay Surgery Center Tampa General Hospital M 8:00 AM - 5:00 PM T 7:00 AM - 11:30 PM W 8:30 AM - 5:00 PM PCMH: No Sheehy, Paul DPM Provider ID: 1264073 Gender: Male Sheehy Ankle and Foot Center 6918 Gum Hwy Tampa, FL 33625 (813) 872-8939 Fax: (813) 872-8649 65 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Tran Bergman, Kiki DPM Provider ID: 619383 Gender: Female A Well Healed Foot PA 13632 W Hillsborough Ave Tampa, FL 33635 (813) 854-3338 Fax: (813) 854-3332 05 Yrs/130 Yrs M-F 9:00 AM - 3:00 PM PCMH: No Valins, Robert DPM Provider ID: 535 Gender: Male Robert J Valins DPM PA 936 Cypress Village Blvd Ste B Sun City Center, FL 33573 (813) 788-3600 Fax: (813) 788-7010 00 Yrs/130 Yrs Columbia South Bay Hospital Florida Hospital Zephyrhills Tampa Bay Surgery Center Languages: Spanish, French, Italian M-F 9:00 AM - 5:00 PM PCMH: No

Prosthetics Randal Minor Ocular Prosthetics, Inc Provider ID: 288184 1628 Dale Mabry Hwy Lutz, FL 33548 (813) 949-2500 Fax: (813) 949-2500 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Tampa Bay Artificial Limbs In Provider ID: 290808 5109 N Armenia Ave Tampa, FL 33603 (813) 801-9110 Fax: (813) 801-9048 18 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

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Pulmonary Disease Ackerman, Ivan MD Provider ID: 19374 Gender: Male Tampa Bay Pulmonary Medicine PA 402 Noland Dr Brandon, FL 33511 (813) 655-2500 Fax: (813) 655-7344 12 Yrs/130 Yrs Brandon Regional Hospital South Florida Baptist Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Argeles, Horacio MD Provider ID: 13143 Gender: Male 1 Sun City Center Blvd Ste 17 Sun City Center, FL 33573 (813) 634-9268 Fax: (941) 746-8901 21 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Axel, Jonathan MD Provider ID: 237 Gender: Male Tampa Bay Pulmonary and Sleep Medic 14471 University Cove Pl Tampa, FL 33613 (813) 655-2500 Fax: (813) 655-2519 18 Yrs/130 Yrs Brandon Regional Hospital Memorial Hospital of Tampa South Florida Baptist Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pulmonary Disease - cont. Bernal, Hernando MD Provider ID: 8224 Gender: Male 6101 Webb Rd Ste 307 Tampa, FL 33615 (813) 971-3564 Fax: (813) 971-4776 18 Yrs/95 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Axel, Jonathan MD Provider ID: 237 Gender: Male Tampa Bay Pulmonary and Sleep Medic 1704 S Alexander St Plant City, FL 33563 (813) 655-2500 Fax: (813) 655-2519 18 Yrs/130 Yrs Brandon Regional Hospital Memorial Hospital of Tampa South Florida Baptist Hospital Calero, Karel MD Languages: Spanish Provider ID: 1109494 M-F 9:00 AM - 5:00 PM Gender: Female PCMH: No 2 Tampa General Cir 3rd Fl Tampa, FL 33606 Axel, Jonathan MD (813) 259-0620 Provider ID: 237 Fax: (813) 259-0620 Gender: Male 18 Yrs/130 Yrs Tampa Bay Pulmonary and M-F 8:00 AM - 5:00 PM Sleep Medic PCMH: No 402 Noland Dr Brandon, FL 33511 Cardona, Jerges MD (813) 655-2500 Provider ID: 200439 Fax: (813) 655-2519 Gender: Male 18 Yrs/130 Yrs 2810 W Waters Ave Brandon Regional Hospital Tampa, FL 33614 Memorial Hospital of Tampa (813) 935-5501 South Florida Baptist Hospital Fax: (813) 933-8784 Languages: Spanish 18 Yrs/130 Yrs MTTHF 9:00 AM - 5:00 PM Florida Hospital Carrollwood W 9:00 AM - 12:00 PM Florida Hospital Tampa PCMH: No St Josephs Hospital Languages: Spanish, Hindi Bernal, Hernando MD M-F 9:00 AM - 5:00 PM Provider ID: 8224 PCMH: No Gender: Male 13801 Bru B Downs Blvd Ste Carpenter, Elizabeth MD 204 Tampa, FL 33613 Provider ID: 1320226 (813) 971-3564 Gender: Female Fax: (813) 971-4776 Lyracore Health Alliance 18 Yrs/95 Yrs Pulmonary Florida Hospital Tampa 17 Davis Blvd Ste 400 St Josephs Hospital Tampa, FL 33606 Languages: Spanish (813) 853-0500 M-F 8:00 AM - 5:00 PM Fax: (813) 533-5334 PCMH: No 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Clum, Stephen MD Provider ID: 1020592 Gender: Male 2 Tampa General Cir 6th Fl Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-0620 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Cosmo, Leonard MD Provider ID: 8231 Gender: Male Pulmonary Associates of Tampa 2919 W Swann Ave Ste 202 Tampa, FL 33609 (813) 879-7726 Fax: (813) 876-2489 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Cox, Jennifer MD Provider ID: 390930 Gender: Female USF Physicicans Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 974-7593 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Figueroa, Astrid DO Provider ID: 1241857 Gender: Female Sunshine Pulmonary and Sleep Medici 13007 Summerfield Square Dr Riverview, FL 33578 (813) 655-1100 Fax: (813) 655-1140 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Figueroa, Astrid DO Provider ID: 1241857 Gender: Female Sunshine Pulmonary and Sleep Medici 2001 W Reynolds St Plant City, FL 33563 (813) 655-1100 Fax: (813) 655-1140 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Figueroa, Astrid DO Provider ID: 1241857 Gender: Female Sunshine Pulmonary and Sleep Medici 621 W Lumsden Rd Brandon, FL 33511 (813) 655-1100 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Furman, Alexandre MD Provider ID: 1320225 Gender: Male Lyracore Health Alliance Pulmonary 17 Davis Blvd Ste 400 Tampa, FL 33606 (813) 853-0500 Fax: (813) 533-5334 18 Yrs/110 Yrs Brandon Regional Hospital Memorial Hospital of Tampa Languages: Spanish, Russian, Ukrainian M-F 8:00 AM - 5:00 PM PCMH: No Giraldo, Hernan MD Provider ID: 8236 Gender: Male 1307 W Fletcher Ave Tampa, FL 33612 (813) 971-3564 16 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Tampa Community Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pulmonary Disease - cont. Kreitzer, Stephen MD Giraldo, Hernan MD Provider ID: 8236 Gender: Male 6101 Webb Rd Ste 208 Tampa, FL 33615 (813) 885-5365 Fax: (813) 882-4908 16 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Tampa Community Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Kaszuba, Francis MD Provider ID: 497638 Gender: Male University Medical Svc Assoc 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-8436 Fax: (813) 979-7255 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Kaszuba, Francis MD Provider ID: 497638 Gender: Male University Medical Svc Assoc 2 Columbia Dr Tampa, FL 33606 (813) 974-2920 Fax: (813) 974-0033 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 8246 Gender: Male 2919 W Swann Ave Ste 105 Tampa, FL 33609 (813) 877-5337 Fax: (813) 872-0284 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish M-F 9:00 AM - 4:30 PM PCMH: No Mandaliya, Naishadh MD Provider ID: 164 Gender: Male 2810 W Waters Ave Tampa, FL 33614 (813) 935-5501 Fax: (813) 933-8784 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Martinez, Rafael MD Provider ID: 205497 Gender: Male Pulmonary and Sleep of Tampa Bay 311 Noland Dr Brandon, FL 33511 (813) 654-8100 Fax: (813) 654-3377 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Martinez, Rafael MD Provider ID: 205497 Gender: Male Pulmonary and Sleep of Tampa Bay 1907 S Alexander St Ste 1 Plant City, FL 33566 (813) 654-8100 Fax: (813) 654-3377 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Menezes, Marian MD

Martinez, Rafael MD Provider ID: 205497 Gender: Male Pulmonary and Sleep of Tampa Bay 4308 N Habana Ave Tampa, FL 33607 (813) 490-9495 Fax: (813) 874-0099 00 Yrs/130 Yrs Brandon Regional Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Modh, Ashok MD Provider ID: 165 Gender: Male Tampa Bay Pulmonology PA 2810 W Waters Ave Tampa, FL 33614 (813) 935-5501 Fax: (813) 933-8784 18 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Menezes, Marian MD Provider ID: 19269 Gender: Male Florida Medical Clinic PA 3000 Medical Park Dr Ste 190 Tampa, FL 33613 (813) 977-7794 Fax: (813) 971-0232 18 Yrs/130 Yrs Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No

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Provider ID: 19269 Gender: Male Florida Medical Clinic, PA 12500 N Dale Mabry Hwy Ste B Tampa, FL 33618 (813) 977-7794 Fax: (813) 355-5067 18 Yrs/130 Yrs Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Patel, Nirav MD Provider ID: 245543 Gender: Male Tampa Bay Pulmonology PA 2810 W Waters Ave Tampa, FL 33614 (813) 935-5501 Fax: (813) 933-8784 18 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Pulmonary Disease - cont. Restrepo Jaramillo, Ricardo Rampertaap, Moonasar MD Provider ID: 13612 Gender: Male Lung Associates PA 4002 State Rd 674 Ste A Sun City Center, FL 33573 (813) 634-3306 Fax: (813) 634-2055 12 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Restrepo Jaramillo, Ricardo MD Provider ID: 1093496 Gender: Male Pulmonary and Sleep of Tampa Bay 1907 S Alexander St Ste 1 Plant City, FL 33566 (813) 654-8100 Fax: (813) 654-3377 18 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Restrepo Jaramillo, Ricardo MD Provider ID: 1093496 Gender: Male Pulmonary and Sleep of Tampa Bay 311 Noland Dr Brandon, FL 33511 (813) 654-8100 Fax: (813) 654-3377 18 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Sorathia, Divyang MD Zanchi, Dragos MD Provider ID: 937363 Gender: Male Provider ID: 271941 Sunshine Pulmonary and Gender: Male Sleep Medici Pulmonary and Sleep of 621 W Lumsden Rd Tampa Bay Brandon, FL 33511 311 Noland Dr (813) 655-1100 Brandon, FL 33511 18 Yrs/130 Yrs (813) 654-8100 Brandon Regional Hospital Fax: (813) 654-3377 Memorial Hospital of Tampa 16 Yrs/130 Yrs South Florida Baptist Hospital Brandon Regional Hospital Languages: Hindi Columbia South Bay Hospital M-F 8:00 AM - 5:00 PM South Florida Baptist Hospital PCMH: No Languages: Spanish, French, Shah, Rakesh MD German Sriaroon, Chakrapol MD Provider ID: 681183 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No Sunshine Pulmonary and Provider ID: 1108175 Zanchi, Dragos MD Sleep Medici Gender: Male 621 W Lumsden Rd 2 Tampa General Cir Brandon, FL 33511 Tampa, FL 33606 Provider ID: 271941 (813) 655-1100 (813) 259-0619 Gender: Male 18 Yrs/130 Yrs Fax: (813) 259-0620 Pulmonary and Sleep of Brandon Regional Hospital Tampa Bay 18 Yrs/110 Yrs South Florida Baptist Hospital M-F 8:00 AM - 5:00 PM 4308 N Habana Ave Languages: Hindi Tampa, FL 33607 PCMH: No M-F 9:00 AM - 5:00 PM (813) 490-9495 PCMH: No Wittine, Lara MD Fax: (813) 874-0099 Provider ID: 1244687 16 Yrs/130 Yrs Shah, Sailesh DO Gender: Female Brandon Regional Hospital Provider ID: 400974 Columbia South Bay Hospital USF Physicians Group Gender: Male South Florida Baptist Hospital 13330 USF Laurel Dr Florida Medical Clinic PA Languages: Spanish, French, Tampa, FL 33612 German 2020 Town Center Blvd Ste B (813) 974-2201 M-F 9:00 AM - 5:00 PM Brandon, FL 33511 Fax: (813) 974-6956 PCMH: No (813) 977-7794 18 Yrs/130 Yrs Fax: (813) 971-0232 M-F 9:00 AM - 5:00 PM Radiation Oncology 12 Yrs/130 Yrs PCMH: No Languages: Gujarati Assad, William MD M-F 9:00 AM - 5:00 PM Zanchi, Dragos MD Provider ID: 3511 PCMH: No Provider ID: 271941 Gender: Male Gender: Male 601 S Armenia Ave Shah, Sailesh DO Pulmonary and Sleep of Tampa, FL 33609 Provider ID: 400974 Tampa Bay (813) 353-8803 Gender: Male 1907 S Alexander St Ste 1 Fax: (813) 353-8602 Florida Medical Clinic PA Plant City, FL 33566 18 Yrs/130 Yrs 3000 E Fletcher Ave Ste 190 (813) 654-8100 CRMC At Bayonet Point Tampa, FL 33613 Fax: (813) 654-3377 Memorial Hospital of Tampa (813) 977-7794 16 Yrs/130 Yrs Tampa Bay Surgery Center Fax: (813) 971-0232 Brandon Regional Hospital M-F 8:00 AM - 4:30 PM 12 Yrs/130 Yrs Columbia South Bay Hospital South Florida Baptist Hospital PCMH: No Languages: Gujarati Languages: Spanish, French, M-F 9:00 AM - 5:00 PM German PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No MD Provider ID: 1093496 Gender: Male Pulmonary and Sleep of Tampa Bay 4308 N Habana Ave Tampa, FL 33607 (813) 490-9495 Fax: (813) 874-0099 18 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 266

Last update 08/14/2017

Specialty Physicians Hillsborough Radiation Oncology cont. Berk, Lawrence MD Provider ID: 328718 Gender: Male USF Physicians Group 3 Tampa General Cir Tampa, FL 33606 (813) 844-8757 Fax: (813) 844-8115 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Franzese, Frank MD Provider ID: 451606 Gender: Male Well Spring Cancer Center LLC 5935 Webb Rd Tampa, FL 33615 (813) 884-7400 Fax: (813) 884-7445 12 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Gandle, Larry MD Provider ID: 3515 Gender: Male Florida Cancer Institute PA 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Fax: (813) 872-2741 18 Yrs/130 Yrs Bayfront Health Dade City CRMC At Bayonet Point Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No

Greenberg, Harvey MD Provider ID: 7105 Gender: Male 12206 Bruce B Dwn Blvd Ste 101 Tampa, FL 33612 (813) 971-8276 Fax: (813) 971-8277 18 Yrs/130 Yrs University Hospital M 4:00 AM - 5:00 PM PCMH: No Greenberg, Harvey MD

Greenberg, Harvey MD Provider ID: 7105 Gender: Male Tampa Bay Radiation Oncology 5931 Webb Rd Tampa, FL 33615 (813) 886-9277 Fax: (813) 886-9377 18 Yrs/130 Yrs University Hospital M-W 12:00 AM - 1:00 PM PCMH: No Greenberg, Harvey MD

Provider ID: 7105 Gender: Male Tampa Bay Radiation Oncology 403 S Kings Ave Ste 150 Brandon, FL 33511 (813) 685-2440 Fax: (813) 685-3019 18 Yrs/130 Yrs University Hospital M 12:00 AM - 1:00 PM PCMH: No Greenberg, Harvey MD Provider ID: 7105 Gender: Male Tampa Bay Radiation Oncology 4031 Upper Creek Dr Sun City Center, FL 33573 (813) 633-2733 Fax: (813) 634-8606 18 Yrs/130 Yrs University Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1242892 Gender: Male USF Physicians Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-3980 Fax: (813) 903-7109 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Greenberg, Harvey MD Provider ID: 1242892 Gender: Male USF Physicians Group 3100 E Fletcher Ave Tampa, FL 33613 (855) 303-3627 Fax: (813) 615-7409 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Heysek, Randy MD Provider ID: 199214 Gender: Male 303 N Alexander St Plant City, FL 33563 (813) 719-7705 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lakeland Reg Medical Center South Florida Baptist Hospital M-F 8:00 AM - 4:30 PM PCMH: No

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Kahn, Randy MD Provider ID: 3516 Gender: Male Tampa Bay Radiation Oncology 403 S Kings Ave Ste 150 Brandon, FL 33511 (813) 685-2440 Fax: (813) 685-3019 18 Yrs/130 Yrs Columbia South Bay Hospital South Florida Baptist Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Kahn, Randy MD Provider ID: 3516 Gender: Male Tampa Bay Radiation Oncology 4031 Upper Creek Dr Sun City Center, FL 33573 (813) 633-2733 Fax: (813) 634-8606 18 Yrs/130 Yrs Columbia South Bay Hospital South Florida Baptist Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Kepes, Kathryn MD Provider ID: 176108 Gender: Female 303 N Alexander St Plant City, FL 33563 (813) 719-7705 18 Yrs/130 Yrs Brandon Regional Hospital Columbia South Bay Hospital Memorial Hospital of Tampa Languages: Spanish M-F 8:00 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Radiation Oncology cont. Koval, John MD Provider ID: 267062 Gender: Male 4031 Upper Creek Dr Sun City Center, FL 33573 (813) 633-2733 Fax: (813) 634-8606 12 Yrs/130 Yrs Columbia South Bay Hospital Florida Hospital Carrollwood Tampa Bay Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No Koval, John MD Provider ID: 267062 Gender: Male 823 S Parsons Ave Brandon, FL 33511 (813) 685-2440 Fax: (813) 685-3019 12 Yrs/130 Yrs Columbia South Bay Hospital Florida Hospital Carrollwood Tampa Bay Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No Koval, John MD Provider ID: 267062 Gender: Male Tampa Bay Radiation Oncology 403 S Kings Ave Ste 150 Brandon, FL 33511 (813) 685-2440 Fax: (813) 685-3019 12 Yrs/130 Yrs Columbia South Bay Hospital Florida Hospital Carrollwood Tampa Bay Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No

Miller, Robert MD Provider ID: 451602 Gender: Male Well Spring Cancer Center LLC 5935 Webb Rd Tampa, FL 33615 (813) 884-7400 Fax: (813) 884-7445 16 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No Nguyen, Tri MD Provider ID: 750213 Gender: Male 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4160 Fax: (813) 544-8084 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Pena-Ponson, Max MD Provider ID: 1944 Gender: Male 7820 N Armenia Ave Tampa, FL 33604 (813) 935-6334 Fax: (813) 930-2835 12 Yrs/130 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 1:00 PM PCMH: No

Steel, John MD Toonkel, Leonard MD Provider ID: 175990 Gender: Male Provider ID: 1069322 Tampa Bay Radiation Gender: Male Oncology Healthpoint Medical Group 12206 Bruce B Dwn Blvd Ste DBA Fred 101 3001 W Dr MLK Blvd Tampa, FL 33612 Tampa, FL 33607 (813) 405-2460 (813) 870-4160 Fax: (813) 971-8277 Fax: (813) 554-8084 18 Yrs/130 Yrs 18 Yrs/130 Yrs Columbia South Bay Hospital M-F 8:30 AM - 4:30 PM Northside Hospital PCMH: No South Florida Baptist Hospital M 8:00 AM - 5:00 PM Radiation Therapy PCMH: No Solc, Zucel MD Steel, John MD Provider ID: 9343 Provider ID: 175990 Gender: Male Gender: Male Well Spring Cancer Center, Tampa Bay Radiation LLC Oncology 5935 Webb Rd 403 S Kings Ave Ste 150 Tampa, FL 33615 Brandon, FL 33511 (813) 884-7400 (813) 685-2440 Fax: (813) 884-7445 Fax: (813) 685-3019 18 Yrs/130 Yrs 18 Yrs/130 Yrs Largo Medical Center Columbia South Bay Hospital Morton Plant North Bay Northside Hospital Hospital South Florida Baptist Hospital St Anthonys Hospital M-F 9:00 AM - 5:00 PM Languages: Spanish PCMH: No MTWTHFSatSun 9:00 AM 5:00 PM Steel, John MD PCMH: No Provider ID: 175990 Gender: Male Radiology - Interventional Tampa Bay Radiation & Vascular Oncology 4031 Upper Creek Dr Hoots, Glenn MD Sun City Center, FL 33573 Provider ID: 1244488 (813) 633-2733 Gender: Male Fax: (813) 634-8606 USF Physicians Group 18 Yrs/130 Yrs 13330 USF Laurel Dr Columbia South Bay Hospital Tampa, FL 33612 Northside Hospital South Florida Baptist Hospital (813) 396-2372 Fax: (813) 396-2355 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Radiology - Interventional Mayer, James MD & Vascular - cont. Provider ID: 7168 Krackov, Warren MD Provider ID: 1224529 Gender: Male Fresenius Vascular Care of Tampa LL 12666 Telecom Dr Tampa, FL 33637 (813) 972-4700 Fax: (813) 972-4705 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lefler, James MD Provider ID: 657148 Gender: Male Medical Group of Tampa Bay Orthopae 3100 E Fletcher Ave Tampa, FL 33613 (813) 615-7075 Fax: (813) 615-7416 00 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-TH 8:00 AM - 4:30 PM F 8:00 AM - 12:00 PM PCMH: No

Reproductive Endocrinology

Gender: Male USF Physicicans Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8561 Fax: (813) 396-2487 16 Yrs/130 Yrs St Josephs Hospital Tampa General Hospital MTWF 9:00 AM - 5:00 PM TH 9:00 AM - 8:00 PM PCMH: No Plosker, Shayne MD Provider ID: 334481 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0692 Fax: (813) 974-2794 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Plosker, Shayne MD Provider ID: 334481 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-0692 Fax: (813) 259-0882 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Imudia, Anthony MD Provider ID: 789831 Gender: Male USF Physicians Group Rheumatology 2 Tampa General Cir Ste 4000 Tampa, FL 33606 Burnette, Michael MD (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Provider ID: 13048 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Baycare Medical Group Primary Care 4612 N Habana Ave 1st Fl Tampa, FL 33614 (813) 840-3526 Fax: (813) 840-3555 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

Burnette, Michael MD Provider ID: 13048 Gender: Male Baycare Medical Group Primary Care 500 Vonderburg Dr W. Tower - Ste 214 Brandon, FL 33511 (813) 423-6116 Fax: (813) 423-6120 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3

Chang Chen Lin, Yih MD

Carter, John MD Provider ID: 175817 Gender: Male 5802 N 30th St Tampa, FL 33610 (813) 236-5200 Fax: (813) 236-5220 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Kramer, Leni MD Provider ID: 918789 Gender: Female Karon Locicero MD PA 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 18 Yrs/130 Yrs Good Samaritan Med Center Memorial Hospital of Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Carter, John MD Provider ID: 175817 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4115 Fax: (813) 974-7567 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Chang Chen Lin, Yih MD Provider ID: 787072 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4115 Fax: (813) 974-5229 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No

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Provider ID: 787072 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5300 Fax: (813) 236-5220 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No

McIlwain, Harris MD Provider ID: 13066 Gender: Male McIlwain Medical Group PA 13801 Bru B Downs Blvd Ste 406 Tampa, FL 33613 (813) 345-2380 Fax: (813) 971-5247 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish MTWF 7:00 AM - 5:00 PM TH 7:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Rheumatology - cont. McIlwain, Harris MD Provider ID: 13066 Gender: Male McIlwain Medical Group PA 4700 N Habana Ave Ste 201 Tampa, FL 33614 (813) 345-2380 Fax: (813) 971-5247 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-W 7:30 AM - 5:00 PM TH 7:30 AM - 12:00 PM PCMH: No McIlwain Cruse, Laura MD Provider ID: 755402 Gender: Female McIlwain Medical Group PA 13801 Bru B Downs Blvd Ste 406 Tampa, FL 33613 (813) 345-2380 Fax: (813) 971-5247 00 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital MTWF 7:00 AM - 5:00 PM TH 7:00 AM - 5:30 PM PCMH: No Melendez, Nicole MD Provider ID: 1226265 Gender: Female Baycare Medical Group 4700 N Habana Ave 303 Tampa, FL 33614 (813) 840-3526 Fax: (813) 840-3555 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Smith, Kimberly MD Provider ID: 461757 Gender: Female McIlwain Medical Group PA 13801 Bru B Downs Blvd Ste 406 Tampa, FL 33613 (813) 345-2380 Fax: (813) 971-5247 00 Yrs/130 Yrs St Josephs Hospital MTWF 7:00 AM - 5:00 PM TH 7:00 AM - 5:30 PM PCMH: No Valeriano-Marcet, Joanne MD Provider ID: 7285 Gender: Female USF Physicicans Group 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-4115 Fax: (813) 396-9175 00 Yrs/130 Yrs PCMH: No

Sleep Medicine Calero, Karel MD Provider ID: 1109494 Gender: Female 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0620 Fax: (813) 259-0620 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Clum, Stephen MD Provider ID: 1020592 Gender: Male 2 Tampa General Cir 6th Fl Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-0620 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Wittine, Lara MD Provider ID: 1244687 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-6956 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Sports Medicine Moran, Byron MD Provider ID: 1136768 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7550 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

Thoracic & Cardiovascular Surgery Angell, William MD Provider ID: 12950 Gender: Male Angell and Ordiway MDS PA 508 S Habana Ave Ste 210 Tampa, FL 33609 (813) 871-5151 Fax: (813) 877-2674 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Anvari, Farshad MD Provider ID: 1339593 Gender: Male Baycare Medical Group Inc 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 357-0520 Fax: (813) 554-8480 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Belisle, Julian MD Provider ID: 148 Gender: Male Cardiac Surgery Associates of Tampa 3000 E Fletcher Ave Ste 320 Tampa, FL 33613 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No Belisle, Julian MD Provider ID: 579084 Gender: Male Fhpg Cardiac Surgery Associates of 3000 E Fletcher Ave Ste 320 Tampa, FL 33613 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bradner, Michael MD Provider ID: 791275 Gender: Male Healthpoint Medical Group Inc 3003 W Dr MLK Blvd Mab Fl 2 Tampa, FL 33607 (813) 321-6580 Fax: (813) 443-8135 18 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Thoracic & Cardiovascular Khan, Faisal MD Surgery - cont. Provider ID: 230033 Bronleewe, Scott MD Provider ID: 579082 Gender: Male Fhpg Cardiac Surgery Associates of 3000 E Fletcher Ave Ste 320 Tampa, FL 33613 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No Bufkin, Bradley MD

Gender: Male Florida Cardiothoracic & Vasular 633 W Lumsden Rd Brandon, FL 33511 (813) 643-0033 Fax: (813) 643-3366 18 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:00 PM PCMH: No Makdisi, George MD Provider ID: 1350631 Gender: Male USF Physicians Group 5 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 844-3228 Fax: (813) 844-7730 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 485999 Gender: Male Cardic Surgica L Associates of Bran 270 S Moon Ave Brandon, FL 33511 (813) 571-9988 Mellor, Ryan MD Fax: (813) 571-9922 18 Yrs/130 Yrs Provider ID: 1119122 Brandon Regional Hospital Gender: Male M-F 8:00 AM - 5:00 PM Fhpg Cardiac Surgery Associates of PCMH: No 3000 E Fletcher Ave Ste 320 Duarte, Ignacio MD Tampa, FL 33613 Provider ID: 295077 (813) 910-0027 Gender: Male Fax: (813) 971-1286 Cardiac Surgical Associates of 18 Yrs/130 Yrs Bran Florida Hospital Tampa 270 S Moon Ave M-F 8:00 AM - 5:00 PM Brandon, FL 33511 PCMH: No (813) 571-9988 Morrison, Richard MD Fax: (813) 587-1998 18 Yrs/130 Yrs Provider ID: 579083 Brandon Regional Hospital Gender: Male St Josephs Hospital Fhpg Cardiac Surgery Languages: Spanish Associates of M-F 8:00 AM - 5:00 PM 3000 E Fletcher Ave Ste 320 PCMH: No Tampa, FL 33613 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Zephyrhills Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Nagamia, Husain MD Provider ID: 749 Gender: Male 500 Vonderburg Dr Ste 203E Brandon, FL 33511 (813) 654-4466 Fax: (813) 684-5500 18 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa General Hospital M-W 1:00 AM - 4:00 PM PCMH: No

Sastry, Narendra MD Provider ID: 1023314 Gender: Male 2 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0606 00 Yrs/130 Yrs CRMC At Bayonet Point Florida Hospital Tampa Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Ordiway, Lester MD

Sherman, Andrew MD

Provider ID: 12525 Provider ID: 581964 Gender: Male Gender: Male Angell and Ordiway MDS PA 3003 W Dr MLK Blvd Mad-2nd 508 S Habana Ave Ste 315 Fl Tampa, FL 33609 Tampa, FL 33607 (813) 871-5151 (813) 321-6580 Fax: (813) 877-2674 Fax: (813) 321-6581 18 Yrs/130 Yrs 18 Yrs/130 Yrs Florida Hospital North Pinellas M-F 9:00 AM - 5:00 PM Tampa Community Hospital PCMH: No Tampa General Hospital M-F 8:00 AM - 5:00 PM Swanson, Rozales MD PCMH: No Provider ID: 815926 Pruitt, Crayton MD Gender: Male Florida Advanced Provider ID: 572835 Cardiothoracic Ins Gender: Male 5 Tampa General Cir Ste 820 Healthpoint Medical Group Tampa, FL 33606 3003 W Dr MLK Blvd (813) 844-3228 Tampa, FL 33607 Fax: (813) 844-7730 (813) 321-6580 18 Yrs/130 Yrs Fax: (813) 321-6581 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Northside Hospital South Florida Baptist Hospital Thoracic Surgery St Josephs Hospital M-F 9:00 AM - 5:00 PM Alkire, Mark MD PCMH: No Provider ID: 1176128 Gender: Male Pruitt, J MD Izzo and Alkire, MD's, PA Provider ID: 581591 1901 Haverford Ave Ste 105 Gender: Male Sun City Center, FL 33573 3003 W Dr MLK Blvd Mab 2nd (813) 258-4733 Fl Fax: (813) 258-4733 Tampa, FL 33607 18 Yrs/130 Yrs (813) 321-6580 Tampa General Hospital Fax: (813) 321-6581 M 8:00 AM - 5:00 PM 18 Yrs/130 Yrs TWTHF 8:30 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Thoracic Surgery - cont. Alkire, Mark MD Provider ID: 1176128 Gender: Male Izzo and Alkire, MD's, PA 5 Tampa General Cir Ste 860 Tampa, FL 33606 (813) 258-4533 Fax: (813) 258-4733 18 Yrs/130 Yrs Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Alkire, Mark MD Provider ID: 1176128 Gender: Male Izzo and Alkire, MD's, PA 6101 Webb Rd Ste 307 Tampa, FL 33615 (813) 258-4733 Fax: (813) 258-4733 18 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 5:00 PM TWTHF 8:30 AM - 5:00 PM PCMH: No Izzo, Edward MD Provider ID: 1176408 Gender: Male Izzo and Alkire MD PA 1901 Haverford Ave Ste 105 Sun City Center, FL 33573 (813) 258-4533 Fax: (813) 258-4733 18 Yrs/130 Yrs Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Izzo, Edward MD Provider ID: 1176408 Gender: Male Izzo and Alkire MD PA 5 Tampa General Cir Ste 860 Tampa, FL 33606 (813) 258-4533 Fax: (813) 258-4733 18 Yrs/130 Yrs Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Izzo, Edward MD Provider ID: 1176408 Gender: Male Izzo and Alkire MD PA 6101 Webb Rd Ste 307 Tampa, FL 33615 (813) 258-4533 Fax: (813) 258-4733 18 Yrs/130 Yrs Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Sommers, Keith MD Provider ID: 1095350 Gender: Male Baycare Medical Group 3003 Dr Martin Luther King Jr Blvd 2nd Fl Tampa, FL 33607 (813) 238-0810 Fax: (813) 238-0811 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Mendoza, Alfredo MD Provider ID: 378269 Gender: Male West Central Gastroenterology LLP 4695 Van Dyke Rd Lutz, FL 33558 (813) 920-8882 Fax: (813) 920-8883 18 Yrs/130 Yrs Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Urology Carrion, Rafael MD Provider ID: 274986 Gender: Male USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 250-2213 Fax: (813) 236-5222 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Vinson, Mary Carolyn DO Provider ID: 1226235 Gender: Female Baycare Medical Group Inc 3003 W Dr Martin Luther King Jr Blvd 2nd Fl Carrion, Rafael MD Tampa, FL 33607 Provider ID: 274986 (813) 238-0810 Gender: Male Fax: (813) 238-0811 USF Physicicans Group 18 Yrs/130 Yrs 5802 N 30th St St Josephs Hospital Tampa, FL 33610 M-F 8:00 AM - 5:00 PM (813) 250-2213 PCMH: No Fax: (813) 259-0852 18 Yrs/130 Yrs Transplant Hepatology Languages: Spanish M-F 8:00 AM - 5:00 PM Mendoza, Alfredo MD PCMH: No Provider ID: 378269 Gender: Male West Central Gastroenterology LLP 11912 Sheldon Rd Ste B Tampa, FL 33626 (813) 920-8882 Fax: (813) 920-8883 18 Yrs/130 Yrs Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Hernandez, David MD Provider ID: 524283 Gender: Male USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 974-4115 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 272

Hernandez, David MD Provider ID: 524283 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5250 Fax: (813) 236-5222 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lockhart, Jorge MD Provider ID: 7157 Gender: Male USF Physicians Group 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 974-4115 Fax: (813) 974-4280 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lockhart, Jorge MD Provider ID: 7157 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 326-5250 Fax: (813) 236-5222 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Parker, Justin MD Provider ID: 687820 Gender: Male 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 259-2507 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Urology - cont. Parker, Justin MD Provider ID: 687820 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 250-2213 Fax: (813) 259-0852 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Parker, Justin MD Provider ID: 687820 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5250 Fax: (813) 236-5222 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patel, Mahesh MD Provider ID: 172 Gender: Male 403 E Dr MLK Jr Blvd Tampa, FL 33603 (813) 224-9025 Fax: (813) 223-1545 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Tampa Bay Surgery Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Patel, Trushar MD Provider ID: 793241 Gender: Male USF Physicians Group 13330 USF Laurel Dr Fl 5 Tampa, FL 33612 (813) 250-2213 Fax: (813) 259-2507 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Trushar MD Provider ID: 793241 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-2507 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Vascular Surgery Armstrong, Paul DO Provider ID: 377330 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0929 Fax: (813) 259-0606 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Rehman, Jamil MD Provider ID: 218216 Bailey, Charles MD Gender: Male Florida Urology Oncology and Provider ID: 1047908 Urogyn Gender: Male 128 S Moon Ave West Florida Cardiology Brandon, FL 33511 Network LLC (813) 653-3737 270 S Moon Ave Fax: (813) 653-2525 Brandon, FL 33511 18 Yrs/130 Yrs (813) 571-9988 Brandon Regional Hospital Fax: (813) 571-9922 South Florida Baptist Hospital 18 Yrs/130 Yrs Languages: Hindi, Urdu, Brandon Regional Hospital Punjabi M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No Sat 8:00 AM - 2:00 PM PCMH: No Calero, Aurelia MD Wiegand, Lucas MD Provider ID: 1088172 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 925-9085 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Wiegand, Lucas MD Provider ID: 1088172 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5250 Fax: (813) 236-5222 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1196813 Gender: Female Fresenius Vascular Care of Tampa LL 12666 Telecom Dr Tampa, FL 33637 (813) 972-4700 Fax: (813) 972-4705 16 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Calero, Aurelia MD Provider ID: 984318 Gender: Male 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0606 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Calero, Aurelia MD Provider ID: 984318 Gender: Male USF Physicians Group 3000 Medical Park Dr Tampa, FL 33613 (813) 259-0929 Fax: (813) 259-0606 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No D'Alessandro, Matthew DO Provider ID: 1244436 Gender: Male Heart Vascular Institute of Florid 310 W Alexander St Plant City, FL 33563 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No De Jesus Gomez, Gustavo MD Provider ID: 1159484 Gender: Male Choice Health Care Inc 11964 Boyette Rd Riverview, FL 33569 (727) 475-6061 Fax: (855) 861-0819 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No De Jesus Gomez, Gustavo MD Provider ID: 1159484 Gender: Male Choice Health Care Inc 1881 W Kennedy Blvd Ste A and B Tampa, FL 33606 (813) 513-3030 Fax: (813) 513-3033 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Hillsborough Vascular Surgery - cont. De Jesus Gomez, Gustavo MD Provider ID: 1235218 Gender: Male Rapha Vascular Specialists Inc 11964 Boyette Rd Ste 4 Riverview, FL 33569 (813) 559-0440 Fax: (855) 861-0819 18 Yrs/130 Yrs Bartow Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Gonzalez, Alberto MD Provider ID: 612918 Gender: Male Thomas M Kerr MD PA 19185 N Dale Mabry Hwy Lutz, FL 33548 (813) 348-9088 Fax: (813) 348-9310 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gonzalez, Alberto MD Provider ID: 612918 Gender: Male Thomas M Kerr MD PA 2809 W Waters Ave Tampa, FL 33614 (813) 348-9088 Fax: (813) 348-9310 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Illig, Karl MD Provider ID: 1196225 Gender: Male Fresenius Vascular Care of Tampa LL 12666 Telecom Dr Tampa, FL 33637 (813) 972-4700 Fax: (813) 972-4705 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Illig, Karl MD Provider ID: 310108 Gender: Male USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0921 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Illig, Karl MD Provider ID: 310108 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0929 Fax: (813) 259-0921 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Illig, Karl MD Provider ID: 310108 Gender: Male USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0921 Fax: (813) 259-0606 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Johnson, Brad MD Provider ID: 7743 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0606 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Jones, Brandt DO Provider ID: 1093491 Gender: Male Thomas M Kerr MD PA 19185 N Dale Mabry Hwy Lutz, FL 33548 (813) 348-9088 Fax: (813) 949-2435 00 Yrs/130 Yrs Medical Center of Trinity M-F 8:00 AM - 5:00 PM PCMH: No

Suresh, Adithya MD

Kerr, Thomas MD Provider ID: 16296 Gender: Male 2809 W Waters Ave Tampa, FL 33614 (813) 348-9088 Fax: (813) 348-9310 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Suresh, Adithya MD

Provider ID: 1331276 Gender: Male Thomas M Kerr MD PA 19185 N Dale Mabry Hwy Lutz, FL 33548 (813) 348-9088 Fax: (813) 348-9310 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1331276 Gender: Male Thomas M Kerr MD PA 2809 W Waters Ave Tampa, FL 33614 (813) 348-9088 Fax: (813) 348-9310 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Shames, Murray MD Provider ID: 200041 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0929 Fax: (813) 259-0606 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Valentin, Marlene MD Provider ID: 299073 Gender: Female Thomas Kerr MD PA 19185 N Dale Mabry Hwy Lutz, FL 33548 (813) 387-3038 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Shames, Murray MD Provider ID: 200041 Gender: Male USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0929 Fax: (813) 259-0886 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Valentin, Marlene MD Provider ID: 299073 Gender: Female Thomas Kerr MD PA 2809 W Waters Ave Tampa, FL 33614 (813) 348-9088 Fax: (813) 348-9310 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Hillsborough Vascular Surgery - cont. Wilson, Jeffrey MD Provider ID: 689304 Gender: Male Lifeline Vascular Center Tampa 13085 N Telecom Pkwy Tampa, FL 33637 (813) 971-3064 Fax: (813) 977-3607 00 Yrs/130 Yrs M-F 7:30 AM - 3:30 PM PCMH: No Wilson, Scott MD Provider ID: 497646 Gender: Male University Medical Svc Assoc 2 Columbia Dr Tampa, FL 33606 (813) 844-7968 Fax: (813) 259-0886 00 Yrs/130 Yrs Tampa General Hospital Languages: German, Arabic M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 275

Last update 08/14/2017

Specialty Physicians Manatee Cardiology Acharya, Naveen MD Provider ID: 549684 Gender: Male Riverside Medical Center 300 Riverside Dr E Ste 2010 Bradenton, FL 34208 (941) 405-1170 Fax: (941) 405-1175 00 Yrs/130 Yrs Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Akella, Jagan MD Provider ID: 915576 Gender: Male Heart Rhythm Care Inc 3649 Cortez Rd W Bradenton, FL 34210 (941) 794-9000 Fax: (941) 729-1382 16 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Davis, Christopher MD Provider ID: 1157128 Gender: Male McWi, PLLC DBA Manatee Cardiovascul 2816 Manatee Ave W Bradenton, FL 34205 (941) 744-1200 Fax: (941) 744-1500 18 Yrs/130 Yrs Blake Medical Center M-F 8:00 AM - 4:30 PM PCMH: No

Krishnamurthy, Ashok MD Provider ID: 345632 Gender: Male Coastal Cardiovascular Consultants 315 75th St W Bradenton, FL 34209 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Krishnamurthy, Ashok MD Provider ID: 345632 Gender: Male Coastal Cardiovascular Consultants 3904 Cortez Rd W Bradenton, FL 34210 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Krishnamurthy, Ashok MD Provider ID: 345632 Gender: Male Coastal Cardiovascular Consultants 4351 Cortez Rd W Ste 200 Bradenton, FL 34210 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Krishnamurthy, Ashok MD Provider ID: 345632 Gender: Male Coastal Cardiovascular Consultants 6110 State Rd 70 E Bradenton, FL 34203 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Rivera, Enrique MD Provider ID: 222071 Gender: Male Coastal Cardiovascular Consultants 315 75th St W Ste 200 Bradenton, FL 34209 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rivera, Enrique MD Provider ID: 222071 Gender: Male Coastal Cardiovascular Consultants 3904 Cortez Rd W Bradenton, FL 34210 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Rivera, Enrique MD Provider ID: 222071 Gender: Male Coastal Cardiovascular Consultants 4351 Cortez Rd W Ste 200 Bradenton, FL 34210 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rivera, Enrique MD Provider ID: 222071 Gender: Male Coastal Cardiovascular Consultants 6110 State Rd 70 E Bradenton, FL 34203 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Chiropractic Constantine, Nicholas DC Provider ID: TPV10220-02 Gender: Male Nicholas P Constantine, DC, PA 509 8th Ave W Ste 120 Palmetto, FL 34221 (941) 729-3730 Fax: (941) 723-9097 10 Yrs/90 Yrs Languages: Greek MTWF 9:00 AM - 5:30 PM TH 10:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Chiropractic - cont. Rowe, Keri DC Provider ID: TPV11405-01 Gender: Female Rowe Family Chiropractic Center 6271 Lake Osprey Dr Lakewood Ranch, FL 34240 (941) 907-3010 Fax: (941) 907-3002 00 Yrs/99 Yrs MWF 8:00 AM - 6:00 PM T 8:00 AM - 12:00 PM TH 2:00 AM - 6:00 PM PCMH: No Shiver, Joseph DC Provider ID: TPV11356-01 Gender: Male Align Chiropractic and Wellness Center 1611 10th Ave W Palmetto, FL 34221 (941) 721-8132 Fax: (941) 722-1734 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sweat, Steven DC Provider ID: TPV10869-02 Gender: Male Manatee County Rural Health Services Inc 300 Riverside Dr E Ste 2010 Bradenton, FL 34208 (941) 405-1170 Fax: (941) 405-1175 10 Yrs/99 Yrs M-W 8:00 AM - 5:00 PM PCMH: No

Dermatology Cottam, John MD Provider ID: 162223 Gender: Male Dr John Cottam 5105 Manatee Ave W Ste 12 Bradenton, FL 34209 (813) 962-4210 Fax: (813) 964-0566 00 Yrs/130 Yrs M 8:00 AM - 2:00 PM PCMH: No

Jawitz, Jack MD Provider ID: 573210 Gender: Male Manatee County Rural Health Service 300 Riverside Dr E E Ste 2010 Bradenton, FL 34208 (941) 405-1170 Fax: (941) 405-1175 00 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M 1:00 AM - 5:00 PM PCMH: No

Ear, Nose & Throat Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head Nec 5911 N Honore Ave Ste 116 Sarasota, FL 34243 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Endodontics Gargasz, Bret DDS Provider ID: TPVP42269-11 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Gargasz, Bret DDS Provider ID: TPVP42269-12 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Millstein, Ashley DMD Provider ID: TPVP139323-07 Gender: Female Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Gargasz, Bret DDS Provider ID: TPVP42269-13 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

Millstein, Ashley DMD Provider ID: TPVP139323-49 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Millstein, Ashley DMD Provider ID: TPVP139323-06 Gender: Female Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

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Family Practice Bollegraf, Morris DO Provider ID: 1051219 Gender: Male Palmetto Family Healthcare Center 404 7th St W Palmetto, FL 34221 (941) 729-3856 Fax: (941) 729-3857 00 Yrs/130 Yrs Manatee Memorial Hospital MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 7:30 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Family Practice - cont. Brand, Andrea MD Provider ID: 1170540 Gender: Female In Home Healthcare LLC 911 70th Dr E Sarasota, FL 34243 (941) 993-5543 Fax: (941) 755-0184 00 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No Greenfield, Steven MD Provider ID: 391052 Gender: Male North Manatee Family Healthcare 5600 Bayshore Rd Palmetto, FL 34221 (941) 721-2020 Fax: (941) 721-2027 00 Yrs/130 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 1:00 PM PCMH: No Jothivijayarani, Arunachal MD Provider ID: 667954 Gender: Female 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3

Jothivijayarani, Arunachalam MD Provider ID: 1169153 Gender: Female Pinnacle Medical Group 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3

Gastroenterology

General Dentistry Acquaro, Ronald DMD Provider ID: TPVP138293-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Trotman, Bruce MD Acquaro, Ronald DMD Provider ID: 226281 Gender: Male Provider ID: TPVP138293-02 Manatee County Rural Health Gender: Male Service Manatee Village Dental 206 2nd St E Center Bradenton, FL 34208 1312 Manatee Ave East (941) 747-8404 Bradenton, FL 34208 Fax: (941) 747-0773 (941) 708-8710 18 Yrs/130 Yrs Fax: (941) 708-8761 Blake Medical Center 00 Yrs/99 Yrs Manatee Memorial Hospital Languages: Spanish West Florida Surgery Center MW 8:00 AM - 8:00 PM Inc TTHF 8:00 AM - 5:00 PM Languages: Laotian, Lithuanian PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Acquaro, Ronald DMD Provider ID: TPVP138293-03 Zalepuga, Rimantas MD Gender: Male Lawton Chiles Dental Provider ID: 209289 1515 26th Ave East Gender: Male Bradenton, FL 34208 Manatee County Rural Health (941) 708-7607 Service Fax: (941) 708-7618 206 2nd St E 00 Yrs/99 Yrs Bradenton, FL 34208 Languages: Spanish (941) 747-8408 M 8:00 AM - 8:00 PM Fax: (727) 747-0773 TWTH 8:00 AM - 5:00 PM 00 Yrs/130 Yrs F 8:00 AM - 1:00 PM Blake Medical Center PCMH: No Manatee Memorial Hospital West Florida Surgery Center Acquaro, Ronald DMD Inc Provider ID: TPVP138293-04 Languages: Russian, Polish Gender: Male M-F 8:00 AM - 5:00 PM Manatee County Rural Health PCMH: No Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs PCMH: No

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Adderly, Erica DDS Provider ID: TPVP131028-05 Gender: Female Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No Adderly, Erica DDS Provider ID: TPVP131028-09 Gender: Female Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No Adibi, Farnaz DMD Provider ID: TPVP133168-19 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Bacchelli, Lara DMD Allen, Kathie DDS Provider ID: TPVP138292-01 Gender: Female Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Alviani, Clay DMD Provider ID: TPVP156721-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Arditi, Sibel DMD Provider ID: TPVP156717-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Bacchelli, Lara DMD Provider ID: TPVP156856-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Barrett, Steven DDS Provider ID: TPV12124-72 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Bacchelli, Lara DMD Provider ID: TPVP156856-13 Gender: Female Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Barrett, Steven DDS Provider ID: TPV12124-61 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Biandudi, Odessa DDS Provider ID: TPVP120881-10 Gender: Female Great Expressions Dental Centers 11215 E State Rd 70 Lakewood Ranch, FL 34202 (941) 757-0490 Fax: (941) 727-7536 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Bacchelli, Lara DMD Provider ID: TPVP156856-17 Gender: Female Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

Barrett, Steven DDS Provider ID: TPV12124-63 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP156856-12 Gender: Female Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

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Boswell, Gibson DMD Provider ID: TPVP156855-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Bradley, Ashley DMD Provider ID: TPVP153368-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Bushati, Ivo DMD Branscombe, Tyler DMD Provider ID: TPVP134684-17 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No Branscombe, Tyler DMD Provider ID: TPVP134684-19 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Brito, Daryl DMD Provider ID: TPVP145792-19 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP134886-19 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Caputo, Michael DDS Provider ID: TPVP156605-51 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-12 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Canizares, Carina DMD Provider ID: TPVP156553-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Caputo, Michael DDS Provider ID: TPVP156605-55 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-13 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Caputo, Michael DDS Provider ID: TPVP156605-50 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Caputo, Michael DDS Provider ID: TPVP156605-56 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-17 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 280

Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Cherkinsky, Jordan DDS Carbonell, Kevin DMD Provider ID: TPVP152393-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Cherkinsky, Jordan DDS Provider ID: TPVP42826-28 Gender: Male Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No Cherkinsky, Jordan DDS Provider ID: TPVP42826-29 Gender: Male Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Provider ID: TPVP42826-61 Gender: Male Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs PCMH: No

Cherry, Jerry DDS Provider ID: TPVP127370-01 Gender: Male Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No Cherry, Jerry DDS Provider ID: TPVP127370-02 Gender: Male Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Cherry, Jerry DDS Provider ID: TPVP127370-03 Gender: Male Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs PCMH: No

Curd, Francis DDS Provider ID: TPVP59308-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-12 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-13 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

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Dockus, Matthew DMD Provider ID: TPVP157263-17 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Eckels, Shane DDS Provider ID: TPVP134881-48 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Genninger, Jasen DMD Fowler, Charlotte DMD Provider ID: TPVP156719-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-12 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-13 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP148171-19 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-13 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Kanach, Paul DMD Provider ID: TPVP137705-27 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Greenberg, Andrew DDS Provider ID: TPV7501-67 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-17 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

Kanach, Paul DMD Provider ID: TPVP137705-28 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-12 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Kanach, Paul DMD Provider ID: TPVP137705-31 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Keo, Phanith DMD Kanach, Paul DMD Provider ID: TPVP137705-33 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Katsur, Justin DDS Provider ID: TPV16372-98 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Keo, Phanith DMD Provider ID: TPVP42931-01 Gender: Male Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish, Cambodian MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP42931-02 Gender: Male Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish, Cambodian M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Keo, Phanith DMD Provider ID: TPVP42931-03 Gender: Male Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Cambodian PCMH: No Lipton, Barry DDS Provider ID: TPVP138203-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Manibo, Lourdes Alexandra DDS Provider ID: TPVP134884-01 Gender: Female Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Spanish, Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Mann, Nicholas DMD Provider ID: TPVP134710-05 Gender: Male Mann Orthodontics PA 7442 N Tamiami Trl Ste B Sarasota, FL 34243 (941) 359-9711 Fax: (941) 359-9771 00 Yrs/99 Yrs M 9:00 AM - 5:00 PM PCMH: No Martinez, Magela DMD Provider ID: TPVP137758-47 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Martinez, Susana DDS Provider ID: TPV13120-02 Gender: Female Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No Martinez, Susana DDS Provider ID: TPV13120-03 Gender: Female Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

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Martinez, Susana DDS Provider ID: TPV13120-04 Gender: Female Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-12 Gender: Female Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-13 Gender: Female Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Melean, Alfonso DMD Mazariegos, Stephanie DMD Provider ID: TPVP156700-17 Gender: Female Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Melean, Alfonso DMD Provider ID: TPVP130412-03 Gender: Male Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP130412-04 Gender: Male Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Melean, Alfonso DMD Provider ID: TPVP130412-05 Gender: Male Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish PCMH: No Mickelson, Nicholas DMD Provider ID: TPVP156555-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Nalley, Brittany DMD Provider ID: TPVP158535-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Ngo, Denise DDS Provider ID: TPVP134878-19 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Patel, Kinjalben DMD Provider ID: TPVP137746-50 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Pardo, Maria DDS Provider ID: TPVP127368-01 Gender: Female Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No

Peralta, Johnny DMD Provider ID: TPVP158762-01 Gender: Male Oneco Dental Care 6320 15th St E Ste C4 Sarasota, FL 34243 (941) 751-4900 Fax: (941) 751-9090 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 9:00 AM - 5:00 PM PCMH: No

Pardo, Maria DDS Provider ID: TPVP127368-02 Gender: Female Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Pardo, Maria DDS Provider ID: TPVP127368-03 Gender: Female Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish PCMH: No

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Phan, Christine DMD Provider ID: TPVP127987-47 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Scheurer, Monica DMD Rivera, Jade DMD Provider ID: TPVP155459-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Rizner, Amanda DMD Provider ID: TPVP131828-47 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Schaffner, Daniel DDS Provider ID: TPVP45055-03 Gender: Male Great Expressions Dental Centers 11215 E State Rd 70 Lakewood Ranch, FL 34202 (941) 757-0490 Fax: (941) 727-7536 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP138920-01 Gender: Female Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Scialfa, August DDS Provider ID: TPVP69386-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Simon, Keith DMD Provider ID: TPVP153371-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Snoke, Don Blair DDS Provider ID: TPVP138600-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Teresi, Kirsten DMD Provider ID: TPVP155452-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-17 Gender: Male Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-12 Gender: Male Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-18 Gender: Male Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-13 Gender: Male Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Turhan, Mine DDS Provider ID: TPVP133274-01 Gender: Female Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Manatee General Dentistry - cont. Vanoverbeke, Allen DMD Turhan, Mine DDS Provider ID: TPVP133274-02 Gender: Female Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Turhan, Mine DDS Provider ID: TPVP133274-03 Gender: Female Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs PCMH: No Vanoverbeke, Allen DMD Provider ID: TPVP157881-01 Gender: Male Manatee Village Dental Center 1312 Manatee Ave East Bradenton, FL 34208 (941) 708-8710 Fax: (941) 708-8761 00 Yrs/99 Yrs Languages: Spanish MW 8:00 AM - 8:00 PM TTHF 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP157881-02 Gender: Male Lawton Chiles Dental 1515 26th Ave East Bradenton, FL 34208 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Vanoverbeke, Allen DMD Provider ID: TPVP157881-03 Gender: Male Manatee County Rural Health Services - Health Express Mobile 12271 US Hwy 301 N Parrish, FL 34219 (941) 708-7607 Fax: (941) 708-7618 00 Yrs/99 Yrs PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-12 Gender: Female Greenberg Dental Orthodontics 5580 Cortez Rd W Bradenton, FL 34210 (941) 914-9181 Fax: (941) 914-9161 00 Yrs/99 Yrs Languages: Spanish MTHF 8:00 AM - 4:00 PM TW 11:00 AM - 7:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-13 Gender: Female Greenberg Dental Orthodontics 579 10th St E Palmetto, FL 34221 (941) 315-9914 Fax: (941) 315-9917 00 Yrs/99 Yrs Languages: Spanish MTH 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No

Wade, Brianne DMD Provider ID: TPVP156720-17 Gender: Female Greenberg Dental Orthodontics 8446 Lockwood Ridge Rd Sarasota, FL 34243 (941) 312-2024 Fax: (941) 312-2035 00 Yrs/99 Yrs Languages: Spanish MTF 8:00 AM - 4:00 PM WTH 9:00 AM - 5:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-18 Gender: Female Greenberg Dental Orthodontics-Brandenton 8754 E State Rd 70 Ste 8752 Bradenton, FL 34202 (941) 702-2229 Fax: (941) 404-4668 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Ward, Clifford DDS Provider ID: TPVP148002-01 Gender: Male Ward Family Dental PA 1619 Tallevast Rd Tallevast, FL 34270 (941) 355-4800 Fax: (941) 355-4060 00 Yrs/99 Yrs Languages: French M 10:00 AM - 6:00 PM TWTH 1:00 AM - 6:00 PM F 12:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM PCMH: No

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Ward, Tasha DDS Provider ID: TPVP44296-07 Gender: Female Ward Family Dental PA 1619 Tallevast Rd Tallevast, FL 34270 (941) 355-4800 Fax: (941) 355-4060 00 Yrs/99 Yrs Languages: French M 10:00 AM - 6:00 PM TWTH 1:00 AM - 6:00 PM F 12:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Zaki, Fady DDS Provider ID: TPVP122369-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Zmiyiwsky, Mark DDS Provider ID: TPVP75834-02 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee General Surgery Browning IV, Robert MD Provider ID: 1308729 Gender: Male Intercoastal Medical Group 11505 Rangeland Pkwy Bradenton, FL 34211 (941) 362-8662 Fax: (941) 362-8602 16 Yrs/130 Yrs M-F 8:00 AM - 4:45 PM PCMH: No Chandler, Nicole MD Provider ID: 461033 Gender: Female Pediatric Physician Services 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No Hermans, Howard MD Provider ID: 1187271 Gender: Male Bradenton Trauma Surgical Group 2010 59th St W Bradenton, FL 34209 (941) 794-5621 Fax: (941) 761-1531 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Hirsch, Kevin MD Oswanski, Michael MD Velcu, Laura MD Provider ID: 1571 Provider ID: 1185564 Gender: Male Gender: Female Provider ID: 642026 West Florida Trauma Network Gender: Male Burn Centers of Florida, Inc. LLC West Florida Trauma Network 2020 59th St W 2010 59th St W Ste 2200 Bradenton, FL 34209 2010 59th St W Ste 2200 Bradenton, FL 34209 (706) 863-9595 Bradenton, FL 34209 (941) 794-5621 Fax: (706) 868-8375 (941) 794-5621 Fax: (941) 761-1532 00 Yrs/130 Yrs Fax: (941) 761-1532 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM 16 Yrs/130 Yrs Blake Medical Center PCMH: No Blake Medical Center St Anthonys Physicians M-F 9:00 AM - 5:00 PM Surgery Walford, Nebbie MD PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Pecoraro, Joseph MD Provider ID: 558061 Gender: Female Hussein, Qaali MD Pediatric Physician Services Provider ID: 1189746 Provider ID: 1184302 Inc Gender: Male Gender: Female 8340 Lakewd Rnch Blvd Ste Pinnacle Medical Group Bradenton Trauma Surgical 160 315 75th St W Group Bradenton, FL 34202 Bradenton, FL 34209 2010 59th St W Ste 2200 (727) 767-4170 (941) 761-1998 Bradenton, FL 34209 Fax: (727) 767-4346 Fax: (877) 501-8537 (941) 794-5621 00 Yrs/21 Yrs 18 Yrs/110 Yrs Fax: (941) 761-1532 Johns Hopkins All Childrens Blake Medical Center 00 Yrs/130 Yrs Hospital Inc Languages: Spanish M-F 6:00 AM - 5:00 PM M-F 8:00 AM - 4:00 PM MT 8:30 AM 3:30 PM PCMH: No PCMH: No PCMH: No Kasiewicz, James MD Hand Surgery Sundberg, Sharla MD Provider ID: 1084655 Gender: Male Bradenton Trauma Surgical Group 2010 59th St W Ste 2200 Bradenton, FL 34209 (941) 794-5621 Fax: (941) 761-1532 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kimbrell, Brian MD Provider ID: 658683 Gender: Male Bradenton Cardiology Physician Netw 2010 59th St W Ste 2200 Bradenton, FL 34209 (941) 794-5621 Fax: (941) 761-1532 16 Yrs/130 Yrs Blake Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1238110 Gender: Female West Florida Physician Network LLC 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Toomey, Paul MD Provider ID: 1161020 Gender: Male Florida Surgical Specialists 607 Manatee Ave E STE102 Bradenton, FL 34208 (941) 216-3602 Fax: (941) 216-3605 12 Yrs/130 Yrs Blake Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

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Leong, Kenneth MD Provider ID: 1296971 Gender: Male Burn Centers of Florida Inc 2020 59th St W Bradenton, FL 34209 (706) 863-9595 Fax: (706) 863-2474 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Hematology & Oncology Harandi, Amir MD Brown, Richard MD Provider ID: 25616 Gender: Male Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Buck, Richard MD Provider ID: 230117 Gender: Male Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Chu, Luis MD Provider ID: 25620 Gender: Male 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Garcia, Rodrigo MD Provider ID: 229940 Gender: Male Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Lakewood Ranch Medical Center Sarasota Memorial Hospital Winter Haven Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 1359350 Gender: Male Florida Cancer Specialists Pl 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kayali, Fadi MD Provider ID: 698432 Gender: Male Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Nadiminti, Yallappa MD Provider ID: 167356 Gender: Male 2401 60th St Ct W Bradenton, FL 34209 (941) 792-1881 Fax: (941) 795-3924 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Telugu M-F 9:00 AM - 5:00 PM PCMH: No Nadiminti, Yallappa MD Provider ID: 167356 Gender: Male Florida Cancer Specialists Pl 401 Manatee Ave E Ste B Bradenton, FL 34208 (941) 748-2217 Fax: (941) 748-5300 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Telugu M-F 8:00 AM - 4:30 PM PCMH: No

Nadiminti, Yallappa MD Provider ID: 167356 Gender: Male Florida Cancer Specialists Pl 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Telugu M-F 8:30 AM - 5:00 PM PCMH: No Pelayo, Miguel MD Provider ID: 1080141 Gender: Male Florida Cancer Specialists Pl 6310 Health Pwky Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Infectious Disease Andrews, Robert MD Provider ID: 27344 Gender: Male Bach & Godofsky MD PA 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 746-2711 Fax: (941) 746-3433 12 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Cooks, Aaron MD Provider ID: 293187 Gender: Male Bach & Godofsky 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 708-8500 Fax: (941) 708-8503 12 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Demaio, James MD Provider ID: 246523 Gender: Male Bach & Godofsky MD PA 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 746-2711 Fax: (941) 746-3433 00 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Demaio, James MD Provider ID: 450246 Gender: Male Manatee County Rural Health Service 4805 26th St W Bradenton, FL 34207 (941) 753-7845 Fax: (947) 175-3784 00 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Infectious Disease - cont. Offner, Stuart MD Dunn, Michael MD Provider ID: 938262 Gender: Male Bach & Godofsky MD PA 2514 University Pkwy Sarasota, FL 34243 (941) 684-4300 Fax: (941) 746-5326 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Godofsky, Eliot MD Provider ID: 16190 Gender: Male Bach & Godofsky MD PA 2415 University Pkwy Ste 215 Sarasota, FL 34243 (941) 746-2711 Fax: (941) 746-3433 12 Yrs/130 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Godofsky, Eliot MD Provider ID: 16190 Gender: Male Bach & Godofsky MD PA 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 746-2711 Fax: (941) 746-3433 12 Yrs/130 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 707778 Gender: Male Pointe West Infectious Diseases 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 746-2711 Fax: (941) 746-3433 12 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Suciu, Lavinia MD Provider ID: 187175 Gender: Female Bach & Godofsky MD PA 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 746-2711 Fax: (941) 746-3433 00 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: French, Romanian M-F 9:00 AM - 5:00 PM PCMH: No

Srivastava, Sunit MD Provider ID: 1157138 Gender: Male Manatee County Rural Health Servic 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 18 Yrs/130 Yrs MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM PCMH: No

Medical Oncology

Offner, Stuart MD Suciu, Lavinia MD Provider ID: 765081 Provider ID: 549208 Berry, Brian MD Gender: Male Gender: Male Provider ID: 206853 Southwest Healthcare Center Manatee County Rural Health Gender: Male 5325 26th St W Service 401 Manatee Ave E Ste B Bradenton, FL 34207 4805 26th St W Bradenton, FL 34208 (941) 752-7173 Bradenton, FL 34207 (941) 748-2217 Fax: (941) 567-6277 (941) 753-7845 Fax: (941) 748-5300 00 Yrs/130 Yrs Fax: (947) 175-3784 18 Yrs/130 Yrs Blake Medical Center 00 Yrs/130 Yrs Blake Medical Center M-F 8:00 AM - 5:00 PM Lakewood Ranch Medical Manatee Memorial Hospital Center PCMH: No M-F 8:00 AM - 4:30 PM Manatee Memorial Hospital PCMH: No Suciu, Lavinia MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 187175 Berry, Brian MD Gender: Female Provider ID: 206853 Internal Medicine Bach & Godofsky MD PA Gender: Male 2415 University Pkwy Ste 215 Florida Cancer Specialists Pl Kuchmak, Olga MD Sarasota, FL 34243 2401 60th St Ct W (941) 684-4300 Bradenton, FL 34209 Provider ID: 1310811 Fax: (941) 746-5326 (941) 792-1881 Gender: Female 00 Yrs/130 Yrs Fax: (941) 795-3924 Kidney Disease Consultants of 18 Yrs/130 Yrs Blake Medical Center Of Br Lakewood Ranch Medical Blake Medical Center Center 508 Manatee Ave E Manatee Memorial Hospital Manatee Memorial Hospital Bradenton, FL 34208 M-F 8:00 AM - 4:30 PM Languages: French, Romanian (941) 744-0024 PCMH: No M-F 8:00 AM - 5:00 PM Fax: (941) 746-1048 PCMH: No 18 Yrs/130 Yrs Patel, Manish MD M-F 8:00 AM - 5:00 PM Provider ID: 622381 PCMH: No Gender: Male Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 289

Last update 08/14/2017

Specialty Physicians Manatee Medical Oncology - cont. Telukuntla, Koteshwar MD Silver, Caryn MD Provider ID: 282068 Gender: Female Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Telukuntla, Koteshwar MD Provider ID: 167354 Gender: Male 2401 60th St Ct W Bradenton, FL 34209 (941) 792-1881 Fax: (941) 795-3924 18 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital Languages: Hindi, Telugu M-F 8:00 AM - 4:30 PM PCMH: No Telukuntla, Koteshwar MD Provider ID: 167354 Gender: Male Florida Cancer Specialists Pl 401 Manatee Ave E Ste B Bradenton, FL 34208 (941) 748-2217 Fax: (941) 748-5300 18 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital Languages: Hindi, Telugu M-F 8:00 AM - 4:30 PM PCMH: No

Provider ID: 167354 Gender: Male Florida Cancer Specialists Pl 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital Languages: Hindi, Telugu M-F 8:00 AM - 4:30 PM PCMH: No Van Der Wall, Ana MD Provider ID: 1033852 Gender: Female Florida Cancer Specialists Pl 2401 60th St Ct W Bradenton, FL 34209 (941) 792-1881 Fax: (941) 795-3924 18 Yrs/130 Yrs Blake Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Whorf, Robert MD Provider ID: 286972 Gender: Male 401 Manatee Ave E Ste B Bradenton, FL 34208 (941) 748-2217 Fax: (941) 748-5300 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 8:00 AM - 4:30 PM PCMH: No Whorf, Robert MD Provider ID: 286972 Gender: Male Florida Cancer Specialists Pl 2401 60th St Ct W Bradenton, FL 34209 (941) 792-1881 Fax: (941) 795-3924 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 8:00 AM - 4:30 PM PCMH: No

Nephrology Andal, Laurie DO Provider ID: 1126134 Gender: Female Renal Hypertension Center 3501 Cortez Rd W Bradenton, FL 34210 (941) 251-4031 Fax: (941) 753-1608 18 Yrs/130 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Andal, Laurie DO Provider ID: 1126134 Gender: Female Renal Hypertension Center 8614 E State Rd 70 Ste. 101 Bradenton, FL 34202 (941) 251-4031 Fax: (941) 251-4034 18 Yrs/130 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bala, Jennifer MD Provider ID: 302853 Gender: Female Manatee Kidney Disease Consultants 3701 Manatee Ave W Bradenton, FL 34205 (941) 746-5840 Fax: (941) 745-3591 21 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chauhan, Veeraish MD Provider ID: 698456 Gender: Male Renal Hypertension Center 3501 Cortez Rd W Ste 104 Bradenton, FL 34210 (941) 753-1035 Fax: (727) 869-8629 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 290

Kuchmak, Olga MD Provider ID: 1310811 Gender: Female Kidney Disease Consultants of Of Br 508 Manatee Ave E Bradenton, FL 34208 (941) 744-0024 Fax: (941) 746-1048 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Liquete, Egbert MD Provider ID: 1176270 Gender: Male Renal Hypertension Center 3501 Cortez Rd W Ste 104 Bradenton, FL 34210 (727) 863-5418 Fax: (727) 869-8626 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Palomino, Celestino MD Provider ID: 12738 Gender: Male Manatee Kidney Diseases Consultants 3701 Manatee Ave W Bradenton, FL 34205 (941) 746-5840 Fax: (941) 745-3591 18 Yrs/130 Yrs Blake Medical Center Columbia South Bay Hospital Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Nephrology - cont.

Neurology

Ramamurthy, Guruswamy MD Esparza, Francisco MD Provider ID: 174749 Gender: Male Kidney Disease Consultants 508 Manatee Ave E Bradenton, FL 34208 (941) 744-0024 Fax: (941) 746-1048 18 Yrs/130 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Toka, Hakan MD Provider ID: 1328257 Gender: Male Manatee Kidney Diseases Consultants 3701 Manatee Ave W Bradenton, FL 34205 (941) 746-5840 Fax: (941) 745-3591 21 Yrs/130 Yrs Manatee Memorial Hospital Languages: German M-F 9:00 AM - 5:00 PM PCMH: No Tolouian, Ramin MD Provider ID: 1331268 Gender: Male Manatee Kidney Diseases Consultants 3701 Manatee Ave W Bradenton, FL 34205 (941) 746-5840 Fax: (941) 745-3591 21 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 223930 Gender: Male West Florida Physician Network, LL 315 75th St W Bradenton, FL 34209 (941) 752-2801 Fax: (941) 501-8537 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Esparza, Francisco MD Provider ID: 223930 Gender: Male West Florida Physician Network, LLC 7005 Cortez Rd W Bradenton, FL 34210 (941) 750-0602 Fax: (941) 748-5626 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Ortstadt, Jeffrey MD Provider ID: 1364266 Gender: Male Pinnacle Medical Group 7005 Cortez Rd W Bradenton, FL 34210 (941) 465-4800 Fax: (877) 446-1404 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Yathiraj, Sanjay MD Provider ID: 280428 Gender: Male West Florida Physicians Network, LL 7005 Cortez Rd W Bradenton, FL 34210 (941) 750-0602 Fax: (941) 748-5626 00 Yrs/130 Yrs Blake Medical Center Languages: Spanish, Kannada M-F 8:00 AM - 5:00 PM PCMH: No

Neurosurgery Boyer, Kevin MD Provider ID: 726417 Gender: Male West Florida Physicians Network LLC 7005 Cortez Rd W Bradenton, FL 34210 (941) 750-0602 Fax: (941) 798-2019 00 Yrs/130 Yrs Blake Medical Center M 8:30 AM - 4:30 PM T 8:30 AM - 12:00 PM W 8:30 AM - 12:30 PM PCMH: No King, Michael MD Provider ID: 15578 Gender: Male Neurospinal Associates P A 200 3rd Ave W Ste 200 Bradenton, FL 34205 (941) 794-3118 Fax: (941) 782-2017 00 Yrs/130 Yrs Blake Medical Center Doctors Hospital Sarasota Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Tally, Philip MD Provider ID: 15576 Gender: Male Neurospinal Associates PA 200 3rd Ave W Ste 200 Bradenton, FL 34205 (941) 794-3118 Fax: (941) 782-2017 00 Yrs/130 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Tiesi, James MD Provider ID: 7811 Gender: Male Neuro Spinal Assoc 200 3rd Ave W Ste 200 Bradenton, FL 34205 (941) 794-3118 Fax: (941) 782-2017 00 Yrs/130 Yrs Columbia South Bay Hospital Doctors Hospital Sarasota Lakewood Ranch Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Obstetrics/Gynecology Caltenco, Elias MD Provider ID: 4818 Gender: Male Manatee County Rural Health Services 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 00 Yrs/130 Yrs Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Obstetrics/Gynecology - Dolskaya, Elena MD cont. Provider ID: 1092086 Caltenco, Elias MD Provider ID: 4818 Gender: Male Manatee County Rural Health Services 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 741-3242 00 Yrs/130 Yrs Manatee Memorial Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 11:00 AM - 8:00 PM PCMH: No Dolskaya, Elena MD Provider ID: 1092086 Gender: Female East Manate Healthcare Center 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 12 Yrs/130 Yrs Manatee Memorial Hospital MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 8:00 PM PCMH: No Dolskaya, Elena MD Provider ID: 1092086 Gender: Female Edgar H Price Jr Family and Childre 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 12 Yrs/130 Yrs Manatee Memorial Hospital MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No

Gender: Female River Landings OB/GYN 5460 63rd St E Ste B Bradenton, FL 34203 (941) 316-8200 Fax: (941) 316-8199 12 Yrs/130 Yrs Manatee Memorial Hospital MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No Dolskaya, Elena MD Provider ID: 1092086 Gender: Female West Manatee Health Center 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 741-3242 12 Yrs/130 Yrs Manatee Memorial Hospital MTTH 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM F 8:00 AM - 1:00 PM PCMH: No Fanarjian, Nicole MD Provider ID: 985158 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM PCMH: No

Jothivijayarani, A MD Provider ID: 306370 Gender: Female West Florida Physicians Network LLC 3501 Cortez Rd W Bradenton, FL 34210 (941) 752-2700 Fax: (941) 752-2730 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Jothivijayarani, Arunachal MD Provider ID: 667954 Gender: Female 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3 Jothivijayarani, Arunachalam MD Provider ID: 1169153 Gender: Female Pinnacle Medical Group 315 75th St W Bradenton, FL 34209 (941) 761-1998 Fax: (877) 501-8537 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: Yes, Level 3

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Lewis, Michael MD Provider ID: 14001 Gender: Male 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 405-1145 12 Yrs/130 Yrs Broward Health Medical Center St Josephs Hospital Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM PCMH: No Lin, Maria DO Provider ID: 791743 Gender: Female 5323 4th Ave Cir E Bradenton, FL 34208 (941) 745-5115 Fax: (941) 750-6538 12 Yrs/112 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No Ortiz, Edwin MD Provider ID: 783354 Gender: Male Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Obstetrics/Gynecology - Rivera-Ortiz, Wilfredo MD cont. Prabhakaran, Sujatha MD Provider ID: 796079 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish, Arabic, Bengali, Armenian M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM PCMH: No Rivera-Ortiz, Wilfredo MD Provider ID: 14920 Gender: Male 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 12 Yrs/80 Yrs Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rivera-Ortiz, Wilfredo MD Provider ID: 14920 Gender: Male 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 12 Yrs/80 Yrs Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 14920 Gender: Male 5460 63rd St E Bradenton, FL 34203 (941) 316-8200 Fax: (941) 316-8199 12 Yrs/80 Yrs Manatee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rivera-Ortiz, Wilfredo MD Provider ID: 14920 Gender: Male Manatee County Rural Health Services 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 741-3242 12 Yrs/80 Yrs Manatee Memorial Hospital Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 11:00 AM - 8:00 PM PCMH: No Rosa, Hector MD Provider ID: 817797 Gender: Male Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM PCMH: No

Saborido Battaglia, Francisco MD Provider ID: 1147002 Gender: Male East Manate E Family Healthcare Center 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 12 Yrs/130 Yrs Manatee Memorial Hospital MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 8:00 PM PCMH: No

South, Stacey MD Provider ID: 492771 Gender: Female Womens Choice Oncology 5315 4th Ave Cir E Bradenton, FL 34208 (941) 746-7507 Fax: (941) 746-7579 12 Yrs/130 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Saborido Battaglia, Francisco MD Provider ID: 1147002 Gender: Male Edgar H Price Jr Family and Childre 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 12 Yrs/130 Yrs Manatee Memorial Hospital M-F 8:30 AM - 2:00 PM PCMH: No

Stephens, Shawn MD

Saborido Battaglia, Francisco MD Provider ID: 1147002 Gender: Male West Manatee Health Center 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 741-3242 12 Yrs/130 Yrs Manatee Memorial Hospital M 8:00 AM - 8:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 293

Provider ID: 728140 Gender: Male Florida Woman Care 2401 University Pkwy Ste 201 Sarasota, FL 34243 (941) 359-8300 Fax: (941) 359-8310 00 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 6:00 PM PCMH: No Vazquez, Carlos MD Provider ID: 226011 Gender: Male 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Vazquez, Carlos MD Provider ID: 226011 Gender: Male 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Obstetrics/Gynecology - Wolford, Dale DO cont. Provider ID: 12187 Vazquez, Carlos MD Provider ID: 226011 Gender: Male 5460 63rd St E Bradenton, FL 34203 (941) 316-8200 Fax: (941) 316-8199 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Vazquez, Carlos MD Provider ID: 226011 Gender: Male Manatee County Rural Health Services 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 741-3242 12 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 11:00 AM - 8:00 PM PCMH: No Waterman II, Philip MD Provider ID: 686208 Gender: Male Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs Lee Memorial Hospital M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM PCMH: No

Gender: Male Edgar H Price Jr Family and C 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 12 Yrs/130 Yrs Desoto Memorial Hospital MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM PCMH: No Woods, Reginald MD Provider ID: 4819 Gender: Male 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/130 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Woods, Reginald MD Provider ID: 4819 Gender: Male Manatee County Rural Health Services 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 00 Yrs/130 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Woods, Reginald MD Provider ID: 4819 Gender: Male Manatee County Rural Health Services 2318 Manatee Ave W Bradenton, FL 34205 (941) 714-7150 Fax: (941) 741-3242 00 Yrs/130 Yrs Manatee Memorial Hospital MWTHF 8:00 AM - 5:00 PM T 11:00 AM - 8:00 PM PCMH: No

Ophthalmology Ahn, Byung-Joon MD Provider ID: TPV1649492711-0 Gender: Male Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Ahn, Byung-Joon MD Provider ID: TPV1649492711-0 Gender: Male Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Ahn, Byung-Joon MD Provider ID: TPV1649492711-0 Gender: Male Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 294

Allarakhia, Liaquat MD Provider ID: 216010 Gender: Male Bradenton Eye Clinic 4812 26th St W Bradenton, FL 34207 (941) 727-3937 Fax: (941) 727-7001 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Anthony, Charles MD Provider ID: TPV1518278142-0 Gender: Male Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 12 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Anthony, Charles MD Provider ID: TPV1518278142-0 Gender: Male Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 12 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Ophthalmology - cont. Anthony, Charles MD Provider ID: TPV1518278142-0 Gender: Male Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 12 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Berger, Todd MD Provider ID: TPV1205836418-0 Gender: Male Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 18 Yrs/99 Yrs Northside Hospital Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Berger, Todd MD Provider ID: TPV1205836418-0 Gender: Male Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 18 Yrs/99 Yrs Northside Hospital Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Berger, Todd MD Provider ID: TPV1205836418-0 Gender: Male Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 18 Yrs/99 Yrs Northside Hospital Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Edelman, Robert MD Friedberg, Murray MD Provider ID: TPV1790783553-0 Provider ID: TPV1609874874-0 Gender: Male Gender: Male Manatee-Sarasota Eye Clinic Manatee-Sarasota Eye Clinic 217 Manatee Ave E 217 Manatee Ave E Bradenton, FL 34208 Bradenton, FL 34208 (941) 748-1818 (941) 748-1818 Fax: (941) 746-1055 Fax: (941) 746-1055 00 Yrs/18 Yrs 00 Yrs/18 Yrs Manatee Memorial Hospital & Manatee Memorial Hospital & Health Syste Health Syste Languages: Spanish Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Davis, Jeffrey MD Foster, John MD Friedberg, Murray MD Provider ID: TPV1275795775-0 Provider ID: TPV1396920906-0 Provider ID: TPV1609874874-0 Gender: Male Gender: Male Gender: Male Manatee-Sarasota Eye Clinic Eye Associates of Manatee Manatee-Sarasota Eye Clinic LLP 217 Manatee Ave E 6310 Health Park Way Ste 340 7915 US Hwy 301 N Bradenton, FL 34208 Bradenton, FL 34202 Ellenton, FL 34222 (941) 748-1818 (941) 748-1818 (941) 729-2020 Fax: (941) 746-1055 Fax: (941) 746-1055 Fax: (941) 782-1089 00 Yrs/18 Yrs 00 Yrs/18 Yrs Manatee Memorial Hospital & 04 Yrs/99 Yrs Manatee Memorial Hospital & Health Syste Blake Medical Center Health Syste Languages: Spanish Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No PCMH: No Friedman, Robert MD Davis, Jeffrey MD Foster, John MD Provider ID: TPV1750327177-0 Provider ID: TPV1275795775-0 Provider ID: TPV1396920906-0 Gender: Male Gender: Male Gender: Male Eye Associates of Manatee LLP Manatee-Sarasota Eye Clinic Eye Associates of Manatee LLP 6002 Pointe W Blvd 6310 Health Park Way Ste 340 6002 Pointe W Blvd Bradenton, FL 34209 Bradenton, FL 34202 Bradenton, FL 34209 (941) 792-2020 (941) 748-1818 (941) 792-2020 Fax: (941) 761-9257 Fax: (941) 746-1055 Fax: (941) 761-9257 18 Yrs/99 Yrs 00 Yrs/18 Yrs Sarasota Memorial Hospital Manatee Memorial Hospital & 04 Yrs/99 Yrs Health Syste Blake Medical Center Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM Languages: Spanish, Korean M 8:00 AM - 12:00 PM PCMH: No M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM W 8:00 AM - 12:30 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 295

Last update 08/14/2017

Specialty Physicians Manatee Ophthalmology - cont. Friedman, Scott MD Provider ID: TPV1497842314-0 Gender: Male Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 00 Yrs/99 Yrs Winter Haven Hospital Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Friedman, Scott MD Provider ID: TPV1497842314-0 Gender: Male Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 00 Yrs/99 Yrs Winter Haven Hospital Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Friedman, Scott MD Provider ID: TPV1497842314-1 Gender: Male Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 00 Yrs/99 Yrs Winter Haven Hospital Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Hector, Richard MD Kasper, Jeffrey MD Provider ID: TPV1073511077-0 Provider ID: TPV1912907122-0 Gender: Male Gender: Male Eye Associates of Manatee Eye Associates of Manatee LLP LLP 6002 Pointe W Blvd 6002 Pointe W Blvd Bradenton, FL 34209 Bradenton, FL 34209 (941) 792-2020 (941) 792-2020 Fax: (941) 761-9257 Fax: (941) 761-9257 18 Yrs/99 Yrs 18 Yrs/99 Yrs Manatee Memorial Hospital & Northside Hospital Health Syste Languages: Spanish, Korean Languages: Spanish, Korean M 8:00 AM - 12:00 PM M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM W 8:00 AM - 12:30 PM PCMH: No PCMH: No Kasper, Jeffrey MD Hector, Richard MD Provider ID: TPV1912907122-0 Provider ID: TPV1073511077-0 Gender: Male Gender: Male Eye Associates of Manatee Eye Associates of Manatee LLP LLP 7230 55th Ave E 7230 55th Ave E Bradenton, FL 34203 Bradenton, FL 34203 (941) 792-2020 (941) 792-2020 Fax: (941) 924-8669 Fax: (941) 924-8669 18 Yrs/99 Yrs 18 Yrs/99 Yrs Northside Hospital Manatee Memorial Hospital & Languages: Spanish, Korean Health Syste M-F 8:00 AM - 5:00 PM Languages: Spanish, Korean PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Kasper, Jeffrey MD Provider ID: TPV1912907122-0 Hector, Richard MD Gender: Male Provider ID: TPV1073511077-0 Eye Associates of Manatee Gender: Male LLP Eye Associates of Manatee 7915 US Hwy 301 N LLP Ellenton, FL 34222 7915 US Hwy 301 N (941) 729-2020 Ellenton, FL 34222 Fax: (941) 782-1089 (941) 729-2020 18 Yrs/99 Yrs Fax: (941) 782-1089 Northside Hospital 18 Yrs/99 Yrs Languages: Spanish, Korean Manatee Memorial Hospital & M-F 8:00 AM - 5:00 PM Health Syste PCMH: No Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 296

Khator, Pooja MD Provider ID: TPV1376592741-0 Gender: Female Manatee-Sarasota Eye Clinic 217 Manatee Ave E Bradenton, FL 34208 (941) 748-1818 Fax: (941) 746-1055 00 Yrs/18 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital & Health Syste Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Khator, Pooja MD Provider ID: TPV1376592741-0 Gender: Female Manatee-Sarasota Eye Clinic 6310 Health Park Way Ste 340 Bradenton, FL 34202 (941) 748-1818 Fax: (941) 746-1055 00 Yrs/18 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital & Health Syste M-F 8:00 AM - 5:00 PM PCMH: No Mali, Joshua MD Provider ID: TPV1124261375-0 Gender: Male Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 01 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Ophthalmology - cont. Mali, Joshua MD Provider ID: TPV1124261375-0 Gender: Male Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 01 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Mali, Joshua MD Provider ID: TPV1124261375-0 Gender: Male Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 01 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Menezes, Allison MD Provider ID: TPV1992741078-0 Gender: Female Manatee-Sarasota Eye Clinic 217 Manatee Ave E Bradenton, FL 34208 (941) 748-1818 Fax: (941) 746-1055 00 Yrs/18 Yrs Sarasota Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Menezes, Allison MD Provider ID: TPV1992741078-0 Gender: Female Manatee-Sarasota Eye Clinic 6310 Health Park Way Ste 340 Bradenton, FL 34202 (941) 748-1818 Fax: (941) 746-1055 00 Yrs/18 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sambursky, Robert MD Provider ID: TPV1477541639-0 Gender: Male Manatee-Sarasota Eye Clinic 217 Manatee Ave E Bradenton, FL 34208 (941) 748-1818 Fax: (941) 746-1055 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

McCabe, Cathleen MD Provider ID: TPV1700840493-0 Gender: Female Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Sambursky, Robert MD Fax: (941) 761-9257 18 Yrs/99 Yrs Provider ID: TPV1477541639-0 Sarasota Memorial Hospital Gender: Male Languages: Spanish, Korean Manatee-Sarasota Eye Clinic M 8:00 AM - 12:00 PM 6310 Health Park Way Ste 340 TTHF 8:00 AM - 5:00 PM Bradenton, FL 34202 W 8:00 AM - 12:30 PM (941) 748-1818 PCMH: No Fax: (941) 746-1055 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Optometry Shane, Anita MD Provider ID: TPV1992998207-0 Blom, Thomas OD Gender: Female Manatee-Sarasota Eye Clinic Provider ID: TPV1699756981-0 217 Manatee Ave E Gender: Male Bradenton, FL 34208 Thomas Blom OD PA (941) 748-1818 3611 1st St Ste 640 Fax: (941) 746-1055 Bradenton, FL 34208 00 Yrs/18 Yrs (941) 747-5567 Lakewood Ranch Medical Fax: (941) 925-4967 Center 8330 Lakew 06 Yrs/99 Yrs Manatee Memorial Hospital & M-F 9:00 AM - 5:00 PM Health Syste PCMH: No Languages: Spanish M-F 8:00 AM - 5:00 PM Camp, Lori OD PCMH: No Provider ID: TPV1871550046-0 Gender: Female Silverman, Scott MD Sinclair Camp OD PA Provider ID: TPV1912905910-0 9122 58th Dr E Gender: Male Bradenton, FL 34202 Manatee-Sarasota Eye Clinic (941) 752-2020 217 Manatee Ave E Fax: (941) 544-2676 Bradenton, FL 34208 05 Yrs/99 Yrs (941) 748-1818 MTTHF 8:00 AM - 5:30 PM Fax: (941) 746-1055 W 8:00 AM - 12:30 PM 00 Yrs/18 Yrs PCMH: No Manatee Memorial Hospital & Health Syste Carr, William OD Languages: Spanish Provider ID: TPV1609803451-0 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Eye Doctors Optical Outlets PA Optician 2827 University Pkwy Sarasota, FL 34231 Eye Doctors Optical Outlets (941) 296-0179 PA Fax: (941) 866-2641 Provider ID: TPV1558552893-0 05 Yrs/99 Yrs 803 Cortez Rd W Languages: Spanish, Bradenton, FL 34207 Vietnamese (941) 753-2323 M-F 9:30 AM - 6:00 PM Fax: (941) 866-7370 Sat 9:30 AM - 1:00 PM 00 Yrs/99 Yrs PCMH: No MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Carr, William OD Sat 9:00 AM - 5:00 PM Provider ID: TPV1609803451-0 PCMH: No Gender: Male Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 05 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 297

Last update 08/14/2017

Specialty Physicians Manatee Optometry - cont. Carr, William OD Provider ID: TPV1609803451-0 Gender: Male Eye Doctors Optical Outlets PA 7313 52nd Pl E Bradenton, FL 34203 (941) 758-4902 Fax: (941) 877-2942 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Chai, Sook OD Provider ID: TPV1760557813-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Daka, Dedrix OD Provider ID: TPV1316202401-1 Gender: Male Manatee County Rural Health Services Inc 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 04 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Daka, Dedrix OD Provider ID: TPV1316202401-1 Gender: Male Manatee County Rural Health Services Inc 1312 Manatee Ave E Bradenton, FL 34208 (941) 750-8797 Fax: (941) 750-8698 04 Yrs/99 Yrs MWF 8:00 AM - 5:00 PM TTH 8:00 AM - 7:00 PM Sat 8:00 AM - 8:00 PM PCMH: No Detweiler, Edwin OD Provider ID: TPV1154303923-0 Gender: Male Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 05 Yrs/99 Yrs Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No Detweiler, Edwin OD Provider ID: TPV1154303923-0 Gender: Male Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 05 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Detweiler, Edwin OD Provider ID: TPV1154303923-0 Gender: Male Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Esperanza, Michelle OD Provider ID: TPV1114010998-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Feliciano, Emy OD Provider ID: TPV1962517821-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

www.wellcare.com/Florida | 298

Flanagan, Thomas OD Provider ID: TPV1265495212-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Foster, Thomas OD Provider ID: TPV1477795284-0 Gender: Male Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 05 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Foster, Thomas OD Provider ID: TPV1477795284-0 Gender: Male Eye Doctors Optical Outlets PA 7313 52nd Pl E Bradenton, FL 34203 (941) 758-4902 Fax: (941) 877-2942 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Optometry - cont. Glassberg, Steven OD Provider ID: TPV1982643136-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Glasser, Jay OD Provider ID: TPV1861557696-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Goldstein, Stacey OD Provider ID: TPV1841523677-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Ingham, Richard OD Provider ID: TPV1952464786-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Jones, Douglas OD Provider ID: TPV1063587327-1 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Joshi, Neha OD Provider ID: TPV1629200043-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Ismail, Esaam OD Provider ID: TPV1588728539-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Jones, Douglas OD Provider ID: TPV1063587327-1 Gender: Male Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 05 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Kanicky, Jee OD Provider ID: TPV1245296599-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Jacoby, Leonard OD Provider ID: TPV1932274255-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Jones, Douglas OD Provider ID: TPV1063587327-1 Gender: Male Eye Doctors Optical Outlets PA 7313 52nd Pl E Bradenton, FL 34203 (941) 758-4902 Fax: (941) 877-2942 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 299

Kanicky, Luc OD Provider ID: TPV1043275175-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Optometry - cont. LA Rosa, Robb OD Provider ID: TPV1952759102-0 Gender: Male Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 05 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Lascaibar, Albert OD Provider ID: TPV1649227810-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Lewenson, Robert OD Provider ID: TPV1235181769-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Lewenson, Robert OD Provider ID: TPV1235181769-1 Gender: Male Eye Doctors Optical Outlets PA 7313 52nd Pl E Bradenton, FL 34203 (941) 758-4902 Fax: (941) 877-2942 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Lewis, John OD Provider ID: TPV1982709341-0 Gender: Male Manatee County Rural Health Services Inc 1312 Manatee Ave E Bradenton, FL 34208 (941) 750-8797 Fax: (941) 750-8698 05 Yrs/99 Yrs MWF 8:00 AM - 5:00 PM TTH 8:00 AM - 7:00 PM Sat 8:00 AM - 8:00 PM PCMH: No Lewis, John OD Provider ID: TPV1982709341-0 Gender: Male Manatee County Rural Health Services Inc 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 05 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No

Long, Lori OD Provider ID: TPV1477685931-0 Gender: Female Eye Associates of Manatee LLP 6002 Pointe W Blvd Bradenton, FL 34209 (941) 792-2020 Fax: (941) 761-9257 05 Yrs/99 Yrs Languages: Spanish, Korean M 8:00 AM - 12:00 PM TTHF 8:00 AM - 5:00 PM W 8:00 AM - 12:30 PM PCMH: No

Malde, Elyse OD Provider ID: TPV1245663061-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Long, Lori OD Provider ID: TPV1477685931-0 Gender: Female Eye Associates of Manatee LLP 7230 55th Ave E Bradenton, FL 34203 (941) 792-2020 Fax: (941) 924-8669 05 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No

Mann, Clare OD Provider ID: TPV1659424927-0 Gender: Female Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 06 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Long, Lori OD Provider ID: TPV1477685931-0 Gender: Female Eye Associates of Manatee LLP 7915 US Hwy 301 N Ellenton, FL 34222 (941) 729-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM PCMH: No Mackie, Michael OD Provider ID: 148452 Gender: Male 2003 Cortez Rd W Bradenton, FL 34207 (941) 756-2020 Fax: (941) 756-4486 03 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Marrotte, Richard OD Provider ID: 1228863 Gender: Male Manatee County Rural Health Service 1312 Manatee Ave E Bradenton, FL 34208 (941) 750-8797 Fax: (941) 750-8698 05 Yrs/130 Yrs MF 8:00 AM - 5:00 PM TTH 8:00 AM - 7:00 PM W 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Optometry - cont. Marrotte, Richard OD Provider ID: TPV1184612780-0 Gender: Male Manatee County Rural Health Services Inc 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 05 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No Marrotte, Richard OD Provider ID: TPV1184612780-0 Gender: Male Manatee County Rural Health Services Inc 1312 Manatee Ave E Bradenton, FL 34208 (941) 750-8797 Fax: (941) 750-8698 05 Yrs/99 Yrs MWF 8:00 AM - 5:00 PM TTH 8:00 AM - 7:00 PM Sat 8:00 AM - 8:00 PM PCMH: No Meer, Henry OD Provider ID: TPV1255449732-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Miller, Barbara OD Paquin, Warren OD Provider ID: TPV1558466870-0 Provider ID: TPV1629128350-0 Gender: Female Gender: Male Eye Doctors Optical Outlets Manatee Family Eyecare PA PA 501 Village Green Pkwy Ste 3 2827 University Pkwy Bradenton, FL 34209 Sarasota, FL 34231 (941) 792-7522 (941) 296-0179 Fax: (941) 798-3713 Fax: (941) 866-2641 03 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish, PCMH: No Vietnamese M-F 9:30 AM - 6:00 PM Paquin, Warren OD Sat 9:30 AM - 1:00 PM Provider ID: TPV1629128350-0 PCMH: No Gender: Male Manatee Family Eyecare PA Nguyen, Quyen OD 319 7th St W Provider ID: TPV1144478868-0 Palmetto, FL 34221 Gender: Female (941) 729-5516 Eye Doctors Optical Outlets Fax: (941) 729-3736 PA 03 Yrs/99 Yrs 2827 University Pkwy M-F 9:00 AM - 5:00 PM Sarasota, FL 34231 PCMH: No (941) 296-0179 Fax: (941) 866-2641 Plante, Parker OD 05 Yrs/99 Yrs Provider ID: TPV1528055043-0 Languages: Spanish, Gender: Male Vietnamese Eye Doctors Optical Outlets M-F 9:30 AM - 6:00 PM PA Sat 9:30 AM - 1:00 PM 2827 University Pkwy PCMH: No Sarasota, FL 34231 (941) 296-0179 Olson, Arlese OD Fax: (941) 866-2641 Provider ID: TPV1063576171-0 05 Yrs/99 Yrs Gender: Female Languages: Spanish, Eye Doctors Optical Outlets Vietnamese PA M-F 9:30 AM - 6:00 PM 2827 University Pkwy Sat 9:30 AM - 1:00 PM Sarasota, FL 34231 PCMH: No (941) 296-0179 Fax: (941) 866-2641 Pradilla, Sergio OD 05 Yrs/99 Yrs Provider ID: TPV1881027811-0 Languages: Spanish, Gender: Male Vietnamese Eye Doctors Optical Outlets M-F 9:30 AM - 6:00 PM PA Sat 9:30 AM - 1:00 PM 2827 University Pkwy PCMH: No Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

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Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 05 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Ramos, Becky OD Provider ID: TPV1215217112-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Raney, Dennis OD Provider ID: TPV1003921974-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Optometry - cont.

Sinclair, Jeffrey OD Provider ID: TPV1558329540-0 Saint Jean, Caleb OD Gender: Male Provider ID: TPV1942650924-0 Sinclair Camp OD PA Gender: Male 9122 58th Dr E Eye Doctors Optical Outlets Bradenton, FL 34202 PA (941) 752-2020 803 Cortez Rd W Fax: (941) 544-2676 Bradenton, FL 34207 05 Yrs/99 Yrs (941) 753-2323 MTTHF 8:00 AM - 5:30 PM Fax: (941) 866-7370 W 8:00 AM - 12:30 PM 03 Yrs/99 Yrs PCMH: No MWF 9:00 AM - 6:00 PM Stoneburner, Jon OD TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Provider ID: TPV1154486975-0 PCMH: No Gender: Male Eye Doctors Optical Outlets Shin, Susan OD PA Provider ID: TPV1912948100-0 2827 University Pkwy Gender: Female Sarasota, FL 34231 Eye Doctors Optical Outlets (941) 296-0179 PA Fax: (941) 866-2641 803 Cortez Rd W 05 Yrs/99 Yrs Bradenton, FL 34207 Languages: Spanish, (941) 753-2323 Vietnamese Fax: (941) 866-7370 M-F 9:30 AM - 6:00 PM 18 Yrs/99 Yrs Sat 9:30 AM - 1:00 PM MWF 9:00 AM - 6:00 PM PCMH: No TTH 9:00 AM - 7:00 PM Stupp, Elliott OD Sat 9:00 AM - 5:00 PM Provider ID: TPV1932131331-0 PCMH: No Gender: Male Shin, Susan OD Eye Doctors Optical Outlets PA Provider ID: TPV1912948100-0 2827 University Pkwy Gender: Female Sarasota, FL 34231 Eye Doctors Optical Outlets PA (941) 296-0179 7313 52nd Pl E Fax: (941) 866-2641 Bradenton, FL 34203 05 Yrs/99 Yrs (941) 758-4902 Languages: Spanish, Vietnamese Fax: (941) 877-2942 M-F 9:30 AM - 6:00 PM 18 Yrs/99 Yrs Sat 9:30 AM - 1:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM PCMH: No

Sudbury, Glenn OD Provider ID: TPV1861572992-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Tran-Lockwood, Julie OD Provider ID: TPV1639377104-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Tuerkheimer, Barry OD Provider ID: TPV1740272939-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

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Tuerkheimer, Barry OD Provider ID: TPV1740272939-0 Gender: Male Eye Doctors Optical Outlets PA 803 Cortez Rd W Bradenton, FL 34207 (941) 753-2323 Fax: (941) 866-7370 05 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Wall, Chanda OD Provider ID: TPV1568685220-1 Gender: Female Chanda W Wall OD PA 8432 Lockwood Ridge Rd Sarasota, FL 34243 (941) 359-1105 Fax: (941) 359-1229 04 Yrs/99 Yrs M-F 9:30 AM - 5:30 PM PCMH: No Weisbond, Steven OD Provider ID: TPV1457390148-0 Gender: Male Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No Wood, Wayne OD Provider ID: TPV1437209087-0 Gender: Male Manatee Family Eyecare PA 501 Village Green Pkwy Ste 3 Bradenton, FL 34209 (941) 792-7522 Fax: (941) 798-3713 03 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Optometry - cont. Wood, Wayne OD Provider ID: TPV1437209087-0 Gender: Male Manatee Family Eyecare PA 319 7th St W Palmetto, FL 34221 (941) 729-5516 Fax: (941) 729-3736 03 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Yancey, April OD Provider ID: TPV1427460955-0 Gender: Female Eye Doctors Optical Outlets PA 2827 University Pkwy Sarasota, FL 34231 (941) 296-0179 Fax: (941) 866-2641 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:30 AM - 6:00 PM Sat 9:30 AM - 1:00 PM PCMH: No

Orthodontics Brockway, Chelsea DDS

McDowell, Ernest DMD Provider ID: TPVP104348-04 Gender: Male Florida Orthodontic Associates 6060 State Rd 70 E Ste A Bradenton, FL 34203 (727) 442-6098 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 5:00 PM PCMH: No

Orthopaedic Surgery Boyce, William MD Provider ID: 188470 Gender: Male West Florida Physicians Network LL 315 75th St W Bradenton, FL 34209 (941) 792-2211 Fax: (941) 761-1502 00 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Connolly, Brendon MD

Provider ID: TPVP159206-03 Gender: Female Florida Orthodontic Associates 6060 State Rd 70 E Ste A Bradenton, FL 34203 (727) 442-6098 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1319555 Gender: Male Brendon Connolly MD Pl 2001 Manatee Ave E Ste 103 Bradenton, FL 34208 (941) 757-3521 Fax: (941) 714-0869 18 Yrs/110 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Morgan, Randall MD Provider ID: 288766 Gender: Male 6310 Health Park Way Ste 23 Bradenton, FL 34202 (941) 360-2211 Fax: (941) 360-2233 00 Yrs/18 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Crawford, Marguerite MD

Nair, Sajeevakumar MD Provider ID: 469729 Gender: Male International Center For Advanced S 1922 53rd Ave E Ste A Bradenton, FL 34203 (941) 753-1756 Fax: (941) 201-1200 02 Yrs/130 Yrs Doctors Hospital Sarasota Manatee Memorial Hospital Sarasota Memorial Hospital Languages: Hindi, Malayalam M-F 8:00 AM - 4:30 PM PCMH: No

Gonzalez, Javier MD

Pediatric Cardiology Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 2020 59th St W Bradenton, FL 34209 (941) 792-6611 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No

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Provider ID: 314170 Gender: Female 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 2020 59th St W Bradenton, FL 34209 (941) 792-6611 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 2020 59th St W Bradenton, FL 34209 (941) 792-6611 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Pediatric Cardiology cont. Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 2020 59th St W Bradenton, FL 34209 (941) 792-6611 00 Yrs/18 Yrs Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 2020 59th St W Bradenton, FL 34209 (941) 792-6611 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc PCMH: No Stapleton, Gary MD Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-3333 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Ear, Nose & Throat Andrews, Thomas MD Provider ID: 1246 Gender: Male Pediatric Otolaryngology Assoc 5911 N Honore Ave Ste 116 Sarasota, FL 34243 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Cressman, Wade MD Provider ID: 8265 Gender: Male Pediatric Otolaryngology 5911 N Honore Ave Ste 116 Sarasota, FL 34243 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Trowbridge, Rose MD Provider ID: 912630 Gender: Female Pediatric Otolaryngology 5911 N Honore Ave Ste 116 Sarasota, FL 34243 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No

Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head Nec 5911 N Honore Ave Ste 116 Sarasota, FL 34243 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Gastroenterology Wilsey Jr, Michael MD Provider ID: 200955 Gender: Male 4443 Rowan Rd Bradenton, FL 34202 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Infectious Disease Berman, David DO Provider ID: 173540 Gender: Male 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-4160 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Messina, Allison MD Provider ID: 346501 Gender: Female Pediatric Physicians Services 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-4160 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Surgery Chandler, Nicole MD Provider ID: 461033 Gender: Female Pediatric Physician Services 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Pedodontics Alter, Lorielle DMD Provider ID: TPVP145398-01 Gender: Female Great Expressions Dental Centers 11215 E State Rd 70 Lakewood Ranch, FL 34202 (941) 757-0490 Fax: (941) 727-7536 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Bowles, David DDS Provider ID: TPVP130996-02 Gender: Male David A Bowles DDS PA 205 6th Ave E Ste A Bradenton, FL 34208 (941) 746-0443 Fax: (941) 364-8160 00 Yrs/99 Yrs M 8:30 AM - 2:30 PM T 8:30 AM - 12:00 PM PCMH: No Bui, Loananh DDS Provider ID: TPVP120562-29 Gender: Female Great Expressions Dental Centers 11215 E State Rd 70 Lakewood Ranch, FL 34202 (941) 757-0490 Fax: (941) 727-7536 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lewis, Andre DDS Provider ID: TPVP115544-03 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-13 Gender: Female Great Expressions Dental Centers 11215 E State Rd 70 Lakewood Ranch, FL 34202 (941) 757-0490 Fax: (941) 727-7536 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Olli, Edward DMD Provider ID: TPVP147177-02 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Periodontics Evans, Michael DDS Provider ID: TPVP137164-01 Gender: Male Lecom School of Dental Medicine 4800 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 405-1600 Fax: (814) 868-1039 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Physical Medicine & Rehabilitation Beard, Margita MD Provider ID: 19647 Gender: Female 1416 59th St W Palma Sola, FL 34209 (941) 794-3998 Fax: (941) 792-2751 30 Yrs/95 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Spanish, German M-TH 9:00 AM - 5:00 PM PCMH: No Kallins, Marc MD Provider ID: 299010 Gender: Male Pinnacle Medical Group, PA 4110 Manatee Ave W Bradenton, FL 34205 (941) 750-0602 Fax: (941) 748-5626 12 Yrs/130 Yrs Blake Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tsai, David MD Provider ID: 32015 Gender: Male West Florida Physician Network, LLC 4110 Manatee Ave W Bradenton, FL 34205 (941) 748-8383 Fax: (941) 748-8484 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Plastic & Reconstructive Surgery Leong, Kenneth MD Provider ID: 1296971 Gender: Male Burn Centers of Florida Inc 2020 59th St W Bradenton, FL 34209 (706) 863-9595 Fax: (706) 863-2474 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mir, Haaris MD Provider ID: 619199 Gender: Male Burn Centers of Flordia Inc 2020 59th St W Bradenton, FL 34209 (706) 863-9595 Fax: (888) 745-3917 00 Yrs/21 Yrs Aventura Hospital and Medical Center Blake Medical Center Kendall Medical Center Languages: French, Hindi, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Podiatry Byun, Sunghwan DPM Provider ID: 1189767 Gender: Male Manatee County Rural Health Service 5300 Bayshore Rd Palmetto, FL 34221 (941) 721-2020 Fax: (941) 721-2027 05 Yrs/130 Yrs M 8:00 AM - 5:00 PM TWTHF 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Podiatry - cont. Chi, Andy DPM Provider ID: 1093026 Gender: Male North Manatee Family Healthcare Center 5600 Bayshore Rd Palmetto, FL 34221 (941) 721-2020 Fax: (941) 721-2027 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No

Denault, Albert DPM Provider ID: 12452 Gender: Male 311 Manatee Ave E Bradenton, FL 34208 (941) 749-0626 Fax: (941) 749-0618 00 Yrs/130 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Manatee Memorial Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Chi, Andy DPM Provider ID: 1093026 Gender: Male Riverside Foot and Ankle 300 Riverside Dr E Ste 1500 Bradenton, FL 34208 (941) 741-3338 Fax: (941) 714-7484 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No

Price, Melvin DPM Provider ID: 207952 Gender: Male Riverside Foot and Ankle 300 Riverside Dr E Ste 2010 Bradenton, FL 34208 (941) 741-3338 Fax: (941) 714-7484 00 Yrs/130 Yrs Manatee Memorial Hospital M-W 8:00 AM - 5:00 PM PCMH: No

Cropper, Robert DPM

Rell, Brian DPM Provider ID: 228505 Gender: Male Southwest Foot and Ankle LLC 6310 Health Park Way Ste 345 Lakewood Ranch, FL 34202 (941) 256-3873 Fax: (941) 355-2292 02 Yrs/130 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Premier Surgery Center of Sarasota M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 176146 Gender: Male Robert M Cropper 8451 Shade Ave Ste 108 Sarasota, FL 34243 (941) 359-1564 Fax: (941) 924-8225 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital MT 9:00 AM - 12:00 PM W 1:30 AM - 5:00 PM PCMH: No

Pulmonary Disease

Fitch, Dwight MD Provider ID: 363218 Gender: Male Ghobrial, Victor MD 21st Century Oncology Provider ID: 306678 6215 21st Ave W Ste B Gender: Male Assoc In Respiratory Medicine Bradenton, FL 34209 (941) 795-2270 PA 00 Yrs/130 Yrs 250 2nd St E Ste 3-A Venice Regional Medical Bradenton, FL 34208 Center (941) 746-7444 M-F 8:00 AM - 5:00 PM Fax: (941) 746-4345 PCMH: No 18 Yrs/130 Yrs Blake Medical Center Hollen, Tyler MD Manatee Memorial Hospital Provider ID: 1003640 Languages: Arabic Gender: Male M-F 8:00 AM - 5:00 PM 21st Century Oncology LLC PCMH: No 401 Manatee Ave E Ste A Rampertaap, Moonasar MD Bradenton, FL 34208 (941) 748-4324 Fax: (941) 748-7878 Provider ID: 13612 12 Yrs/130 Yrs Gender: Male Sarasota Memorial Hospital Lung Associates PA Venice Regional Medical 203 3rd Ave E Center Bradenton, FL 34208 M-F 8:00 AM - 5:00 PM (941) 741-8633 PCMH: No Fax: (941) 741-8632 12 Yrs/130 Yrs Hollen, Tyler MD Blake Medical Center Provider ID: 1003640 Columbia South Bay Hospital Gender: Male Manatee Memorial Hospital 21st Century Oncology LLC M-F 8:00 AM - 5:00 PM 6310 Health Park Way Ste 100 PCMH: No Bradenton, FL 34202 (941) 373-6534 Radiation Oncology Fax: (941) 373-6532 12 Yrs/130 Yrs Fitch, Dwight MD Sarasota Memorial Hospital Provider ID: 363218 Venice Regional Medical Gender: Male Center 21st Century Oncology M-F 8:00 AM - 5:00 PM 401 Manatee Ave E Ste A PCMH: No Bradenton, FL 34208 (941) 748-4324 Hollen, Tyler MD Fax: (941) 474-2981 Provider ID: 1003640 00 Yrs/130 Yrs Gender: Male Venice Regional Medical 21st Century Oncology LLC Center 8946 77th Ter E M-F 9:00 AM - 5:00 PM Bradenton, FL 34202 PCMH: No (941) 907-9053 Fax: (941) 907-9473 12 Yrs/130 Yrs Sarasota Memorial Hospital Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 306

Last update 08/14/2017

Specialty Physicians Manatee Radiation Oncology cont. Koshy, Mary MD Provider ID: 505100 Gender: Female 21st Century Oncology LLC 6555 Cortez Rd W Bradenton, FL 34210 (941) 308-1050 Fax: (941) 308-1051 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Koshy, Mary MD Provider ID: 505100 Gender: Female Manatee Cancer Center 401 Manatee Ave E Ste A Bradenton, FL 34208 (941) 748-4324 Fax: (941) 748-7878 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Koshy, Mary MD Provider ID: 505100 Gender: Female Manatee Cancer Center 6215 21st Ave W Ste B Bradenton, FL 34209 (941) 795-2270 Fax: (941) 795-7995 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Nguyen, Tri MD Provider ID: 750213 Gender: Male 6215 21st Ave W Ste B Bradenton, FL 34209 (941) 795-2270 Fax: (941) 795-7995 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Radiation Oncology Center Provider ID: 14489 Radiation Oncology Centers of SW Florida 6215 21st Ave W Ste B Bradenton, FL 34209 (941) 795-2270 Fax: (941) 795-7995 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 38:00 PM PCMH: No Sylvester, John MD Provider ID: 716590 Gender: Male 8946 77th Ter E Lakewood Ranch, FL 34202 (941) 907-9053 Fax: (941) 907-9473 16 Yrs/130 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital M-F 8:00 AM - 4:30 PM PCMH: No

Rheumatology Crager, Kenneth MD Provider ID: 278615 Gender: Male West Florida Physician Network LLC 315 75th St W Bradenton, FL 34209 (941) 792-8329 Fax: (941) 761-0599 18 Yrs/130 Yrs Languages: Italian M-F 8:00 AM - 5:00 PM PCMH: No

Sleep Medicine McConnell, Jeremy MD Provider ID: 1333879 Gender: Male Jeremy D. McConnell, MD PA 5517 21st Ave W Ste F Bradenton, FL 34209 (941) 792-8383 Fax: (941) 792-8484 12 Yrs/130 Yrs Bayfront Medical Center Manatee Memorial Hospital M-F 7:30 AM - 4:00 PM PCMH: No

Smith Jr, Ronald MD Provider ID: 594294 Gender: Male Riverview Cardiac Surgery PA 5304 4th Ave Cir E Bradenton, FL 34208 (941) 744-2640 Fax: (941) 744-2650 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital Languages: Italian M-F 9:00 AM - 4:00 PM PCMH: No

Urology Thoracic & Cardiovascular Bilik Jr, Alfred MD Surgery Alesnik, Joseph MD Provider ID: 657821 Gender: Male Riverview Cardiac Surgery PA 5304 4th Ave Cir E Bradenton, FL 34208 (941) 744-2640 Fax: (941) 744-2650 18 Yrs/130 Yrs Blake Medical Center Manatee Memorial Hospital West Marion Community Hospital M-F 9:00 AM - 5:00 PM PCMH: No Golino, Alessandro MD Provider ID: 215038 Gender: Male Riverview Cardiac Surgery PA 5304 4th Ave Cir E Bradenton, FL 34208 (941) 744-2640 Fax: (941) 744-2650 18 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Sarasota Memorial Hospital Languages: Spanish, Italian M-F 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 307

Provider ID: 1193539 Gender: Not Available 1040 River Hert Blvd Ste 202 Bradenton, FL 34212 (941) 309-7000 Fax: (941) 917-6764 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 3651 Cortez Rd W Ste 100 Bradenton, FL 34210 (941) 727-7400 Fax: (941) 761-4478 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Manatee Urology - cont. Curtis, Gerard MD Provider ID: 1192993 Gender: Male 6130 S Tamiami Trl Sarasota, FL 34231 (941) 358-6777 Fax: (941) 358-9814 18 Yrs/110 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 1040 River Hert Blvd Ste 202 Bradenton, FL 34212 (941) 309-7000 Fax: (941) 917-6764 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 3651 Cortez Rd W Ste 100 Bradenton, FL 34210 (941) 727-7400 Fax: (941) 761-4478 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 600 8th Ave W Ste 301 Palmetto, FL 34221 (941) 722-4261 Fax: (941) 722-4281 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M 8:30 AM - 12:00 PM PCMH: No Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 1040 River Hert Blvd Unit 202 Bradenton, FL 34212 (941) 309-7000 Fax: (941) 917-6764 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 3651 Cortez Rd W Ste 100 Bradenton, FL 34210 (941) 309-7000 Fax: (941) 308-8508 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 5860 Ranch Lake Blvd Ste 200 Bradenton, FL 34202 (941) 309-7000 Fax: (941) 309-7012 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 600 8th Ave W Ste 301 Palmetto, FL 34221 (941) 722-4261 Fax: (941) 722-4281 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tingle, William MD Provider ID: 1193488 Gender: Not Available 1040 River Hert Blvd Ste 202 Bradenton, FL 34212 (941) 309-7000 Fax: (941) 917-6764 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No Tingle, William MD

Tingle, William MD Provider ID: 1193488 Gender: Not Available 600 8th Ave W Ste 301 Palmetto, FL 34221 (941) 309-7000 Fax: (941) 722-4281 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No Williams, Thomas MD Provider ID: 1193531 Gender: Not Available 1040 River Hert Blvd Ste 202 Bradenton, FL 34212 (941) 309-7000 Fax: (941) 917-6764 18 Yrs/110 Yrs Sarasota Memorial Hospital M 8:00 AM - 12:00 PM T 11:00 AM - 7:00 PM W 8:00 AM - 5:30 PM PCMH: No Williams, Thomas MD

Provider ID: 1193488 Gender: Not Available 3651 Cortez Rd W Ste 100 Bradenton, FL 34210 (941) 727-7400 Fax: (941) 761-4478 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No

www.wellcare.com/Florida | 308

Provider ID: 1193531 Gender: Not Available 600 8th Ave W Ste 301 Palmetto, FL 34221 (941) 722-4261 Fax: (941) 722-4281 18 Yrs/110 Yrs Sarasota Memorial Hospital M 8:00 AM - 12:00 PM T 11:00 AM - 7:00 PM W 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Allergy & Immunology Chamarthy, Latha MD

Nallamshetty, Samridhi MD Provider ID: 483380 Gender: Female Florida Medical Clinic PA 2241 Green Hedges Way Ste 101 Wesley Chapel, FL 33544 (813) 388-6855 Fax: (813) 355-5894 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 28023 Gender: Female Advanced Allergy and Asthma Care 1823 Health Care Dr New Port Richey, FL 34655 (727) 544-8100 Fax: (727) 544-8200 00 Yrs/130 Yrs Bayfront Medical Center Florida Hospital North Pinellas Johns Hopkins All Childrens Hospital Inc Sanka, Madhurima DO Languages: Tamil, Telugu M-F 9:00 AM - 5:00 PM PCMH: No Provider ID: 449909 Gender: Female Degala, Ami MD Advanced Allergy Asthma Provider ID: 970029 Care Gender: Female 1823 Health Care Dr Advanced Allergy Asthma New Port Richey, FL 34655 Care (727) 544-8100 1823 Health Care Dr Fax: (727) 544-8200 New Port Richey, FL 34655 00 Yrs/130 Yrs (727) 544-8100 Languages: Spanish Fax: (727) 544-8200 M-F 9:00 AM - 5:00 PM 02 Yrs/130 Yrs PCMH: No Languages: Gujarati M-TH 9:00 AM - 5:00 PM Shetty, Ranjith MD F 9:00 AM - 1:00 PM Provider ID: 6835 PCMH: No Gender: Male 5307 Main St Ste 201 Nallamshetty, Samridhi MD New Port Richey, FL 34652 (727) 841-8876 Provider ID: 483380 Fax: (727) 843-8508 Gender: Female 00 Yrs/130 Yrs Allergy Asthma and Medical Center of Trinity Immunology Assoc Morton Plant North Bay 2352 Bruce B Downs Blvd Ste Hospital 303 MW 8:00 AM - 5:00 PM Wesley Chapel, FL 33544 T 8:00 AM - 12:00 PM (813) 388-6855 PCMH: No Fax: (813) 355-5894 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Cardiac Electrophysiology Yamamura, Kenneth MD Annoni-Suau, Luis MD Provider ID: 13504 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Jimenez, Raul MD Provider ID: 245768 Gender: Male Interventional Cardiac Consultants 14100 Fivay Rd Ste 310 Hudson, FL 34667 (727) 862-3202 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Morton Plant Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Yamamura, Kenneth MD Provider ID: 151860 Gender: Male Interventional Cardiac Consultants 14100 Fivay Rd Ste 310 Hudson, FL 34667 (727) 376-7820 Fax: (727) 376-7799 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 309

Provider ID: 151860 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No

Cardiology Akel, Rami MD Provider ID: 525676 Gender: Male Florida Cardiology Associates LLC 3543 Little Rd Ste A New Port Richey, FL 34655 (727) 848-6400 Fax: (727) 848-6200 12 Yrs/130 Yrs Medical Center of Trinity Languages: Romanian M-F 8:30 AM - 5:00 PM PCMH: No Ali, Rias MD Provider ID: 226121 Gender: Male Holiday Heart and Vascular 4740 Mile Stretch Dr Holiday, FL 34690 (727) 943-5200 Fax: (727) 943-5201 18 Yrs/130 Yrs CRMC At Bayonet Point Florida Hospital North Pinellas Medical Center of Trinity M-F 8:30 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Cardiology - cont. Annoni-Suau, Luis MD Provider ID: 13504 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Bayron, Carlos MD Provider ID: 1437 Gender: Male 14100 Fivay Rd Ste 310 Hudson, FL 34667 (727) 862-3202 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Boyiadzis, Harris MD Provider ID: 1226254 Gender: Female Baycare Medical Group Inc 6633 Forest Ave Ste 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Caballero, Jaime MD Provider ID: 1272014 Gender: Male Premier Heart and Vascular Center P 38035 Medical Center Ave Zephyrhills, FL 33540 (813) 788-1400 Fax: (813) 788-7691 18 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM PCMH: No Chadda, Nader MD Provider ID: 1354394 Gender: Male 14100 Fivay Rd Ste 150 Hudson, FL 34667 (727) 859-7670 Fax: (813) 925-9640 18 Yrs/130 Yrs Morton Plant North Bay Hospital Oak Hill Hospital MT 8:30 AM - 12:00 PM PCMH: No Chadda, Nader MD Provider ID: 1354394 Gender: Male 2650 Narnia Way Ste 101 Land O Lakes, FL 34638 (727) 859-7670 Fax: (813) 925-9640 18 Yrs/130 Yrs Morton Plant North Bay Hospital Oak Hill Hospital M 8:30 AM - 5:00 PM PCMH: No

Chadda, Nader MD Provider ID: 1354394 Gender: Male 4738 Grand Blvd Ste E New Port Richey, FL 34652 (727) 859-7670 Fax: (813) 925-9640 18 Yrs/130 Yrs Morton Plant North Bay Hospital Oak Hill Hospital M 2:00 AM - 5:00 PM PCMH: No Chang, Fong MD Provider ID: 217 Gender: Female Pasco Cardiology Center Inc 14153 Yosemite Dr Ste 202 Hudson, FL 34667 (727) 868-5404 Fax: (727) 863-1787 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: German M-F 8:00 AM - 5:00 PM PCMH: No Chang, Fong MD Provider ID: 217 Gender: Female Pasco Cardiology Center Inc 3633 Little Rd Ste 102 Trinity, FL 34655 (727) 372-5952 Fax: (727) 863-1787 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: German M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 310

Chang, Fong MD Provider ID: 217 Gender: Female Pasco Cardiology Center Inc 5307 Main St Ste 102 New Port Richey, FL 34652 (727) 847-3733 Fax: (727) 863-1787 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: German M-F 8:00 AM - 5:00 PM PCMH: No Dagher, Georges MD Provider ID: 1145953 Gender: Male Baycare Medical Group 6633 Forest Ave Ste 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs Mease Countryside Hospital M-F 9:00 AM - 5:00 PM PCMH: No Di Martino, Peter MD Provider ID: 714654 Gender: Male Florida Cardiology Group LLC 4738 Grand Blvd Ste E New Port Richey, FL 34652 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Medical Center of Trinity Languages: Spanish, Italian M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Cardiology - cont. Di Martino, Peter MD Provider ID: 714654 Gender: Male Florida Cardiology Group LLC 7614 Jacque Rd Hudson, FL 34667 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Medical Center of Trinity Languages: Spanish, Italian MT 1:00 AM - 4:00 PM PCMH: No Feliz De LA Cruz, Victor MD Provider ID: 810957 Gender: Male Vasco M Marques MD PA 2106 Ashley Oaks Cir Ste 101 Wesley Chapel, FL 33544 (813) 975-2822 Fax: (813) 977-7631 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Wesley Chapel Tampa Community Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Goldman, Stephen MD Provider ID: 163403 Gender: Male S Goldman MD and C Pitarys Md 6633 Forest Ave Ste 302 New Port Richey, FL 34653 (727) 849-8771 Fax: (727) 842-4962 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Hindi, Greek M-F 8:30 AM - 5:00 PM PCMH: No

Goldman, Stephen MD Jacob, Binu MD Provider ID: 163403 Provider ID: 569165 Gender: Male Gender: Male S Goldman MD- C Pitarys, Md Pasco Cardiology Assoc Pl 37852 Medical Arts Ct UNT A 14100 Fivay Rd Ste 110 Zephyrhills, FL 33541 Hudson, FL 34667 (813) 788-0439 (727) 849-8771 Fax: (813) 788-6194 Fax: (727) 842-4962 16 Yrs/130 Yrs 18 Yrs/130 Yrs Florida Hospital Tampa CRMC At Bayonet Point Florida Hospital Zephyrhills Medical Center of Trinity St Petersburg Endoscopy Morton Plant North Bay Center Hospital M-F 8:00 AM - 5:00 PM Languages: Spanish, Hindi, PCMH: No Greek M-F 9:00 AM - 5:00 PM Jauch, Werner MD PCMH: No Provider ID: 167418 Gender: Male Gupta, Sunil MD Pasco Cardiology Center Inc Provider ID: 152315 14153 Yosemite Dr Ste 202 Gender: Male Hudson, FL 34667 Premier Heart Vascular Center (727) 868-5404 38035 Medical Center Ave Fax: (727) 863-1787 Zephyrhills, FL 33540 00 Yrs/130 Yrs (813) 788-1400 CRMC At Bayonet Point Fax: (813) 788-7691 Medical Center of Trinity 18 Yrs/130 Yrs Morton Plant North Bay Hospital Bayfront Health Dade City Florida Hospital Carrollwood Languages: German Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM Languages: Hindi PCMH: No M-TH 9:00 AM - 4:30 PM Jauch, Werner MD F 9:00 AM - 5:00 PM PCMH: No Provider ID: 167418 Gender: Male Gupta, Sunil MD Pasco Cardiology Center Inc Provider ID: 152315 3633 Little Rd Ste 102 Gender: Male Trinity, FL 34655 Premier Heart and Vascular (727) 372-5952 Center P Fax: (727) 863-1787 27424 Cashford Cir 00 Yrs/130 Yrs Wesley Chapel, FL 33544 CRMC At Bayonet Point (813) 788-1400 Medical Center of Trinity Fax: (813) 788-7691 Morton Plant North Bay Hospital 18 Yrs/130 Yrs Languages: German Bayfront Health Dade City Florida Hospital Carrollwood M-F 8:00 AM - 5:00 PM Florida Hospital Zephyrhills PCMH: No Languages: Hindi M 9:00 AM - 12:30 PM T 8:30 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 311

Jauch, Werner MD Provider ID: 167418 Gender: Male Pasco Cardiology Center Inc 5307 Main St Ste 102 New Prt Rchy, FL 34652 (727) 847-3733 Fax: (727) 863-1787 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: German M-F 8:00 AM - 5:00 PM PCMH: No Javeed, Najam MD Provider ID: 28865 Gender: Male 4740 Mile Stretch Dr Holiday, FL 34690 (727) 943-5200 Fax: (727) 943-5201 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Hindi, Urdu M-F 9:00 AM - 5:00 PM PCMH: No Jimenez, Raul MD Provider ID: 245768 Gender: Male Interventional Cardiac Consultants 14100 Fivay Rd Ste 310 Hudson, FL 34667 (727) 862-3202 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Morton Plant Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Cardiology - cont. Kaplan, Kerry MD Provider ID: 1144345 Gender: Male Baycare Medical Group Inc 6633 Forest Ave Ste 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 372-4923 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Khadim, Ghazanfar MD

Khamare, Chetan MD Provider ID: 728394 Gender: Male 27424 Cashford Cir Wesley Chapel, FL 33544 (813) 788-1400 Fax: (813) 788-7691 00 Yrs/130 Yrs Languages: Spanish, Hindi M-W 9:00 AM - 4:30 PM THF 9:00 AM - 5:00 PM PCMH: No

Khamare, Chetan MD Provider ID: 728394 Provider ID: 456632 Gender: Male Gender: Male Premier Heart and Vascular Center P Aung Tun MD PA 38035 Medical Center Ave 6833 Medical View Ln Zephyrhills, FL 33540 Zephyrhills, FL 33542 (813) 788-1400 (813) 780-6687 Fax: (813) 788-7691 Fax: (813) 788-6554 00 Yrs/130 Yrs 18 Yrs/130 Yrs Languages: Spanish, Hindi Bayfront Health Dade City Florida Hospital Zephyrhills M-TH 9:00 AM - 4:30 PM South Florida Baptist Hospital F 9:00 AM - 5:00 PM Languages: Spanish, Chinese, PCMH: No Burmese M-F 8:00 AM - 5:00 PM Khan, Wali MD PCMH: No Provider ID: 4192 Gender: Male Khadim, Ghazanfar MD Bay Area Medical Clinic PA 37914 Daughtery Rd Provider ID: 456632 Zephyrhills, FL 33541 Gender: Male (813) 780-9900 Florida Heart Institute Fax: (813) 780-9901 26827 Foggy Creek Rd Ste 18 Yrs/130 Yrs 101A Bldg 6 Bayfront Health Dade City Wesley Chapel, FL 33544 Florida Hospital Zephyrhills (813) 780-6687 Languages: Urdu Fax: (813) 788-6554 M-TH 8:00 AM - 5:00 PM 18 Yrs/130 Yrs F 8:00 AM - 4:00 PM Bayfront Health Dade City PCMH: No Florida Hospital Zephyrhills South Florida Baptist Hospital Languages: Spanish, Chinese, Burmese M 3:00 AM - 5:00 PM PCMH: No

Kunhardt, Rene MD Lin, Huang-Ta MD Provider ID: 170974 Provider ID: 218 Gender: Male Gender: Male Interventional Cardiac Pasco Cardiology Center Inc Consultants 14153 Yosemite Dr Ste 202 2035 Little Rd Hudson, FL 34667 Trinity, FL 34655 (727) 868-5404 (727) 842-9486 Fax: (727) 863-1787 Fax: (727) 849-2623 00 Yrs/130 Yrs 18 Yrs/130 Yrs CRMC At Bayonet Point CRMC At Bayonet Point Medical Center of Trinity Florida Hospital North Pinellas Morton Plant North Bay Medical Center of Trinity Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Lin, Huang-Ta MD Kunhardt, Rene MD Provider ID: 218 Provider ID: 170974 Gender: Male Gender: Male Pasco Cardiology Center Inc Interventional Cardiac 3633 Little Rd Ste 102 Consultants Trinity, FL 34655 2055 Little Rd (727) 372-5952 Trinity, FL 34655 Fax: (727) 863-1787 (727) 842-9488 00 Yrs/130 Yrs Fax: (727) 376-7799 CRMC At Bayonet Point 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant North Bay CRMC At Bayonet Point Florida Hospital North Pinellas Hospital Medical Center of Trinity M-F 8:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 9:00 AM - 5:00 PM Lin, Huang-Ta MD PCMH: No Provider ID: 218 Lall, Rajesh MD Gender: Male Provider ID: 1191439 Pasco Cardiology Center Inc Gender: Male 5307 Main St Ste 102 Premier Heart and Vascular New Port Richey, FL 34652 Center (727) 847-3733 38035 Medical Center Ave Fax: (727) 863-1787 Zephyrhills, FL 33540 00 Yrs/130 Yrs (813) 788-1400 CRMC At Bayonet Point Fax: (813) 788-7691 Medical Center of Trinity Morton Plant North Bay 18 Yrs/130 Yrs Hospital Bartow Regional Medical M-F 8:00 AM - 5:00 PM Center PCMH: No M-F 8:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 312

Last update 08/14/2017

Specialty Physicians Pasco Cardiology - cont. Marques, Vasco MD Provider ID: 168322 Gender: Male Vasco M Marques MD PA 2106 Ashley Oaks Cir Ste 101 Wesley Chapel, FL 33544 (813) 975-2800 Fax: (813) 977-7631 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Wesley Chapel Tampa Community Hospital Languages: Spanish, French, Italian, Portuguese M 8:30 AM - 5:00 PM PCMH: No Musunuru, S K Rao MD Provider ID: 1500 Gender: Male Bayonet PT Hudson Card Associates 14100 Fivay Rd Ste 160 Hudson, FL 34667 (727) 862-1080 Fax: (727) 863-3093 21 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:30 AM - 5:00 PM PCMH: No Nareddy, Jogi MD Provider ID: 1501 Gender: Male Bayonet PT Hudson Card Associates 14100 Fivay Rd Ste 160 Hudson, FL 34667 (727) 862-1080 Fax: (813) 863-3093 21 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM PCMH: No

Parekh, Dipak MD Provider ID: 9427 Gender: Male Dipak Parekh MD 11915 Oak Trail Way Port Richey, FL 34668 (727) 863-7995 Fax: (727) 868-4359 18 Yrs/130 Yrs Florida Hospital Carrollwood Medical Center of Trinity Morton Plant North Bay Hospital Languages: Hindi M-F 9:00 AM - 4:30 PM PCMH: No Parekh, Dipak MD Provider ID: 9427 Gender: Male Dipak Parekh, MD 8849 Hawbuck St New Port Richey, FL 34655 (727) 863-7995 Fax: (727) 868-4359 18 Yrs/130 Yrs Florida Hospital Carrollwood Medical Center of Trinity Morton Plant North Bay Hospital Languages: Hindi M 9:00 AM - 4:30 PM PCMH: No Patel, Darshan MD Provider ID: 590587 Gender: Male Florida Cardiology Group 7614 Jacque Rd Ste C Hudson, FL 34667 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Languages: Spanish, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Patel, Darshan MD Provider ID: 590587 Gender: Male Florida Cardiology Group LLC 4738 Grand Blvd Ste E New Port Richey, FL 34652 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Languages: Spanish, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No Pitarys II, Christos MD Provider ID: 169440 Gender: Male S Goldman/C Pitarys MD Pl 14100 Fivay Rd Ste 110 Hudson, FL 34667 (727) 849-8771 Fax: (727) 842-4962 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Greek M-F 9:00 AM - 5:00 PM PCMH: No Pitarys II, Christos MD Provider ID: 169440 Gender: Male S Goldman/C Pitarys MD Pl 6633 Forest Ave Ste 302 New Port Richey, FL 34652 (727) 849-8771 Fax: (727) 842-4962 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Greek M-F 8:30 AM - 5:00 PM PCMH: No

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Rahim, Abdur MD Provider ID: 724525 Gender: Male 14100 Fivay Rd Ste 310 Hudson, FL 34667 (727) 842-9486 Fax: (727) 862-2182 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Rahim, Abdur MD Provider ID: 724525 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Ramireddy, Kesavulureddy MD Provider ID: 25027 Gender: Male Bayonet PT Hudson Card Associates 14100 Fivay Rd Ste 160 Hudson, FL 34667 (727) 862-1080 Fax: (727) 863-3093 21 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM PCMH: No Ramireddy, Kesavulureddy MD Provider ID: 25027 Gender: Male Keshave Ramireddy Pl 13740 Office Park Ct Ste C Hudson, FL 34667 (727) 862-1080 Fax: (727) 781-2300 21 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Cardiology - cont.

Raxwal, Vinod MD Rossi, Peter MD Provider ID: 1029471 Provider ID: 216 Ramireddy, Kesavulureddy MD Gender: Male Gender: Male 14100 Fivay Rd Ste 130 Pasco Cardiology Center Inc Hudson, FL 34667 3633 Little Rd Ste 102 Provider ID: 801798 (727) 857-4871 Trinity, FL 34655 Gender: Male Fax: (727) 857-4894 (727) 372-5952 Keshave Ramireddy 18 Yrs/130 Yrs Fax: (727) 863-1787 13740 Office Park Ct Ste C Florida Hospital North Pinellas 00 Yrs/130 Yrs Hudson, FL 34667 Languages: Russian, Hindi, CRMC At Bayonet Point (727) 862-1080 Punjabi Medical Center of Trinity Fax: (727) 781-2300 M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No PCMH: No CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM Raxwal, Vinod MD Rossi, Peter MD PCMH: No Provider ID: 1029471 Provider ID: 216 Gender: Male Gender: Male Rao, Ramanath MD 6325 State Rd 54 Pasco Cardiology Center Inc Provider ID: 1262 New Port Richey, FL 34653 5307 Main St Ste 102 Gender: Male (727) 203-3802 New Prt Rchy, FL 34652 Pasco Cardiology Assoc Fax: (727) 807-3391 (727) 847-3733 37852 Medical Arts Ct Unit A 18 Yrs/130 Yrs Fax: (727) 863-1787 Zephyrhills, FL 33541 Florida Hospital North Pinellas 00 Yrs/130 Yrs (813) 788-4100 Languages: Russian, Hindi, CRMC At Bayonet Point Fax: (813) 788-6194 Punjabi Medical Center of Trinity 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Bayfront Health Dade City PCMH: No PCMH: No Florida Hospital Tampa Florida Hospital Zephyrhills Roca, Jose MD Sawar, Asad MD Languages: Spanish, Hindi Provider ID: 174747 Provider ID: 521080 M-F 8:00 AM - 5:00 PM Gender: Male Gender: Male PCMH: No Jose R Roca MD 2106 Ashley Oaks Cir Ste 101 Rao, Ramanath MD 2154 Duck Slough Blvd Ste 102 Wesley Chapel, FL 33544 New Port Richey, FL 34655 (813) 975-2800 Provider ID: 1262 (727) 939-1737 Fax: (813) 977-7631 Gender: Male Fax: (727) 375-1557 18 Yrs/130 Yrs Pasco Cardiology Associates 12 Yrs/130 Yrs Florida Hospital Tampa 13933 17th St Ste B Florida Hospital Wesley Largo Medical Center Dade City, FL 33525 Chapel Mease Hospital Dunedin (813) 788-0439 Tampa Community Hospital Morton Plant North Bay Fax: (813) 788-6194 Hospital Languages: Hindi 18 Yrs/130 Yrs Languages: Spanish M 8:30 AM - 5:00 PM Bayfront Health Dade City M-F 9:00 AM - 4:30 PM PCMH: No Florida Hospital Tampa PCMH: No Florida Hospital Zephyrhills Languages: Spanish, Hindi Rossi, Peter MD M-F 9:00 AM - 5:00 PM Provider ID: 216 PCMH: No Gender: Male Pasco Cardiology Center Inc 14153 Yosemite Dr Ste 202 Hudson, FL 34667 (727) 868-5404 Fax: (727) 863-1787 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity M-F 8:00 AM - 5:00 PM PCMH: No

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Sharma, Nagaraja MD Provider ID: 245811 Gender: Male Florida Cardiology Group LLC 7614 Jacque Rd Ste C Hudson, FL 34667 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Bayfront Health Spring Hill CRMC At Bayonet Point Morton Plant Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Tun, Aung MD Provider ID: 19694 Gender: Male 6833 Medical View Ln Zephyrhills, FL 33542 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills Languages: Burmese M-F 8:00 AM - 5:00 PM PCMH: No Win, Moethu MD Provider ID: 1117447 Gender: Male Aung Tun, MD, PA Associates 6833 Medical View Ln Zephyrhills, FL 33542 (813) 780-6687 Fax: (813) 788-6554 00 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Cardiology - cont. Yamamura, Kenneth MD Provider ID: 151860 Gender: Male Interventional Cardiac Consultants 14100 Fivay Rd Ste 310 Hudson, FL 34667 (727) 376-7820 Fax: (727) 376-7799 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No Yamamura, Kenneth MD Provider ID: 151860 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No Zaki, Khaja MD Provider ID: 1502 Gender: Male Bayonet PT Hudson Card Associates 14100 Fivay Rd Ste 160 Hudson, FL 34667 (727) 862-1080 Fax: (813) 863-3093 21 Yrs/130 Yrs CRMC At Bayonet Point Languages: Spanish, German M-F 8:30 AM - 5:00 PM PCMH: No

Child Neurology Winesett, Steven MD Provider ID: 461042 Gender: Male 4443 Rowan Rd New Port Richey, FL 34653 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Chiropractic Bell, Roger DC Provider ID: TPV11095-01 Gender: Male Roger H Bell DC 11329 Little Rd New Port Richey, FL 34654 (727) 863-1912 Fax: (727) 869-2214 00 Yrs/99 Yrs M-W 8:30 AM - 6:30 PM TH 8:30 AM - 2:00 PM PCMH: No Blanco, Allisha DC Provider ID: TPV17395-01 Gender: Female Laura A Kinkead DC PA 6145 Grand Blvd New Port Richey, FL 34652 (727) 849-5077 Fax: (727) 849-7901 00 Yrs/99 Yrs MWTH 8:00 AM - 6:00 PM T 2:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No Conner, Kevin DC Provider ID: TPV10915-01 Gender: Male Congress Chiropractic Clinic 7534 Congress St New Port Richey, FL 34653 (727) 847-3852 Fax: (727) 849-9900 00 Yrs/99 Yrs MWTH 8:45 AM - 6:00 PM T 2:00 AM - 6:00 PM PCMH: No

Craven, Michael DC Provider ID: TPV10323-01 Gender: Male Craven Chiropractic Center 5420 Land O'Lakes Blvd Ste 105 Land O'Lakes, FL 34639 (813) 996-9800 Fax: (813) 996-3326 00 Yrs/99 Yrs MWTH 9:00 AM - 6:00 PM T 2:00 AM - 6:00 PM F 9:00 AM - 12:00 PM PCMH: No Decubellis, Chase DC Provider ID: TPV11621-02 Gender: Male Beyond Bones Health Solutions 4115 Little Rd Trinity, FL 34655 (727) 376-2024 Fax: (727) 376-2104 00 Yrs/99 Yrs MWTH 9:00 AM - 6:30 PM T 3:00 AM - 6:30 PM PCMH: No Del Grosso, Robert DC Provider ID: TPV17652-02 Gender: Male Family Chiropractic Center For Wellness Inc 9206 State Rd 52 Hudson, FL 34669 (727) 862-8571 Fax: (727) 862-8573 00 Yrs/99 Yrs PCMH: No Horne, Leslie DC Provider ID: TPV17481-01 Gender: Female Land Olakes Chiropractic 2414 Raden Dr Land O'Lakes, FL 34639 (813) 948-2225 Fax: (813) 949-7029 00 Yrs/99 Yrs M 9:00 AM - 12:00 PM TW 11:00 AM - 6:00 PM PCMH: No

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Kinkead, Laura DC Provider ID: TPV10332-01 Gender: Female Laura A Kinkead DC PA 6145 Grand Blvd New Port Richey, FL 34652 (727) 849-5077 Fax: (727) 849-7901 00 Yrs/99 Yrs M-TH 8:00 AM - 6:00 PM PCMH: No Patel, Anish DC Provider ID: TPV11392-01 Gender: Male Family Chiropractic Center For Wellness, Inc 9206 State Rd 52 Hudson, FL 34669 (727) 862-8571 Fax: (727) 862-8573 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 6:00 PM TH 7:30 AM - 4:30 PM PCMH: No Pease, Michael DC Provider ID: TPV17644-01 Gender: Male New Leaf Chiropractic Wellness Center 2029 Osprey Lane Ste B Lutz, FL 33549 (813) 354-2500 Fax: (813) 567-1897 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM Sat 10:00 AM - 5:00 PM PCMH: No Santana, Jorge DC Provider ID: TPV11432-02 Gender: Male 1 Source Chiropractic Physical Medicine Center 19409 Shumard Oak Dr Ste 102 Land O Lakes, FL 34638 (813) 448-2222 Fax: (813) 948-7111 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Chiropractic - cont. Scheu, William DC Provider ID: TPV10627-01 Gender: Male Cdm Chiros LLC 2312 Crestover Lane Ste 102 Wesley Chapel, FL 33544 (813) 994-6111 Fax: (813) 991-5574 00 Yrs/99 Yrs MWTH 8:00 AM - 6:00 PM T 2:00 AM - 6:00 PM F 8:00 AM - 12:00 PM PCMH: No Shontz, Michael DC Provider ID: TPV10334-01 Gender: Male Randolph C Harding DC PA 2326 US Hwy 19 N Holiday, FL 34691 (727) 937-4191 Fax: (727) 942-4331 02 Yrs/99 Yrs M-F 8:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Williams, Gregory DC Provider ID: TPV10169-02 Gender: Male Medical Chiropractic Clinic Inc 5346 8th St Zephyrhills, FL 33542 (813) 782-1316 Fax: (813) 237-3792 00 Yrs/99 Yrs MT 9:00 AM - 7:00 PM W 9:00 AM - 1:00 PM PCMH: No Willis, Steven DC Provider ID: TPV11411-02 Gender: Male Access Healthcare Physicians 7633 Cita Lane New Port Richey, FL 34653 (727) 372-1005 Fax: (727) 372-1009 00 Yrs/99 Yrs MT 8:00 AM - 7:00 PM W 8:00 AM - 1:00 PM PCMH: No

Dermatology Belongie, Iriana MD Provider ID: 755816 Gender: Female Academic Alliance In Dermatology 2412 Cypress Glen DR Ste 102 Wesley Chapel, FL 33544 (813) 341-1480 Fax: (813) 528-8730 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Fotopoulos, Theodore MD Provider ID: 8190 Gender: Male New Image Dermatology 5534 Gulf Dr New Prt Rchy, FL 34652 (727) 847-3992 Fax: (727) 848-1118 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Greek M-W 7:30 AM - 4:30 PM TH 7:30 AM - 4:00 PM F 7:30 AM - 12:30 PM PCMH: No Fotopoulos, Theodore MD Provider ID: 8190 Gender: Male New Image Dermatology 7509 SR 52 Ste 150 Hudson, FL 34667 (727) 847-3992 Fax: (727) 848-1118 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Greek M-TH 7:30 AM - 4:30 PM F 7:30 AM - 12:30 PM PCMH: No

Hamill Jr, John MD Provider ID: 279872 Gender: Male Gulf Coast Dermatology PA 7547 Jacque Rd Hudson, FL 34667 (727) 862-8561 Fax: (727) 861-1951 12 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Monticciolo, Natalie DO Provider ID: 199577 Gender: Female Prestige Dermatology 4546 Grand Blvd New Port Richey, FL 34652 (727) 849-1447 Fax: (727) 849-3208 00 Yrs/130 Yrs Medical Center of Trinity M-TH 6:30 AM - 5:00 PM F 7:00 AM - 4:00 PM PCMH: No

Lam, David MD Provider ID: 757529 Gender: Male Proper, Steven MD Academic Alliance In Dermatology I Provider ID: 164836 2044 Trinity Oaks Blvd Ste 222 Gender: Male Trinity, FL 34655 Center For Dermatology and (727) 375-5961 Skin Fax: (727) 376-8710 13908 Lakeshore Blvd Ste 240 00 Yrs/130 Yrs Hudson, FL 34667 Florida Hospital North Pinellas (727) 868-1312 Johns Hopkins All Childrens Fax: (727) 863-7929 Hospital Inc 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM MT 7:00 AM - 5:00 PM PCMH: No PCMH: No Romagnolo, Stephen MD Lam, David MD Provider ID: 757529 Provider ID: 472296 Gender: Male Gender: Male Academic Alliance In Center For Dermatology and Dermatology I Skin 2412 Cypress Glen DR Ste 102 27612 Cashford Cir Ste 102 Wesley Chapel, FL 33544 Wesley Chapel, FL 33544 (813) 341-1480 (813) 991-1457 Fax: (813) 528-8730 Fax: (813) 907-2706 00 Yrs/130 Yrs Florida Hospital North Pinellas 00 Yrs/130 Yrs Languages: Spanish Johns Hopkins All Childrens M-F 9:00 AM - 4:00 PM Hospital Inc PCMH: No Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Mauch, James MD Provider ID: 959986 Gender: Male 6719 Gall Blvd Ste 106 Zephyrhills, FL 33542 (813) 355-5870 Fax: (813) 355-5891 18 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pasco Dermatology - cont. Romagnolo, Stephen MD Provider ID: 472296 Gender: Male Center For Dermatology and Skin 8209 SR 54 New Port Richey, FL 34655 (727) 569-1055 Fax: (727) 569-1505 00 Yrs/130 Yrs Languages: Spanish M-F 8:15 AM - 5:00 PM PCMH: No Romagnolo, Stephen MD Provider ID: 916158 Gender: Male Leavitt Medical Associates of Flori 13908 Lakeshore Blvd Ste 240 Hudson, FL 34667 (727) 868-1312 Fax: (727) 863-7929 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Romagnolo, Stephen MD Provider ID: 916158 Gender: Male Leavitt Medical Associates of Flori 8209 State Rd 54 New Port Richey, FL 34655 (727) 569-1055 Fax: (727) 569-1505 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Sable, David MD Provider ID: 703023 Gender: Male Academic Alliance In Dermatology 13910 Fivay Rd Ste 5 Hudson, FL 34667 (727) 259-7930 Fax: (727) 259-7929 00 Yrs/130 Yrs Memorial Hospital of Tampa Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Scannon, Michael MD Provider ID: 131 Gender: Male 13732 17th St Dade City, FL 33525 (800) 809-4811 Fax: (813) 872-8978 18 Yrs/130 Yrs St Josephs Hospital M-TH 7:00 AM - 5:00 PM F 7:00 AM - 4:00 PM PCMH: No Vasiloudes, Panos MD Provider ID: 209502 Gender: Male Academic Alliance In Dermatology, I 2412 Cypress Glen DR Ste 102 Wesley Chapel, FL 33544 (813) 341-1480 Fax: (813) 528-8730 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Community Hospital Languages: Spanish, German, Greek M-F 8:00 AM - 5:00 PM PCMH: No Zook, Matthew MD Provider ID: 759269 Gender: Male 2412 Cypress Glen DR Ste 102 Wesley Chapel, FL 33544 (813) 341-1480 Fax: (813) 528-8730 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Dermatopathology Belongie, Iriana MD Provider ID: 755816 Gender: Female Academic Alliance In Dermatology 2412 Cypress Glen DR Ste 102 Wesley Chapel, FL 33544 (813) 341-1480 Fax: (813) 528-8730 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Community Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ear, Nose & Throat Dipasquale, Paul DO Provider ID: 909024 Gender: Male Vitale Institute Pl 27516 Cashford Cir Ste 101 Wesley Chapel, FL 33544 (813) 406-4400 Fax: (813) 929-6633 00 Yrs/130 Yrs Florida Hospital Zephyrhills New Tampa Surgery Center Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Patel, Nalin MD Provider ID: 271692 Gender: Male Florida Pediatric Associates LLC 26853 Foggy Creek Rd Wesley Chapel, FL 33544 (813) 262-1330 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc New Tampa Surgery Center Tampa Bay Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 317

Endocrinology, Diabetes, Metabolism Faris, Talal MD Provider ID: 175336 Gender: Male Diabetes Thyroid & Endocrinology 7414 Community Ct Hudson, FL 34667 (727) 868-3200 Fax: (727) 868-3204 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Arabic M-TH 8:00 AM - 4:00 PM PCMH: No Faris, Talal MD Provider ID: 175336 Gender: Male Diabetes Thyroid and Endocrinology 1815 Health Care Dr Ste A Trinity, FL 34655 (727) 868-3200 Fax: (727) 807-3302 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Arabic M-W 8:00 AM - 4:00 PM PCMH: No Gilling, Lucia MD Provider ID: 217121 Gender: Female Lucia Gilling 2252 Twelve Oaks Way Ste 101 Wesley Chapel, FL 33544 (813) 915-6811 Fax: (813) 907-0495 18 Yrs/130 Yrs Florida Hospital Tampa Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Endocrinology, Diabetes, Penabad, Jesus MD Metabolism - cont. Provider ID: 14580 Janicka, Ania DO Provider ID: 423400 Gender: Female Diabetes Care Center Inc 14100 Fivay Rd Ste 250 Hudson, FL 34667 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs Languages: Polish M-F 8:30 AM - 4:00 PM PCMH: No Janicka, Ania DO Provider ID: 423400 Gender: Female Diabetes Care Center Inc 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs Languages: Polish M-F 8:30 AM - 4:00 PM PCMH: No Loman, Lusiana MD Provider ID: 14578 Gender: Female Diabetes Care Center Inc 5422 US Hwy 19 New Prt Rchy, FL 34652 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Morton Plant Hospital MTWF 8:30 AM - 4:30 PM TH 8:30 AM - 5:00 PM PCMH: No Palacio Ramirez, Carlos MD

Gender: Male Diabetes Care Center Inc 14100 Fivay Rd Ste 250 Hudson, FL 34667 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Languages: Spanish M-W 8:30 AM - 5:00 PM PCMH: No Penabad, Jesus MD Provider ID: 14580 Gender: Male Diabetes Care Center Inc 5422 US Hwy 19 New Prt Rchy, FL 34652 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Languages: Spanish M-F 8:30 AM - 4:00 PM PCMH: No Pinero-Pilona, Antonio MD Provider ID: 187645 Gender: Male Diabetes Care Center Inc 14100 Fivay Rd Ste 250 Hudson, FL 34667 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Languages: Spanish M-F 8:30 AM - 4:00 PM PCMH: No

Pinero-Pilona, Antonio MD Provider ID: 187645 Gender: Male Diabetes Care Center Inc 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Languages: Spanish M-F 8:30 AM - 4:00 PM PCMH: No Plazarte, Monica DO Provider ID: 1270914 Gender: Female Diabetes Care Center, Inc. 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 869-3688 00 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM Sat 0:0 AM - 0:00 PM PCMH: No Szafran Swietlik, Anna MD Provider ID: 574625 Gender: Female Diabetes Care Center Inc 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 869-6673 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No

Provider ID: 1247730 Gender: Male Florida Medical Clinic PA 2100 Via Bella Blvd Land O Lakes, FL 34639 (813) 779-8953 Fax: (813) 355-5081 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 318

Endodontics Millstein, Ashley DMD Provider ID: TPVP139323-51 Gender: Female Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Family Practice Bain, Darryl MD Provider ID: 1226248 Gender: Male Baycare Medical Group Inc 6633 Forest Ave New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gastroenterology Freedland, Curtis DO Provider ID: 2014 Gender: Male West Florida Medical Specialists 10820 State Rd 54 Ste 201 New Port Richey, FL 34655 (727) 846-7031 Fax: (727) 846-7132 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Italian, German, Hindi M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Gastroenterology - cont. Kozhimala, John MD Freedland, Curtis DO Provider ID: 2014 Gender: Male West Florida Medical Specialists 7515 State Rd 52 Hudson, FL 34667 (727) 846-7031 Fax: (727) 846-7132 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Italian, German, Hindi M-F 8:00 AM - 5:00 PM PCMH: No Ghanekar, Dilip MD Provider ID: 148355 Gender: Male West Florida Medical Specialists 7515 State Rd 52 Hudson, FL 34667 (727) 846-7031 Fax: (727) 846-7132 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Italian, Hindi M-F 9:00 AM - 5:00 PM PCMH: No John, Thomas MD Provider ID: 1162094 Gender: Male Pasco Hernando Hma Physician Manage 6340 Fort King Rd Zephyrhills, FL 33542 (813) 782-6116 Fax: (813) 780-1051 18 Yrs/130 Yrs Bayfront Medical Center MTHF 1:00 AM - 5:00 PM T 9:00 AM - 1:00 PM W 9:00 AM - 12:00 PM PCMH: No

Provider ID: 224 Gender: Male Pasco Hernando Hma Physicians Manag 6340 Fort King Rd Zephyrhills, FL 33542 (813) 782-6116 Fax: (813) 780-1051 18 Yrs/110 Yrs Bayfront Health Dade City MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 4:00 PM PCMH: No Kozhimala, John MD Provider ID: 1308823 Gender: Male Pasco Hernando Hma Physicians Manag 6340 Fort King Rd Zephyrhills, FL 33542 (813) 782-6116 Fax: (813) 780-1051 12 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 4:00 PM PCMH: No Patel, Jigneshkumar MD

Patel, Jigneshkumar MD Staffetti, Joseph MD Provider ID: 625531 Provider ID: 1564 Gender: Male Gender: Male Bay Area Gastroenterology West Florida Med Specialists Associate 7515 State Rd 52 7545 Medical DR Hudson, FL 34667 Hudson, FL 34667 (727) 846-7031 (727) 372-4500 Fax: (727) 868-3151 Fax: (727) 372-3500 18 Yrs/130 Yrs 00 Yrs/130 Yrs CRMC At Bayonet Point Florida Hospital North Pinellas Medical Center of Trinity Medical Center of Trinity Morton Plant North Bay Morton Plant North Bay Hospital Hospital Languages: Spanish, Italian, Languages: Hindi German M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Patel, Satish MD Vangara, Sreenivas MD Provider ID: 223 Provider ID: 22749 Gender: Male Gender: Male Satish Patel MD PA 5515 Gulf Dr Ste B 5340 Gulf Dr Ste 105 New Port Richey, FL 34652 New Port Richey, FL 34652 (727) 848-3995 (727) 849-0222 Fax: (727) 843-9400 Fax: (727) 847-7685 18 Yrs/130 Yrs 18 Yrs/130 Yrs Mease Hospital Dunedin Florida Hospital North Pinellas Medical Center of Trinity Morton Plant North Bay Medical Center of Trinity Hospital Morton Plant North Bay Hospital Languages: Hindi M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Provider ID: 625531 Reddy, Tiyyagura MD Gender: Male Bay Area Gastroenterology Provider ID: 167251 Associate Gender: Male 1818 Short Branch Dr Ste 102 Advanced Gastroenterology Trinity, FL 34655 Associate (727) 372-4500 7614 Jacque Rd Ste B Fax: (727) 372-3500 Hudson, FL 34667 00 Yrs/130 Yrs Florida Hospital North Pinellas (727) 863-2105 Fax: (727) 862-2512 Medical Center of Trinity 18 Yrs/130 Yrs Morton Plant North Bay CRMC At Bayonet Point Hospital Hernando Endoscopy And Languages: Hindi Surgery Center M-F 9:00 AM - 5:00 PM Oak Hill Hospital PCMH: No Languages: Hindi, Telugu M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 319

General Dentistry Bacchelli, Lara DMD Provider ID: TPVP156856-19 Gender: Female Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco General Dentistry - cont. Barinas-Duval, Froilan DDS Baghdadi-Gegati, Marcel DDS

Provider ID: TPV14806-02 Gender: Male Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

Provider ID: TPVP128340-02 Gender: Male Economy Dentures of Hudson 12123 Little Rd Hudson, FL 34667 (727) 862-5476 Fax: (727) 862-1370 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 4:00 PM Berk, Madeline DMD PCMH: No Provider ID: TPVP134183-01 Baker, Wayne DDS Gender: Female Provider ID: TPVP43802-02 Premier Community Gender: Male Healthcare Group Inc Cobbe Dental 37944 Pasco Ave 5120 US Hwy 19 North Dade City, FL 33525 New Port Richey, FL 34652 (352) 518-2000 (727) 847-3113 Fax: (352) 437-1783 Fax: (727) 847-2904 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish M 7:00 AM - 7:00 PM M-TH 8:00 AM - 5:30 PM TWTHF 7:00 AM - 4:00 PM F 8:00 AM - 5:00 PM PCMH: No PCMH: No Berk, Madeline DMD Provider ID: TPVP134183-04 Baker, Wayne DDS Gender: Female Provider ID: TPVP43802-04 Cobbe Dental Gender: Male 5120 US Hwy 19 North Cobbe Dental New Port Richey, FL 34652 6606 Forest Ave (727) 847-3113 New Port Richey, FL 34653 Fax: (727) 847-2904 (727) 849-2454 00 Yrs/99 Yrs Fax: (727) 847-2386 Languages: Spanish 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM F 8:00 AM - 5:00 PM PCMH: No PCMH: No Berk, Madeline DMD Provider ID: TPVP134183-06 Gender: Female Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Bessada, Ashraf DMD Budzinski, Volha DDS Provider ID: TPVP42367-02 Provider ID: TPVP147349-04 Gender: Male Gender: Female Economy Dentures of Hudson Cobbe Dental 12123 Little Rd 6606 Forest Ave Hudson, FL 34667 New Port Richey, FL 34653 (727) 862-5476 (727) 849-2454 Fax: (727) 862-1370 Fax: (727) 847-2386 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM MTWTHFSat 7:00 AM - 4:00 F 8:00 AM - 5:00 PM PM PCMH: No PCMH: No Calcagno, Manuel DDS Biandudi, Odessa DDS Provider ID: TPVP45645-02 Provider ID: TPVP120881-06 Gender: Male Gender: Female Economy Dentures of Hudson Great Expressions Dental 12123 Little Rd Centers Hudson, FL 34667 1748 Bruce B Downs Blvd Ste (727) 862-5476 125 Fax: (727) 862-1370 Wesley Chapel, FL 33543 00 Yrs/99 Yrs (813) 907-1151 Languages: Spanish Fax: (813) 973-1728 MTWTHFSat 7:00 AM - 4:00 00 Yrs/99 Yrs PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM Chapagain, Shweta DDS PCMH: No Provider ID: TPVP76164-02 Branscombe, Tyler DMD Gender: Female Provider ID: TPVP134684-20 Cobbe Dental Gender: Male 5120 US Hwy 19 North Greenberg Dental New Port Richey, FL 34652 Orthodontics (727) 847-3113 3338 US Hwy 19 Fax: (727) 847-2904 Holiday, FL 34691 00 Yrs/99 Yrs (727) 359-0371 Languages: Spanish Fax: (727) 359-0374 M-TH 8:00 AM - 5:30 PM 00 Yrs/99 Yrs F 8:00 AM - 5:00 PM Languages: Spanish PCMH: No MTF 7:00 AM - 3:00 PM Chapagain, Shweta DDS WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM Provider ID: TPVP76164-04 PCMH: No Gender: Female Cobbe Dental Budzinski, Volha DDS 6606 Forest Ave Provider ID: TPVP147349-02 New Port Richey, FL 34653 Gender: Female (727) 849-2454 Cobbe Dental Fax: (727) 847-2386 5120 US Hwy 19 North 00 Yrs/99 Yrs New Port Richey, FL 34652 M-TH 8:00 AM - 5:30 PM (727) 847-3113 F 8:00 AM - 5:00 PM Fax: (727) 847-2904 PCMH: No 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 320

Last update 08/14/2017

Specialty Physicians Pasco General Dentistry - cont. Dao, Thieu DDS Charles, Jay II DDS Provider ID: TPVP156591-17 Gender: Male Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Charles, Jay II DDS Provider ID: TPVP156591-19 Gender: Male Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP43794-04 Gender: Male Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Das, Shilpa DDS Provider ID: TPVP121131-03 Gender: Female Great Expressions Dental Centers 7950 Gall Blvd Zephyrhills, FL 33541 (813) 715-1271 Fax: (813) 715-1402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Decambra, Nicole DMD Provider ID: TPVP134605-02 Crandall, James DDS Gender: Female Provider ID: TPVP41891-02 Great Expressions Dental Gender: Male Centers Economy Dentures of Hudson 1748 Bruce B Downs Blvd Ste 125 12123 Little Rd Wesley Chapel, FL 33543 Hudson, FL 34667 (813) 907-1151 (727) 862-5476 Fax: (813) 973-1728 Fax: (727) 862-1370 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish M-F 8:00 AM - 5:00 PM MTWTHFSat 7:00 AM - 4:00 PM PCMH: No PCMH: No Dockus, Matthew DMD Dao, Thieu DDS Provider ID: TPVP157263-19 Provider ID: TPVP43794-02 Gender: Male Gender: Male Greenberg Dental Cobbe Dental Orthodontics 5120 US Hwy 19 North 3338 US Hwy 19 New Port Richey, FL 34652 Holiday, FL 34691 (727) 847-3113 (727) 359-0371 Fax: (727) 847-2904 Fax: (727) 359-0374 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish M-TH 8:00 AM - 5:30 PM MTF 7:00 AM - 3:00 PM F 8:00 AM - 5:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Sat 7:00 AM - 2:00 PM PCMH: No

El-Sherbini, Sara DDS Provider ID: TPVP145514-04 Gender: Female Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Frankel, Manuel DDS Provider ID: TPVP152815-02 Gender: Male Economy Dentures of Hudson 12123 Little Rd Hudson, FL 34667 (727) 862-5476 Fax: (727) 862-1370 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 4:00 PM PCMH: No

El-Sherbini, Sara DDS Provider ID: TPVP145514-06 Gender: Female Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Genho, Beth DDS Provider ID: TPVP125136-01 Gender: Female Doh - Pasco County Health Department 10841 Little Rd New Port Richey, FL 34654 (727) 861-5260 Fax: (727) 861-4873 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 12:00 PM PCMH: No

Farrell, Thomas DDS Genho, Beth DDS Provider ID: TPVP149830-02 Gender: Male Provider ID: TPVP125136-02 Economy Dentures of Hudson Gender: Female 12123 Little Rd Doh - Pasco County Health Department Hudson, FL 34667 37615 Martin Luther King Blvd (727) 862-5476 Dade City, FL 33523 Fax: (727) 862-1370 (352) 521-1450 00 Yrs/99 Yrs Fax: (727) 861-4873 Languages: Spanish 00 Yrs/99 Yrs MTWTHFSat 7:00 AM - 4:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Figaro, Mark DDS Genninger, Jasen DMD Provider ID: TPVP131307-02 Provider ID: TPVP148171-20 Gender: Male Gender: Male Economy Dentures of Hudson Greenberg Dental Orthodontics 12123 Little Rd 3338 US Hwy 19 Hudson, FL 34667 Holiday, FL 34691 (727) 862-5476 (727) 359-0371 Fax: (727) 862-1370 Fax: (727) 359-0374 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish MTWTHFSat 7:00 AM - 4:00 PM MTF 7:00 AM - 3:00 PM PCMH: No WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 321

Last update 08/14/2017

Specialty Physicians Pasco General Dentistry - cont. Greenberg, Andrew DDS Gottipati, Padmalatha DDS Provider ID: TPVP130860-02 Gender: Female Economy Dentures of Hudson 12123 Little Rd Hudson, FL 34667 (727) 862-5476 Fax: (727) 862-1370 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 4:00 PM PCMH: No

Provider ID: TPV7501-69 Gender: Male Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-19 Gender: Male Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Immadi, Lakshmi DDS Provider ID: TPVP107938-14 Gender: Female Great Expressions Dental Centers 7950 Gall Blvd Zephyrhills, FL 33541 (813) 715-1271 Fax: (813) 715-1402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Jensen, Stephen DDS Provider ID: TPVP43790-02 Gender: Male Grier, Carrol DDS Homayouni, Siavash DDS Cobbe Dental Grace, Willie DDS Provider ID: TPVP41905-02 Provider ID: TPVP43376-02 5120 US Hwy 19 North Gender: Female Gender: Male Provider ID: TPVP43657-02 New Port Richey, FL 34652 Economy Dentures of Hudson Economy Dentures of Hudson Gender: Male (727) 847-3113 12123 Little Rd Economy Dentures of Hudson 12123 Little Rd Fax: (727) 847-2904 Hudson, FL 34667 Hudson, FL 34667 12123 Little Rd 00 Yrs/99 Yrs (727) 862-5476 (727) 862-5476 Hudson, FL 34667 Languages: Spanish Fax: (727) 862-1370 Fax: (727) 862-1370 (727) 862-5476 M-TH 8:00 AM - 5:30 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (727) 862-1370 F 8:00 AM - 5:00 PM Languages: Spanish Languages: Spanish 00 Yrs/99 Yrs PCMH: No MTWTHFSat 7:00 AM - 4:00 MTWTHFSat 7:00 AM - 4:00 Languages: Spanish PM PM MTWTHFSat 7:00 AM - 4:00 Jensen, Stephen DDS PCMH: No PCMH: No PM Provider ID: TPVP43790-04 PCMH: No Hale, Jonathan DDS Howe, Douglas DDS Gender: Male Cobbe Dental Graddy, Nathan DDS Provider ID: TPVP147592-01 Provider ID: TPVP70266-02 6606 Forest Ave Gender: Male Gender: Male Provider ID: TPVP44090-02 New Port Richey, FL 34653 Great Expressions Dental Economy Dentures of Hudson Gender: Male (727) 849-2454 12123 Little Rd Economy Dentures of Hudson Centers 7950 Gall Blvd Fax: (727) 847-2386 Hudson, FL 34667 12123 Little Rd Zephyrhills, FL 33541 00 Yrs/99 Yrs (727) 862-5476 Hudson, FL 34667 (813) 715-1271 M-TH 8:00 AM - 5:30 PM Fax: (727) 862-1370 (727) 862-5476 Fax: (813) 715-1402 F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs Fax: (727) 862-1370 00 Yrs/99 Yrs PCMH: No Languages: Spanish 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 4:00 Languages: Spanish Kanach, Paul DMD M-F 8:00 AM - 5:00 PM PM MTWTHFSat 7:00 AM - 4:00 Provider ID: TPVP137705-34 PCMH: No PCMH: No PM Gender: Male PCMH: No Immadi, Lakshmi DDS Greenberg Dental Orthodontics Provider ID: TPVP107938-07 3338 US Hwy 19 Gender: Female Holiday, FL 34691 Great Expressions Dental Centers (727) 359-0371 1748 Bruce B Downs Blvd Ste Fax: (727) 359-0374 125 00 Yrs/99 Yrs Wesley Chapel, FL 33543 Languages: Spanish (813) 907-1151 MTF 7:00 AM - 3:00 PM Fax: (813) 973-1728 WTH 11:00 AM - 7:00 PM 00 Yrs/99 Yrs Sat 7:00 AM - 2:00 PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 322

Last update 08/14/2017

Specialty Physicians Pasco General Dentistry - cont. Lee-Loy, Ingrid DDS Karapasha, Christopher DDS Provider ID: TPVP158530-01 Gender: Male Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Karapasha, Christopher DDS Provider ID: TPVP158530-02 Gender: Male Premier Community Healthcare Group Inc Mobile Unit 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/99 Yrs PCMH: No Katsur, Justin DDS Provider ID: TPV16372-A1 Gender: Male Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Provider ID: TPVP43283-01 Gender: Female Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Mauricio, Margaret DDS Provider ID: TPVP43119-03 Gender: Male Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Mauricio, Margaret DDS Provider ID: TPVP43119-04 Gender: Male Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Mauricio, Margaret DDS Provider ID: TPVP43119-06 Gender: Male Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Mauricio, Margaret DDS Provider ID: TPVP43119-08 Gender: Male Premier Community Healthcare Group Inc Mobile Unit 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/99 Yrs PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-19 Gender: Female Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

McNair, Clarence DDS Provider ID: TPVP134184-01 Gender: Male Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Mejias, Karen DDS Provider ID: TPVP112236-05 Gender: Female Smileville Dental Center PA 26827 Foggy Creek Rd Ste 103 Wesley Chapel, FL 33544 (813) 994-4777 Fax: (877) 596-5014 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Melean, Alfonso DMD Provider ID: TPVP130412-06 McLaughlin, Matthew DMD Gender: Male Doh - Pasco County Health Department Provider ID: TPVP157623-04 10841 Little Rd Gender: Male Economy Dentures of Hudson New Port Richey, FL 34654 (727) 861-5260 12123 Little Rd Fax: (727) 861-4873 Hudson, FL 34667 00 Yrs/99 Yrs (727) 862-5476 Languages: Spanish Fax: (727) 862-1370 M-TH 8:00 AM - 5:30 PM 00 Yrs/99 Yrs F 8:00 AM - 12:00 PM Languages: Spanish PCMH: No MTWTHFSat 7:00 AM - 4:00 PM Modaff, Michelle DDS PCMH: No Provider ID: TPVP64856-13 Gender: Female Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 323

Last update 08/14/2017

Specialty Physicians Pasco General Dentistry - cont. Nagabandi, Padma DDS Modaff, Michelle DDS Provider ID: TPVP64856-14 Gender: Female Premier Community Healthcare Group Inc Mobile Unit 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/99 Yrs PCMH: No Moore, Alicia DDS Provider ID: TPVP134368-01 Gender: Female Doh - Pasco County Health Department 10841 Little Rd New Port Richey, FL 34654 (727) 861-5260 Fax: (727) 861-4873 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 12:00 PM PCMH: No Moore, Alicia DDS Provider ID: TPVP134368-02 Gender: Female Doh - Pasco County Health Department 37615 Martin Luther King Blvd Dade City, FL 33523 (352) 521-1450 Fax: (727) 861-4873 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nagabandi, Padma DDS Provider ID: TPVP127443-03 Gender: Female Doh - Pasco County Health Department 10841 Little Rd New Port Richey, FL 34654 (727) 861-5260 Fax: (727) 861-4873 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 12:00 PM PCMH: No

Provider ID: TPVP127443-04 Gender: Female Doh - Pasco County Health Department 37615 Martin Luther King Blvd Dade City, FL 33523 (352) 521-1450 Fax: (727) 861-4873 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nakarmi, Bibek DDS Provider ID: TPVP147282-02 Gender: Male Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish, Bengali M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Nakarmi, Bibek DDS Provider ID: TPVP147282-04 Gender: Male Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs Languages: Bengali M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Paula, Kelly DMD Provider ID: TPVP157406-01 Gender: Female Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Paula, Kelly DMD Provider ID: TPVP157406-03 Gender: Female Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Peralta, Jose DDS Provider ID: TPVP42670-01 Gender: Male Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Peralta, Jose DDS Provider ID: TPVP42670-02 Gender: Male Premier Community Healthcare Group Inc Mobile Unit 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Pham, Thanh DDS Provider ID: TPVP42126-01 Gender: Female Premier Community Healthcare Group Inc 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 437-1783 00 Yrs/99 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Pham, Thanh DDS Provider ID: TPVP42126-02 Gender: Female Premier Community Healthcare Group Inc Mobile Unit 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/99 Yrs PCMH: No Polite, Leroy DMD Provider ID: TPVP43739-02 Gender: Male Economy Dentures of Hudson 12123 Little Rd Hudson, FL 34667 (727) 862-5476 Fax: (727) 862-1370 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 4:00 PM PCMH: No

Pratt, Frederick DDS Peters, Edward DDS Provider ID: TPVP92720-02 Provider ID: TPV4384-03 Gender: Male Gender: Male Economy Dentures of Hudson Economy Dentures of Hudson 12123 Little Rd 12123 Little Rd Hudson, FL 34667 Hudson, FL 34667 (727) 862-5476 (727) 862-5476 Fax: (727) 862-1370 Fax: (727) 862-1370 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish MTWTHFSat 7:00 AM - 4:00 MTWTHFSat 7:00 AM - 4:00 PM PM PCMH: No PCMH: No

www.wellcare.com/Florida | 324

Last update 08/14/2017

Specialty Physicians Pasco General Dentistry - cont. Scalercio, John DMD Reed, Samantha DDS Provider ID: TPVP43792-14 Gender: Female Smile Design New Port Richey 4104 Little Rd New Port Richey, FL 34655 (727) 376-2666 Fax: (888) 582-0179 00 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM PCMH: No Reed, Samantha DDS Provider ID: TPVP43792-18 Gender: Female Smile Design Port Richey 10806 US Hwy 19 Ste 101 Port Richey, FL 34668 (727) 863-2497 Fax: (727) 862-7862 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Rostami, Maryam DMD Provider ID: TPVP141320-01 Gender: Female Great Expressions Dental Centers 1748 Bruce B Downs Blvd Ste 125 Wesley Chapel, FL 33543 (813) 907-1151 Fax: (813) 973-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Sachdev, Manu DMD Provider ID: TPV18942-60 Gender: Male Orange Grove Dental 4122 Rowan Rd New Port Richey, FL 34653 (727) 645-6943 Fax: (727) 203-3925 00 Yrs/99 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Provider ID: TPV17830-05 Gender: Male Economy Dentures of Hudson 12123 Little Rd Hudson, FL 34667 (727) 862-5476 Fax: (727) 862-1370 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 4:00 PM PCMH: No

Siemiet, Erika DDS Provider ID: TPVP43793-04 Gender: Female Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs Languages: Portuguese M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Schaffner, Daniel DDS Provider ID: TPVP45055-04 Gender: Male Great Expressions Dental Centers 1748 Bruce B Downs Blvd Ste 125 Wesley Chapel, FL 33543 (813) 907-1151 Fax: (813) 973-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-19 Gender: Male Greenberg Dental Orthodontics 3338 US Hwy 19 Holiday, FL 34691 (727) 359-0371 Fax: (727) 359-0374 00 Yrs/99 Yrs Languages: Spanish MTF 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Smith, Daryl DDS Provider ID: TPVP42251-02 Vo, Jossette DMD Gender: Male Economy Dentures of Hudson Provider ID: TPVP42628-02 Gender: Female 12123 Little Rd Economy Dentures of Hudson Hudson, FL 34667 12123 Little Rd (727) 862-5476 Hudson, FL 34667 Fax: (727) 862-1370 (727) 862-5476 00 Yrs/99 Yrs Fax: (727) 862-1370 Languages: Spanish 00 Yrs/99 Yrs MTWTHFSat 7:00 AM - 4:00 PM Languages: Spanish PCMH: No MTWTHFSat 7:00 AM - 4:00 PM Spouh, Mohammad DDS PCMH: No Schutt, Charles DDS Provider ID: TPVP134609-01 Provider ID: TPVP122236-01 Wright, Carl DDS Gender: Male Gender: Male Provider ID: TPVP121445-04 Great Expressions Dental Economy Dentures of Hudson Centers Gender: Male 12123 Little Rd 7950 Gall Blvd Economy Dentures of Hudson Hudson, FL 34667 Zephyrhills, FL 33541 12123 Little Rd (727) 862-5476 (813) 715-1271 Hudson, FL 34667 Fax: (727) 862-1370 Fax: (813) 715-1402 (727) 862-5476 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (727) 862-1370 Languages: Spanish Languages: Spanish 00 Yrs/99 Yrs MTWTHFSat 7:00 AM - 4:00 M-F 8:00 AM - 5:00 PM Languages: Spanish PM PCMH: No MTWTHFSat 7:00 AM - 4:00 PCMH: No PM Tiwary, Alka DDS PCMH: No Siemiet, Erika DDS Provider ID: TPVP44353-02 Provider ID: TPVP43793-02 Gender: Female Gender: Female Economy Dentures of Hudson Cobbe Dental 12123 Little Rd 5120 US Hwy 19 North Hudson, FL 34667 New Port Richey, FL 34652 (727) 862-5476 (727) 847-3113 Fax: (727) 862-1370 Fax: (727) 847-2904 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish, MTWTHFSat 7:00 AM - 4:00 Portuguese PM M-TH 8:00 AM - 5:30 PM PCMH: No F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 325

Last update 08/14/2017

Specialty Physicians Pasco General Surgery Alkafaji, Aziz MD Provider ID: 2781 Gender: Male West Coast Surgical Associates 5411 Grand Blvd Ste 109 New Port Richey, FL 34652 (727) 842-3445 Fax: (727) 841-9141 16 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital M 10:00 AM - 3:30 PM T 1:30 AM - 4:30 PM PCMH: No

Davidson, Robert MD Provider ID: 215087 Gender: Male 2102 Trinity Oaks Blvd Ste 204 New Port Richey, FL 34655 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin M 1:00 AM - 4:30 PM PCMH: No

Dicicco, Richard MD Provider ID: 330086 Gender: Male Pasco Surgical Associates PA 37840 Medical Arts Ct Zephyrhills, FL 33541 Allen, Kathleen MD (813) 788-5569 Fax: (813) 782-8628 Provider ID: 495854 16 Yrs/130 Yrs Gender: Female Bayfront Health Dade City Baycare Medical Group St Anthonys Physicians 2102 Trinity Oaks Blvd Ste 204 Surgery New Port Richey, FL 34655 M-F 9:00 AM - 4:00 PM (727) 462-2131 PCMH: No Fax: (727) 266-4914 Ferris, Vijay MD 12 Yrs/130 Yrs Largo Medical Center Provider ID: 1360090 Morton Plant Hospital Gender: Male M-F 9:00 AM - 5:00 PM Fhpg Wc Surgical Associates PCMH: No of Pasc 27415 Cashford Cir Ste 102 Chisholm, Keith MD Wesley Chapel, FL 33544 Provider ID: 666673 (813) 782-5801 Gender: Male Fax: (813) 785-5732 Surgical Specialists of Trinity 16 Yrs/130 Yrs 10751 Maple Creek Dr Ste 103 Florida Hospital Tampa Trinity, FL 34655 Florida Hospital Wesley Chapel (727) 372-0400 Florida Hospital Zephyrhills Fax: (727) 372-0403 M-F 9:00 AM - 5:00 PM 12 Yrs/130 Yrs Florida Hospital North Pinellas PCMH: No M-F 9:00 AM - 5:00 PM Ferris, Vijay MD PCMH: No Provider ID: 165431 Gender: Male 38056 Daughtery Rd Zephyrhills, FL 33540 (813) 782-5801 Fax: (813) 782-5732 18 Yrs/130 Yrs New Tampa Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No

Kwazneski, Douglas MD Provider ID: 1326753 Gender: Male West Florida Trauma Network 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Norwood, Scott MD Provider ID: 637402 Gender: Male West Florida Trauma Network, LLC 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No

Villarreal, David MD Provider ID: 626347 Gender: Male 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No Wilson, Jason MD Provider ID: 1323381 Gender: Male Baycare Medical Group Inc 2102 Trinity Oaks Blvd New Port Richey, FL 34655 (727) 462-2131 Fax: (727) 266-4914 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Wilson, Jason MD Provider ID: 1323381 Gender: Male Roth, Robert MD Baycare Medical Group Inc Provider ID: 191604 400 Pinellas St Gender: Male New Port Richey, FL 34655 2102 Trinity Oaks Blvd Ste 204 (727) 462-2131 New Port Richey, FL 34655 Fax: (727) 266-4914 (727) 712-3233 18 Yrs/130 Yrs Fax: (727) 712-1853 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No Mease Countryside Hospital Wright, Alene MD Mease Hospital Dunedin St Josephs Hospital Provider ID: 606673 M 9:00 AM - 11:30 PM Gender: Female PCMH: No Community Hospital Family Practice Thatimatla, Naga MD 9332 SR 54 Ste 400 New Port Richey, FL 34655 Provider ID: 1198176 (727) 372-4779 Gender: Male Fax: (727) 372-4559 Bayfront Health Medical 00 Yrs/130 Yrs Group Medical Center of Trinity 2718 Windguard Cir Ste 101 Languages: Spanish, German Wesley Chapel, FL 33544 M-F 8:00 AM - 5:00 PM (352) 567-1411 PCMH: No Fax: (352) 567-6391 00 Yrs/130 Yrs Bayfront Health Dade City M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 326

Last update 08/14/2017

Specialty Physicians Pasco Geriatric Medicine

Patel, Shilen MD Provider ID: 1061996 Choksi, Tarak MD Gender: Male Provider ID: 1226382 Florida Cancer Specialists Gender: Male 8763 River Crossing Blvd Sunmed Primary Care New Port Richey, FL 34655 19409 Shumard Oak Dr Ste 101 (727) 842-8411 Land O Lakes, FL 34638 Fax: (877) 917-2336 (813) 909-1146 18 Yrs/130 Yrs Fax: (813) 909-4334 Bayfront Health Brooksville Bayfront Health Spring Hill 18 Yrs/130 Yrs Oak Hill Hospital M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Hematology

Dutt, Ramana MD Provider ID: 148556 Gender: Male 5802 State Rd 54 New Port Richey, FL 34652 (727) 842-2795 Fax: (727) 842-8676 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No Dutt, Ramana MD Provider ID: 148556 Gender: Male 7463 State Rd 52 Hudson, FL 34667 (727) 862-9026 Fax: (727) 862-5886 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No Patel, Shilen MD Provider ID: 1061996 Gender: Male Florida Cancer Specialists 7651 Medical Dr Hudson, FL 34667 (727) 868-9208 Fax: (877) 917-2347 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Oak Hill Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Hematology & Oncology Abid, Syed MD Provider ID: 300444 Gender: Male Pinellas Hematology and Oncology PA 3611 Little Rd New Port Richey, FL 34655 (727) 344-6569 Fax: (727) 384-4388 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Apuri, Susmitha MD Provider ID: 1431448 Gender: Female Florida Medical Clinic PA 2100 Via Bella Blvd Ste 201 Land O Lakes, FL 34639 (813) 778-0400 Fax: (813) 355-5903 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Apuri, Susmitha MD Provider ID: 1431448 Gender: Female Florida Medical Clinic PA 38135 Market Sq Zephyrhills, FL 33542 (813) 778-0400 Fax: (813) 355-5903 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Arevalo-Araujo, Roberto MD Provider ID: 190764 Gender: Male Cancer Center of Pasco Pinellas 3000 US Hwy 19 Holiday, FL 34691 (727) 942-7070 Fax: (727) 942-8628 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant North Bay Hospital North Pinellas Surgery Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Ayub, Jorge MD Provider ID: 1397 Gender: Male Florida Cancer Institute PA 7651 Medical Dr Hudson, FL 34667 (727) 868-9208 Fax: (727) 868-6420 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Oak Hill Hospital Languages: Spanish, Portuguese M-F 9:00 AM - 5:00 PM PCMH: No Dandamudi, Uday MD Provider ID: 731328 Gender: Male Florida Cancer Specialists 8763 River Crossing Blvd New Port Richey, FL 34655 (727) 842-8411 Fax: (877) 917-2336 18 Yrs/130 Yrs Languages: Hindi, Telugu M-F 8:30 AM - 5:00 PM PCMH: No

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Dandamudi, Uday MD Provider ID: 731328 Gender: Male Florida Cancer Specialists Pl 38010 Medical Center Ave Zephyrhills, FL 33540 (813) 783-1676 Fax: (877) 917-1262 18 Yrs/130 Yrs Languages: Hindi, Telugu M-F 9:00 AM - 5:00 PM PCMH: No Dandamudi, Uday MD Provider ID: 731328 Gender: Male Florida Cancer Specialists Pl 7651 Medical Dr Hudson, FL 34667 (727) 868-9208 Fax: (877) 917-2347 18 Yrs/130 Yrs Languages: Hindi, Telugu M-F 9:00 AM - 5:00 PM PCMH: No Desai, Pratibha MD Provider ID: 690666 Gender: Male Pinellas Hematology and Oncology PA 3611 Little Rd New Port Richey, FL 34655 (727) 344-6569 Fax: (727) 384-4388 16 Yrs/130 Yrs Palms of Pasadena Hospital Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Hematology & Oncology Kumar, Kapisthalam MD - cont. Gupta, Sneh MD Provider ID: 2687 Gender: Female 5340 Gulf Dr Ste 105 New Port Richey, FL 34652 (727) 844-3351 Fax: (727) 847-7685 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital M-TH 9:00 AM - 5:30 PM F 9:00 AM - 4:00 PM PCMH: No Kulkarni, Gajanan MD Provider ID: 10680 Gender: Male Florida Cancer Specialists Pl 5802 Srd 54 New Port Richey, FL 34652 (727) 842-2795 Fax: (727) 842-8676 00 Yrs/130 Yrs Bayfront Health Spring Hill CRMC At Bayonet Point Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No Kulkarni, Gajanan MD Provider ID: 10680 Gender: Male Florida Cancer Specialists Pl 7463 State Rd 52 Hudson, FL 34667 (727) 862-9026 Fax: (727) 862-5886 00 Yrs/130 Yrs Bayfront Health Spring Hill CRMC At Bayonet Point Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 10674 Gender: Male Florida Cancer Specialists Pl 5802 State Rd 54 New Prt Rchy, FL 34652 (727) 842-2795 Fax: (352) 597-2337 00 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No Kumar, Kapisthalam MD Provider ID: 10674 Gender: Male Florida Cancer Specialists Pl 7463 State Rd 52 Hudson, FL 34667 (727) 862-9026 Fax: (727) 863-3034 00 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No Sennabaum, Joseph MD Provider ID: 3522 Gender: Male Florida Cancer Specialists 7651 Medical Dr Hudson, FL 34667 (727) 868-9208 Fax: (727) 868-6420 18 Yrs/130 Yrs Bayfront Health Brooksville Medical Center of Trinity Morton Plant North Bay Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Tang, Huayang MD Provider ID: 225851 Gender: Male Florida Cancer Institute, P A 8763 River Crossing Blvd New Port Richey, FL 34655 (352) 382-0258 Fax: (727) 847-2923 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Morton Plant North Bay Hospital Languages: French, Chinese M-F 9:00 AM - 5:00 PM PCMH: No

Infectious Disease Mai, Jane MD Provider ID: 1107294 Gender: Female Infectious Disease Associates of Ta 5504 Gateway Blvd Ste 102 Wesley Chapel, FL 33544 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Mohmand, Asad MD Provider ID: 1261859 Gender: Male Margarita R. Cancio, MD, PA D/B/A I 5504 Gateway Blvd Wesley Chapel, FL 33544 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

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Internal Medicine Di Martino, Peter MD Provider ID: 714654 Gender: Male Florida Cardiology Group LLC 4738 Grand Blvd Ste E New Port Richey, FL 34652 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Medical Center of Trinity Languages: Spanish, Italian M-F 9:00 AM - 5:00 PM PCMH: No Di Martino, Peter MD Provider ID: 714654 Gender: Male Florida Cardiology Group LLC 7614 Jacque Rd Hudson, FL 34667 (727) 862-8383 Fax: (727) 863-4766 18 Yrs/130 Yrs Medical Center of Trinity Languages: Spanish, Italian MT 1:00 AM - 4:00 PM PCMH: No Digiovanni, Ernest DO Provider ID: 1296985 Gender: Female West Florida Medical Specialists 10820 State Rd 54 Ste 201 New Port Richey, FL 34655 (727) 846-7031 Fax: (727) 846-9444 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Internal Medicine - cont. Mohmand, Asad MD Harris, Meghan MD Provider ID: 1231603 Gender: Female Infectious Disease Associates of Ta 5504 Gateway Blvd Ste 102 Wesley Chapel, FL 33544 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Khadim, Ghazanfar MD

Provider ID: 1261859 Gender: Male Margarita R. Cancio, MD, PA D/B/A I 5504 Gateway Blvd Wesley Chapel, FL 33544 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Pitarys II, Christos MD Provider ID: 169440 Gender: Male S Goldman/C Pitarys MD Pl 14100 Fivay Rd Ste 110 Hudson, FL 34667 (727) 849-8771 Fax: (727) 842-4962 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Greek M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 456632 Gender: Male Aung Tun MD PA 6833 Medical View Ln Zephyrhills, FL 33542 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills South Florida Baptist Hospital Languages: Spanish, Chinese, Burmese M-F 8:00 AM - 5:00 PM Pitarys II, Christos MD PCMH: No Khadim, Ghazanfar MD Provider ID: 456632 Gender: Male Florida Heart Institute 26827 Foggy Creek Rd Ste 101A Bldg 6 Wesley Chapel, FL 33544 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills South Florida Baptist Hospital Languages: Spanish, Chinese, Burmese M 3:00 AM - 5:00 PM PCMH: No

Provider ID: 169440 Gender: Male S Goldman/C Pitarys MD Pl 6633 Forest Ave Ste 302 New Port Richey, FL 34652 (727) 849-8771 Fax: (727) 842-4962 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Greek M-F 8:30 AM - 5:00 PM PCMH: No

Sanchez-Ponce, Rafael MD Provider ID: 405952 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Win, Moethu MD Provider ID: 1117447 Gender: Male Aung Tun, MD, PA Associates 6833 Medical View Ln Zephyrhills, FL 33542 (813) 780-6687 Fax: (813) 788-6554 00 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Interventional Cardiology Marmagkiolis, Konstantinos MD Provider ID: 1240927 Gender: Male Premier Heart and Vascular Center P 38035 Medical Center Ave Zephyrhills, FL 33540 (813) 788-1400 Fax: (813) 788-7691 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Mosher, Laura MD Provider ID: 1226251 Gender: Female Baycare Medical Group Inc 6633 Forest Ave 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patel, Parag MD Provider ID: 1145957 Gender: Male Baycare Medical Group 6633 Forest Ave Ste 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Raxwal, Vinod MD Provider ID: 1029471 Gender: Male 14100 Fivay Rd Ste 130 Hudson, FL 34667 (727) 857-4871 Fax: (727) 857-4894 18 Yrs/130 Yrs Florida Hospital North Pinellas Languages: Russian, Hindi, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No Raxwal, Vinod MD Provider ID: 1029471 Gender: Male 6325 State Rd 54 New Port Richey, FL 34653 (727) 203-3802 Fax: (727) 807-3391 18 Yrs/130 Yrs Florida Hospital North Pinellas Languages: Russian, Hindi, Punjabi M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Interventional Cardiology Soma, Vikas MD - cont. Provider ID: 1031058 Sanchez-Ponce, Rafael MD Provider ID: 405952 Gender: Male Interventional Cardiac Consultants 2035 Little Rd Trinity, FL 34655 (727) 842-9486 Fax: (727) 849-2623 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Soma, Vikas MD Provider ID: 1031058 Gender: Male Premier Heart and Vascular Center P 13933 17th St Ste 100 Dade City, FL 33525 (813) 788-1400 Fax: (813) 788-7691 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No Soma, Vikas MD Provider ID: 1031058 Gender: Male Premier Heart and Vascular Center P 27424 Cashford Cir Wesley Chapel, FL 33544 (813) 788-1400 Fax: (813) 788-7691 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No

Gender: Male Premier Heart and Vascular Center P 38035 Medical Center Ave Zephyrhills, FL 33540 (813) 788-1400 Fax: (813) 788-7691 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No

Maternal Fetal Medicine Baacke, Keri MD Provider ID: 1344794 Gender: Female Pediatrix Medical Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 Fax: (855) 527-5510 12 Yrs/130 Yrs MT 9:00 AM - 5:00 PM W 8:30 AM - 5:00 PM PCMH: No

Nirgudkar, Pranita MD Provider ID: 1352153 Gender: Female Pediatrix Medical Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/130 Yrs Languages: Hindi, Marathi M-F 9:00 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Medical Oncology Dutt, Ramana MD Provider ID: 148556 Gender: Male 5802 State Rd 54 New Port Richey, FL 34652 (727) 842-2795 Fax: (727) 842-8676 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No Dutt, Ramana MD Provider ID: 148556 Gender: Male 7463 State Rd 52 Hudson, FL 34667 (727) 862-9026 Fax: (727) 862-5886 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No

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Patel, Shilen MD Provider ID: 1061996 Gender: Male Florida Cancer Specialists 7651 Medical Dr Hudson, FL 34667 (727) 868-9208 Fax: (877) 917-2347 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Oak Hill Hospital M-F 8:00 AM - 5:00 PM PCMH: No Patel, Shilen MD Provider ID: 1061996 Gender: Male Florida Cancer Specialists 8763 River Crossing Blvd New Port Richey, FL 34655 (727) 842-8411 Fax: (877) 917-2336 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Oak Hill Hospital M-F 8:00 AM - 5:00 PM PCMH: No Wright, Gail MD Provider ID: 226665 Gender: Female Florida Cancer Institute New Hope 7651 Medical Dr Ste 330 Hudson, FL 34667 (727) 868-9208 Fax: (727) 868-6420 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Nephrology Acharya, Muralidhar MD Provider ID: 9599 Gender: Male Renal Hypertension Center 14134 Nephron Ln Hudson, FL 34667 (727) 863-5418 Fax: (727) 869-8626 18 Yrs/130 Yrs Bayfront Health Brooksville Largo Medical Center Morton Plant North Bay Hospital M-F 9:00 AM - 5:00 PM PCMH: No Adla Reddy, Mahathi MD Provider ID: 518972 Gender: Female Renal Hypertension 4113 Little Rd Ste 101 New Port Richey, FL 34655 (727) 376-3725 Fax: (727) 376-3742 18 Yrs/130 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Languages: Hindi, Telugu M-F 9:00 AM - 5:00 PM PCMH: No Badillo, Linda MD Provider ID: 9597 Gender: Female Renal Hypertension Center 14134 Nephron Ln Hudson, FL 34667 (727) 863-5418 Fax: (727) 869-8626 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Badillo, Linda MD Provider ID: 9597 Gender: Female Renal Hypertension Center 4133 Little Rd Ste 101 New Port Richey, FL 34655 (727) 376-3725 Fax: (727) 376-3742 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Dcunha, Prakas MD Provider ID: 245342 Gender: Male Renal Hypertension Center 4113 Little Rd Ste 101 New Port Richey, FL 34655 (727) 376-3725 Fax: (727) 376-3742 18 Yrs/130 Yrs Bayfront Health Brooksville Mease Hospital Dunedin Morton Plant North Bay Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Hariachar, Srinivas MD Provider ID: 222906 Gender: Male Renal Hypertension Center 14134 Nephron Ln Hudson, FL 34667 (727) 863-5418 Fax: (727) 869-8626 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Mathew, Ajay DO Provider ID: 1352386 Gender: Male 38135 Market Sq Zephyrhills, FL 33542 (813) 782-3727 Fax: (813) 355-5051 18 Yrs/110 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No Mathew, Ajay DO Provider ID: 1352386 Gender: Male Florida Medical Clinic PA 2352 Bruce Downs Blvd Ste 203 Wesley Chapel, FL 33544 (813) 994-3389 Fax: (813) 355-5051 18 Yrs/110 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No Numrungroad, Visal MD Provider ID: 229491 Gender: Male 14153 Yosemite Dr Ste 102B Hudson, FL 34667 (727) 848-1274 Fax: (727) 849-6409 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish, Chinese, Cantonese, Mandarin M-F 8:30 AM - 5:00 PM PCMH: No

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Qi, Quanle MD Provider ID: 284417 Gender: Male Gulf Coast Nephrology Associates 4738 Grand Blvd New Port Richey, FL 34652 (727) 848-1274 Fax: (727) 849-6409 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Solaris Healthcare Bayonet Point Languages: Chinese M-F 8:30 AM - 5:00 PM PCMH: No Read, Sonia MD Provider ID: 1124 Gender: Female 5411 Grand Blvd Ste 106 New Port Richey, FL 34652 (727) 845-1652 Fax: (727) 845-1642 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No Reddy, Purushottam MD Provider ID: 9594 Gender: Male Renal Hypertension Center 14134 Nephron Ln Hudson, FL 34667 (727) 863-5418 Fax: (813) 869-8626 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Morton Plant North Bay Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Neurology Chari, Ganesh MD Provider ID: 12 Gender: Male 7543 Medical Dr Hudson, FL 34667 (727) 863-6165 Fax: (352) 686-9468 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Oak Hill Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Kiss, Alexander MD Provider ID: 1349717 Gender: Male Pasco Hernando Hma Physician Manage 6751 Gall Blvd Zephyrhills, FL 33542 (813) 602-8805 Fax: (813) 602-8833 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Shah, Rakesh MD Provider ID: 193347 Gender: Male Siddharth H Shah MD PA 4762 Rowan Rd New Port Richey, FL 34653 (727) 848-0800 Fax: (727) 843-8157 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Languages: Hindi, Gujarati M-F 8:00 AM - 5:00 PM PCMH: No

Gu, Qin MD Provider ID: 288695 Gender: Male David W Malka MD PA 2595 Tampa Rd Hudson, FL 34667 (727) 442-6463 Fax: (727) 781-7273 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Shah, Siddharth MD Morton Plant North Bay Hospital Provider ID: 11185 Languages: Chinese, Mandarin Gender: Male M-F 8:00 AM - 5:00 PM Siddharth H Shah MD PA PCMH: No 4762 Rowan Rd New Port Richey, FL 34653 Kiss, Alexander MD (727) 848-0800 Provider ID: 4553 Fax: (727) 843-8157 Gender: Male 18 Yrs/130 Yrs Bayfront Health CRMC At Bayonet Point 6751 Gall Blvd Medical Center of Trinity Morton Plant North Bay Zephyrhills, FL 33542 Hospital (813) 602-8805 Languages: Hindi 16 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM Bayfront Health Dade City PCMH: No Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No

Subramanian, Thondikulam MD Provider ID: 219838 Gender: Male David W Malka MD PA 8140 Picton Way Ste 103 New Port Richey, FL 34655 (727) 841-7993 Fax: (727) 841-7963 00 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill CRMC At Bayonet Point M-F 9:00 AM - 5:00 PM PCMH: No Umamaheswaran, Indira MD

Neurosurgery Jain, Surbhi MD Provider ID: 802251 Gender: Female Suncoast Advanced Surgery 2038 Ashley Oaks Cir Ste 102 Wesley Chapel, FL 33544 (352) 397-4505 Fax: (352) 340-5921 00 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa M 9:00 AM - 5:00 PM PCMH: No

Sincoff, Eric MD Provider ID: 1097167 Gender: Male Provider ID: 348276 David W Malka MD PA Gender: Female 5622 Marine Pkwy Ste 21 David W Malka MD New Port Richey, FL 34652 5622 Marine Pkwy (727) 841-7993 New Port Richey, FL 34652 Fax: (727) 841-7963 (727) 841-7993 00 Yrs/130 Yrs Fax: (727) 841-7963 Morton Plant North Bay 00 Yrs/130 Yrs Hospital Bayfront Health Brooksville Florida Hospital North Pinellas M-F 8:30 AM - 4:30 PM Medical Center of Trinity PCMH: No M-F 9:00 AM - 5:00 PM Sincoff, Eric MD PCMH: No Provider ID: 1097167 Umamaheswaran, Indira MD Gender: Male David W Malka MD PA 7539 Medical Dr Provider ID: 348276 Hudson, FL 34667 Gender: Female (727) 869-2115 David W Malka MD PA Fax: (727) 863-6167 7539 Medical Dr 00 Yrs/130 Yrs Hudson, FL 34667 Morton Plant North Bay (727) 869-2115 Hospital 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Bayfront Health Brooksville Florida Hospital North Pinellas PCMH: No Medical Center of Trinity Sincoff, Eric MD M-F 9:00 AM - 5:00 PM Provider ID: 1414914 PCMH: No Gender: Male Brain and Spine Neuroscience Instit 16541 Pointe Village Dr Ste 209 Lutz, FL 33558 (813) 336-4461 Fax: (813) 336-4466 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pasco Neurosurgery - cont.

Irani, Jennifer MD Provider ID: 969460 Soliman, John DO Gender: Female Provider ID: 1240926 Womens Care Florida LLC Gender: Male 2324 Cypress Cv Brain and Spine Neuroscience Wesley Chapel, FL 33544 Instit (813) 876-0914 16541 PT Village Dr Ste 209 Fax: (813) 876-9198 Lutz, FL 33558 12 Yrs/130 Yrs (844) 916-3876 Florida Hospital Tampa Fax: (813) 336-4466 M-TH 8:30 AM - 5:00 PM 18 Yrs/130 Yrs F 7:30 AM - 4:00 PM M-TH 8:00 AM - 5:00 PM PCMH: No F 8:00 AM - 3:00 PM Irani, Jennifer MD PCMH: No Provider ID: 969460 Obstetrics Gender: Female Womens Care Florida LLC Gooden, Natasha MD 3743 Maryweather Ln Wesley Chapel, FL 33544 Provider ID: 979313 (813) 973-0398 Gender: Female Fax: (813) 907-7608 Womens Care Florida LLC 12 Yrs/130 Yrs 2324 Cypress Cv Florida Hospital Tampa Wesley Chapel, FL 33544 M-TH 8:30 AM - 5:00 PM (813) 876-0914 F 7:30 AM - 4:00 PM Fax: (813) 876-9198 PCMH: No 12 Yrs/130 Yrs Jones, Galen MD Florida Hospital Tampa Provider ID: 18768 M-TH 8:30 AM - 5:00 PM Gender: Male F 7:30 AM - 4:00 PM Insignia Care For Women PCMH: No 3743 Maryweather Ln Greenberg, Steven MD Wesley Chapel, FL 33544 (813) 973-0398 Fax: (813) 907-7608 Provider ID: 18767 12 Yrs/130 Yrs Gender: Male Florida Hospital Carrollwood 2324 Cypress Cv Florida Hospital Tampa Wesley Chapel, FL 33544 M-TH 8:30 AM - 5:00 PM (813) 876-0914 F 7:30 AM - 4:00 PM Fax: (813) 876-9198 PCMH: No 12 Yrs/130 Yrs Florida Hospital Tampa Jones, Galen MD M-TH 8:30 AM - 5:00 PM Provider ID: 18768 F 7:30 AM - 4:00 PM Gender: Male PCMH: No Womens Care Florida LLC 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Miller, Tracey MD Provider ID: 984992 Gender: Female Womens Care Florida LLC 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Newton, William MD

Patel, Niraj MD Provider ID: 542049 Gender: Male Womens Care Florida LLC 3743 Maryweather Ln Wesley Chapel, FL 33544 (813) 973-0398 Fax: (813) 907-7608 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa Languages: Hindi, Gujarati M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Provider ID: 18766 Gender: Male Womens Care Florida 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Carrollwood Florida Hospital Tampa St Josephs Hospital M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Von Thron, James MD

Nolan, Christy DO Provider ID: 973534 Gender: Female Womens Care Florida 2102 Trinity Oaks Blvd Ste 171 Trinity, FL 34655 (727) 376-7734 Fax: (727) 408-5336 12 Yrs/130 Yrs Mease Countryside Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No

Von Thron, James MD

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Provider ID: 18759 Gender: Male Womens Care Florida LLC 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 971-4545 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Provider ID: 18759 Gender: Male Womens Care Florida LLC 3743 Maryweather Ln Wesley Chapel, FL 33544 (813) 973-0398 Fax: (813) 907-7608 12 Yrs/130 Yrs Florida Hospital Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Obstetrics - cont. Wilkerson, Wallace MD Provider ID: 18758 Gender: Male Womens Care Florida LLC 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No Wilkerson, Wallace MD Provider ID: 18758 Gender: Male Womens Care Florida LLC 3743 Maryweather Ln Wesley Chapel, FL 33544 (813) 973-0398 Fax: (813) 907-7608 12 Yrs/130 Yrs Florida Hospital Tampa M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM PCMH: No

Obstetrics/Gynecology Abiose, Olufunke MD Provider ID: 617667 Gender: Female Premier Community Healthcare Group 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Bardach, Reut MD Provider ID: 1169389 Gender: Female Obstetrics and Gynecology of Trinit 9332 State Rd 54 Ste 406 Trinity, FL 34655 (727) 376-3798 Fax: (727) 375-0678 00 Yrs/130 Yrs Medical Center of Trinity M-F 8:00 AM - 5:00 PM PCMH: No Cain, Mary MD Provider ID: 678053 Gender: Female USF Physicians Group 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Cain, Mary MD Provider ID: 678053 Gender: Female USF Physicians Group 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Colon Rivera, Malieri MD Provider ID: 1421876 Gender: Female Florida Woman Care LLC 2044 Trinity Oaks Blvd Ste 215 Trinity, FL 34655 (727) 376-0060 Fax: (727) 375-7308 12 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Connors, Donna MD Provider ID: 1168872 Gender: Female Premier Community Healthcare Group 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs Florida Hospital Zephyrhills M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Connors, Donna MD Provider ID: 1168872 Gender: Female Premier Community Healthcare Group 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs Florida Hospital Zephyrhills M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Efemini, Ese MD Provider ID: 1313431 Gender: Male My Gynecologist of Hudson 14751 State Rd 52 Ste A105 Hudson, FL 34669 (352) 686-8888 12 Yrs/130 Yrs M 9:00 AM - 6:30 PM TW 7:00 AM - 5:00 PM TH 7:00 AM - 3:00 PM PCMH: No

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Ferlita, John MD Provider ID: 149055 Gender: Male Fhpg East Pasco GYN 6719 Gall Blvd Ste 208 Zephyrhills, FL 33542 (813) 782-7318 Fax: (813) 788-5067 16 Yrs/130 Yrs Bayfront Health Dade City Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Gomez, Christina MD Provider ID: 1310513 Gender: Female Brooksville Hma Physician Managemen 14751 State Rd 52 A Ste 105 Hudson, FL 34669 (352) 686-8888 Fax: (352) 684-6888 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Harper, Jennifer MD Provider ID: 1238067 Gender: Female Premier Community Heatlhcare Group 2114 Seven Springs Blvd New Port Richey, FL 34655 (352) 518-2000 Fax: (352) 567-0218 18 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No Harper, Jennifer MD Provider ID: 1238067 Gender: Female Premier Community Heatlhcare Group 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 Fax: (352) 567-0218 18 Yrs/130 Yrs M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Obstetrics/Gynecology - King III, Joseph MD cont. Hoche, Nay MD Provider ID: 1202835 Gender: Male Obstetrics Gynecology of Trinity 9332 State Rd 54 Ste 406 New Port Richey, FL 34655 (727) 376-3798 Fax: (727) 375-0698 00 Yrs/130 Yrs Medical Center of Trinity M-F 8:00 AM - 5:00 PM PCMH: No Hoche, Nay MD Provider ID: 1226663 Gender: Female Obstetrics and Gycecology of Trinit 9332 State Rd 54 New Port Richey, FL 34655 (727) 376-3798 Fax: (727) 375-0698 00 Yrs/130 Yrs Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No Imudia, Anthony MD Provider ID: 789831 Gender: Male USF Physicians Group 2718 Windguard Cir Ste 101 Wesley Chapel, FL 33544 (813) 259-0692 Fax: (813) 259-0882 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 933234 Gender: Male Premier Community Healthcare Group 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 Fax: (352) 567-1974 12 Yrs/130 Yrs Languages: Spanish M 7:00 AM - 7:00 PM TWTHF 7:00 AM - 4:00 PM PCMH: No

Perez, Hugo MD Provider ID: 11031 Gender: Male Florida Woman Care LLC 8605 Easthaven Ct Ste 102 New Port Richey, FL 34655 (727) 836-9750 Fax: (727) 836-9752 12 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin Medical Center of Trinity Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Ramappa, Renuka MD Provider ID: 27161 Gender: Female Provider ID: 1073748 5321 Grand Blvd Gender: Female New Prt Rchy, FL 34652 Premier Community (727) 863-5975 Healthcare Group Fax: (727) 849-4076 2114 Seven Springs Blvd 12 Yrs/130 Yrs New Port Richey, FL 34655 Medical Center of Trinity (352) 518-2000 Morton Plant North Bay Fax: (352) 567-0218 Hospital 12 Yrs/130 Yrs Languages: Hindi Florida Hospital North Pinellas M 1:00 AM - 4:00 PM Languages: Spanish TW 9:00 AM - 4:30 PM M 7:00 AM - 7:00 PM PCMH: No TWTHF 7:00 AM - 4:00 PM PCMH: No Sampson, Marian MD

Marsh Dinham, Keddie MD

Marsh Dinham, Keddie MD

Provider ID: 1074567 Gender: Female Fhz East Pasco Womens Care 7050 Gall Blvd Zephyrhills, FL 33541 (813) 779-2900 Fax: (813) 773-2901 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1073748 Gender: Female Premier Community Healthcare Group 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 Fax: (352) 567-0218 12 Yrs/130 Yrs Florida Hospital North Pinellas Shelden, Sarah DO Languages: Spanish Provider ID: 1142168 MTH 7:00 AM - 7:00 PM Gender: Female TWF 7:00 AM - 4:00 PM Women's Care Florida LLC PCMH: No 2102 Trinity Oaks Blvd Ste 171 New Port Richey, FL 34655 (727) 376-7734 Fax: (727) 408-5336 12 Yrs/130 Yrs Mease Countryside Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Smith, Robert MD Provider ID: 16356 Gender: Male Womens Care Center of Pasco PA 9332 State Rd 54 Ste 202 Trinity, FL 34655 (727) 849-1659 Fax: (727) 842-3627 00 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital M-F 8:00 AM - 5:00 PM PCMH: No Torres, Wanda MD Provider ID: 643377 Gender: Female 2044 Trinity Oaks Blvd Ste 215 New Port Richey, FL 34655 (727) 376-0060 Fax: (727) 375-7308 00 Yrs/130 Yrs Mease Countryside Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Umstead, Thomas MD Provider ID: 8878 Gender: Male 1812 Health Care Dr New Prt Rchy, FL 34655 (727) 376-2229 Fax: (727) 376-5456 00 Yrs/130 Yrs Florida Hospital North Pinellas Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Weiss, Michael MD Provider ID: 1366842 Gender: Male Fhz Dade City Primary Care 37740 Meridian Ave Dade City, FL 33525 (352) 437-5970 Fax: (352) 437-5998 12 Yrs/130 Yrs Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Obstetrics/Gynecology - Hamilton, Richard MD cont. Provider ID: TPV1568412823-0 Weiss, Michael MD Provider ID: 1366842 Gender: Male Fhz East Pasco Womens Care 7050 Gall Blvd Zephyrhills, FL 33541 (813) 782-8761 Fax: (813) 783-6038 12 Yrs/130 Yrs Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No Weiss, Michael MD Provider ID: 283624 Gender: Male Womens Health of Pasco 7860 Gall Blvd Zephyrhills, FL 33541 (813) 788-7669 Fax: (352) 567-6391 05 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ophthalmology Berger, Adam MD Provider ID: TPV1972574408-0 Gender: Male Vitreous and Retina Consultants 6719 Gall Blvd Ste 206 Zephyrhills, FL 33540 (863) 297-5400 Fax: (863) 293-9780 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Male Vitreous and Retina Consultants 6719 Gall Blvd Ste 206 Zephyrhills, FL 33540 (863) 297-5400 Fax: (863) 293-9780 18 Yrs/99 Yrs South Lake Hospital Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Handza, Jason DO Provider ID: TPV1083603146-0 Gender: Male Gulf Coast Retina Specialists PLLC 10730 US Hwy 19 Ste 7 Port Richey, FL 34668 (727) 862-3090 Fax: (727) 862-3023 18 Yrs/99 Yrs Largo Medical Center PCMH: No Hauber, Frederick MD Provider ID: TPV1881654101-0 Gender: Male F A Hauber MD PA 5347 Main St Ste 100 New Port Richey, FL 34652 (727) 847-4448 Fax: (727) 845-1572 10 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Misch, David MD Provider ID: TPV1992775571-0 Gender: Male Vitreous and Retina Consultants 6719 Gall Blvd Ste 206 Zephyrhills, FL 33540 (863) 297-5400 Fax: (863) 293-9780 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Moinfar, Nader MD Perich, Larry DO Provider ID: TPV1740206028-0 Provider ID: TPV1891724019-0 Gender: Male Gender: Male Florida Retina Consultants Larry M Perich DO PA 35788 SR 54 Ste 102 6905 Medical View Ln Zephyrhills, FL 33541 Zephyrhills, FL 33542 (877) 245-2020 (813) 788-2020 Fax: (863) 802-4587 Fax: (813) 788-2044 18 Yrs/99 Yrs 07 Yrs/99 Yrs Winter Haven Hospital Languages: Spanish Languages: French MTH 8:00 AM - 7:00 PM M-F 8:00 AM - 5:00 PM TW 8:00 AM - 5:00 PM PCMH: No F 8:00 AM - 5:30 PM Sat 9:00 AM - 12:00 PM Montzka, Dan MD PCMH: No Provider ID: TPV1841290293-0 Plous, Oren MD Gender: Male Gulf Coast Retina Center Provider ID: TPV1467422659-1 10730 US Hwy 19 Ste 7 Gender: Male Port Richey, FL 34668 Tampa Bay Retina PA (727) 862-3090 7631 Gall Blvd Fax: (727) 862-3023 Zephyrhills, FL 33541 06 Yrs/99 Yrs (941) 312-2769 Mease Countryside Hospital Fax: (866) 426-2169 Mease Dunedin Hospital 12 Yrs/99 Yrs M 8:00 AM - 5:00 PM Mease Countryside Hospital T 8:00 AM - 12:30 PM Morton Plant Hospital Winter Haven Hospital PCMH: No M 1:00 AM - 5:00 PM Moon, Suk MD PCMH: No Provider ID: TPV1477524130-0 Randolph, John MD Gender: Male Provider ID: TPV1164621330-0 Vitreous and Retina Consultants Gender: Male 6719 Gall Blvd Ste 206 Vitreous and Retina Consultants Zephyrhills, FL 33540 6719 Gall Blvd Ste 206 (863) 297-5400 Zephyrhills, FL 33540 Fax: (863) 293-9780 (863) 297-5400 18 Yrs/99 Yrs Fax: (863) 293-9780 Winter Haven Hospital 06 Yrs/99 Yrs Languages: Korean Languages: Korean M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Perich, Larry DO Provider ID: TPV1891724019-0 Gender: Male Larry M Perich DO PA 2020 Seven Springs Blvd New Port Richey, FL 34655 (727) 372-1311 Fax: (727) 372-1972 07 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 336

Last update 08/14/2017

Specialty Physicians Pasco Ophthalmology - cont. Rowan, Carey MD Provider ID: TPV1114981875-0 Gender: Male Rowan Eye Center Inc 5305 Grand Blvd New Port Richey, FL 34652 (727) 847-0889 Fax: (727) 846-8458 18 Yrs/99 Yrs Languages: Spanish M 8:30 AM - 4:00 PM TWTHF 8:00 AM - 4:00 PM PCMH: No Sanchez, Juan MD Provider ID: TPV1568493369-0 Gender: Male Juan Sanchez MD PA 5340 Gulf Dr Ste 101 New Port Richey, FL 34652 (727) 847-1111 Fax: (727) 849-3937 05 Yrs/99 Yrs Medical Center of Trinity Oak Hill Hospital Regional Medical Center Bayonet Point Languages: Spanish M-W 8:00 AM - 5:00 PM PCMH: No

Shah, Geeta MD Provider ID: TPV1568487205-0 Gender: Female Larry M Perich DO PA 6905 Medical View Ln Zephyrhills, FL 33542 (813) 788-2020 Fax: (813) 788-2044 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish MTH 8:00 AM - 7:00 PM TW 8:00 AM - 5:00 PM F 8:00 AM - 5:30 PM Sat 9:00 AM - 12:00 PM PCMH: No Tarabishy, Ahmad MD Provider ID: TPV1770629933-0 Gender: Male Seashore Retina LLC 26851 Tanic Dr Ste 102 Wesley Chapel, FL 33544 (813) 973-3333 Fax: (813) 973-3888 18 Yrs/99 Yrs Florida Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Optician

Optometry

Eye Doctors Optical Outlets PA Provider ID: TPV1114461746-0 6844 Gall Blvd Zephyrhills, FL 33542 (813) 603-3479 Fax: (813) 333-7990 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Anderson, Clinton OD Provider ID: TPV1326034349-1 Gender: Male Lutz Anderson Inc 29154 Chapel Park Dr Wesley Chapel, FL 33543 (813) 949-7274 Fax: (813) 994-1457 05 Yrs/99 Yrs M 9:30 AM - 7:00 PM TW 9:30 AM - 6:00 PM TH 8:30 AM - 4:00 PM PCMH: No

Eye Doctors Optical Outlets PA Provider ID: TPV1447441787-0 9409 US Hwy 19 Ste 443 Port Richey, FL 34668 (727) 848-2978 Fax: (727) 213-9018 00 Yrs/99 Yrs MTWTHFSat 10:00 AM - 7:00 PM PCMH: No

Argiropoulos-Dhima, Margaret OD Provider ID: TPV1730141581-0 Gender: Female Margaret A Dhima PA 9644 Scenic Dr Port Richey, FL 34668 (727) 845-0082 Fax: (727) 847-3525 04 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 5:00 PM Sun 12:00 AM - 4:00 PM PCMH: No

Optimart Inc Provider ID: TPV1124235049-0 10041 A US Hwy 19 N Port Richey, FL 34668 (727) 868-0780 Fax: (727) 868-0819 Urban, Jr, Robert MD Barrido, Kevin OD Provider ID: TPV1669440947-0 00 Yrs/99 Yrs Provider ID: TPV1205895604-0 Shah, Geeta MD M-F 9:00 AM - 5:00 PM Gender: Male Gender: Male Provider ID: TPV1568487205-0 Robert C Urban Jr MD LLC PCMH: No Larry M Perich DO PA Gender: Female 4439 Rowan Rd 2020 Seven Springs Blvd Optimart Inc Larry M Perich DO PA New Port Richey, FL 34653 New Port Richey, FL 34655 Provider ID: TPV1609083484-0 (727) 372-1311 2020 Seven Springs Blvd (727) 807-7090 7400 Gall Blvd New Port Richey, FL 34655 Fax: (727) 807-7076 Fax: (727) 372-1972 Zephyrhills, FL 33541 (727) 372-1311 18 Yrs/99 Yrs 01 Yrs/99 Yrs (813) 782-4546 Fax: (727) 372-1972 Bayfront Medical Center Languages: Spanish Fax: (813) 782-1902 05 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs No Hospital PrivilegesM-F 8:30 AM - 5:00 PM PCMH: No Covering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No Languages: Spanish PCMH: No Barrido, Kevin OD M-F 8:00 AM - 5:00 PM Provider ID: TPV1205895604-0 Visionworks Inc PCMH: No Gender: Male Provider ID: TPV1104103274-0 Larry M Perich DO PA 9644 Scenic Dr 2020 Seven Springs Blvd Port Richey, FL 34668 New Port Richey, FL 34655 (727) 848-3018 (727) 372-1311 Fax: (727) 847-3463 Fax: (727) 372-1972 00 Yrs/99 Yrs 01 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pasco Optometry - cont.

Day, Paul OD Ferris, Anthony OD Provider ID: TPV1265634224-0 Provider ID: TPV1457547366-1 Beiler, Mark OD Gender: Male Gender: Male Provider ID: TPV1205858115-0 Vision Specialty Associates PA Eye Doctors Optical Outlets PA Gender: Male 10041 A US Hwy 19 N 9409 US Hwy 19 Ste 443 Eye Doctors Optical Outlets Port Richey, FL 34668 PA Port Richey, FL 34668 (727) 868-0780 9409 US Hwy 19 Ste 443 (727) 848-2978 Fax: (727) 857-4365 Port Richey, FL 34668 Fax: (727) 213-9018 05 Yrs/99 Yrs (727) 848-2978 04 Yrs/99 Yrs Languages: Spanish Fax: (727) 213-9018 Languages: Vietnamese M-F 9:00 AM - 5:00 PM 12 Yrs/99 Yrs MTWTHFSat 10:00 AM - 7:00 Sat 9:00 AM - 2:00 PM PM Languages: Vietnamese PCMH: No PCMH: No MTWTHFSat 10:00 AM - 7:00 PM Day, Paul OD PCMH: No Provider ID: TPV1265634224-1 Ferris, Anthony OD Provider ID: TPV1457547366-1 Gender: Male Causey, Michael OD Vision Specialty Associates PA Gender: Male Provider ID: TPV1033103999-0 Eye Doctors Optical Outlets 7400 Gall Blvd PA Gender: Male Zephyrhills, FL 33541 6844 Gall Blvd Michael J Causey OD PA (813) 782-4546 Zephyrhills, FL 33542 9948 Grove Dr Fax: (813) 702-4054 (813) 603-3479 New Port Richey, FL 34654 05 Yrs/99 Yrs Fax: (813) 333-7990 (727) 868-9898 M-F 8:00 AM - 5:00 PM 04 Yrs/99 Yrs Fax: (727) 862-4436 PCMH: No M-F 9:00 AM - 6:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 3:00 PM M-F 9:00 AM - 6:00 PM Demarco, Leo OD PCMH: No PCMH: No Provider ID: TPV1477608156-0 Gender: Male Clough, Scott OD Eye Doctors Optical Outlets Furman, Adam OD Provider ID: TPV1336541465-0 Provider ID: TPV1326042375-0 PA Gender: Male Gender: Male 9409 US Hwy 19 Ste 443 Vision Specialty Associates PA Vision Specialty Associates PA Port Richey, FL 34668 10041 A US Hwy 19 N 10041 A US Hwy 19 N (727) 848-2978 Port Richey, FL 34668 Port Richey, FL 34668 Fax: (727) 213-9018 (727) 868-0780 (727) 868-0780 05 Yrs/99 Yrs Fax: (727) 857-4365 Fax: (727) 857-4365 Languages: Vietnamese 06 Yrs/99 Yrs 06 Yrs/99 Yrs MTWTHFSat 10:00 AM - 7:00 Languages: Spanish Languages: Spanish PM M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No Sat 9:00 AM - 2:00 PM Sat 9:00 AM - 2:00 PM Demarco, Leo OD PCMH: No PCMH: No Provider ID: TPV1477608156-0 Furman, Adam OD Clough, Scott OD Gender: Male Provider ID: TPV1326042375-1 Dr Leo Jonathan Demarco OD Provider ID: TPV1336541465-0 Gender: Male Gender: Male 4126 US Hwy 19 N Vision Specialty Associates PA Vision Specialty Associates PA New Port Richey, FL 34652 7400 Gall Blvd 7400 Gall Blvd (727) 846-0823 Zephyrhills, FL 33541 Zephyrhills, FL 33541 Fax: (727) 842-2010 (813) 782-4546 (813) 782-4546 05 Yrs/99 Yrs Fax: (813) 702-4054 Fax: (813) 702-4054 MT 9:00 AM - 3:00 PM 06 Yrs/99 Yrs 06 Yrs/99 Yrs PCMH: No M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Havens, Alicia OD Provider ID: TPV1437566155-0 Gender: Female Rowan Eye Center Inc 5305 Grand Blvd New Port Richey, FL 34652 (727) 847-0889 Fax: (727) 846-8458 09 Yrs/99 Yrs Languages: Spanish M 8:30 AM - 4:00 PM TWTHF 8:00 AM - 4:00 PM PCMH: No Hernandez, Madeline OD Provider ID: TPV1710907944-0 Gender: Female Vision Specialty Associates PA 10041 A US Hwy 19 N Port Richey, FL 34668 (727) 868-0780 Fax: (727) 857-4365 07 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Hernandez, Madeline OD Provider ID: TPV1710907944-1 Gender: Female Vision Specialty Associates PA 7400 Gall Blvd Zephyrhills, FL 33541 (813) 782-4546 Fax: (813) 702-4054 07 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Hernandez, Madeline OD Provider ID: TPV1710907944-2 Gender: Female Eye Doctors Optical Outlets PA 9409 US Hwy 19 Ste 443 Port Richey, FL 34668 (727) 848-2978 Fax: (727) 213-9018 07 Yrs/99 Yrs Languages: Vietnamese MTWTHFSat 10:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Optometry - cont.

Honeyblue, Shamika OD Jones, Douglas OD Provider ID: TPV1538317219-1 Provider ID: TPV1063587327-0 Herriott, Michael OD Gender: Female Gender: Male Provider ID: TPV1942588926-0 Vision Specialty Associates PA Vision Specialty Associates PA Gender: Male 7400 Gall Blvd 7400 Gall Blvd Eye Doctors Optical Outlets Zephyrhills, FL 33541 Zephyrhills, FL 33541 PA (813) 782-4546 (813) 782-4546 6844 Gall Blvd Fax: (813) 702-4054 Fax: (813) 702-4054 Zephyrhills, FL 33542 07 Yrs/99 Yrs 05 Yrs/99 Yrs (813) 603-3479 M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Fax: (813) 333-7990 PCMH: No PCMH: No 05 Yrs/99 Yrs Huggett, Edward OD Kudryk, John OD M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM Provider ID: 214090 Provider ID: TPV1376500975-0 PCMH: No Gender: Male Gender: Male 14003 Lakeshore Blvd Larry M Perich DO PA Hetherington, Mark OD Hudson, FL 34667 2020 Seven Springs Blvd Provider ID: TPV1437258944-0 (813) 868-9442 New Port Richey, FL 34655 Gender: Male Fax: (727) 862-6210 (727) 372-1311 Vision Specialty Associates PA 00 Yrs/130 Yrs Fax: (727) 372-1972 10041 A US Hwy 19 N PCMH: No 05 Yrs/99 Yrs Port Richey, FL 34668 Languages: Spanish Huggett, Edward OD (727) 868-0780 M-F 8:00 AM - 5:00 PM Fax: (727) 857-4365 Provider ID: TPV1760415905-0 PCMH: No 07 Yrs/99 Yrs Gender: Male Kudryk, John OD Languages: Spanish Seashore Retina LLC M-F 9:00 AM - 5:00 PM 26851 Tanic Dr Ste 102 Provider ID: TPV1376500975-0 Sat 9:00 AM - 2:00 PM Wesley Chapel, FL 33544 Gender: Male PCMH: No (813) 973-3333 Larry M Perich DO PA Fax: (813) 973-3888 6905 Medical View Ln Hetherington, Mark OD 18 Yrs/99 Yrs Zephyrhills, FL 33542 Provider ID: TPV1437258944-0 M-F 8:00 AM - 5:00 PM (813) 788-2020 Gender: Male PCMH: No Fax: (813) 788-2044 Vision Specialty Associates PA 05 Yrs/99 Yrs Jones, Douglas OD 7400 Gall Blvd Languages: Spanish Zephyrhills, FL 33541 Provider ID: TPV1063587327-0 MTH 8:00 AM - 7:00 PM (813) 782-4546 Gender: Male TW 8:00 AM - 5:00 PM Fax: (813) 702-4054 Vision Specialty Associates PA F 8:00 AM - 5:30 PM 07 Yrs/99 Yrs 10041 A US Hwy 19 N Sat 9:00 AM - 12:00 PM M-F 8:00 AM - 5:00 PM Port Richey, FL 34668 PCMH: No PCMH: No (727) 868-0780 Lappano, Alfred OD Fax: (727) 857-4365 Honeyblue, Shamika OD 05 Yrs/99 Yrs Provider ID: TPV1194727669-0 Provider ID: TPV1538317219-0 Languages: Spanish Gender: Male Gender: Female M-F 9:00 AM - 5:00 PM Vision Specialty Associates PA Vision Specialty Associates PA Sat 9:00 AM - 2:00 PM 10041 A US Hwy 19 N 10041 A US Hwy 19 N PCMH: No Port Richey, FL 34668 Port Richey, FL 34668 (727) 868-0780 (727) 868-0780 Fax: (727) 857-4365 Fax: (727) 857-4365 05 Yrs/99 Yrs 07 Yrs/99 Yrs Languages: Spanish Languages: Spanish M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No

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Lappano, Alfred OD Provider ID: TPV1194727669-1 Gender: Male Vision Specialty Associates PA 7400 Gall Blvd Zephyrhills, FL 33541 (813) 782-4546 Fax: (813) 702-4054 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lewenson, Robert OD Provider ID: TPV1235181769-1 Gender: Male Eye Doctors Optical Outlets PA 6844 Gall Blvd Zephyrhills, FL 33542 (813) 603-3479 Fax: (813) 333-7990 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Linsey, Dennis OD Provider ID: TPV1861460784-0 Gender: Male Parsons Eye Associates PA 8936 US Hwy 19 Port Richey, FL 34668 (727) 844-3400 Fax: (727) 848-6641 05 Yrs/99 Yrs MTH 8:00 AM - 8:00 PM TW 8:00 AM - 6:00 PM F 8:00 AM - 12:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Meer, Henry OD Provider ID: TPV1255449732-0 Gender: Male Eye Doctors Optical Outlets PA 9409 US Hwy 19 Ste 443 Port Richey, FL 34668 (727) 848-2978 Fax: (727) 213-9018 05 Yrs/99 Yrs Languages: Vietnamese MTWTHFSat 10:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Optometry - cont.

Miller, Matthew OD Provider ID: TPV1669603130-0 Merlino, Brian OD Gender: Male Provider ID: TPV1841418555-0 Larry M Perich DO PA Gender: Male 6905 Medical View Ln Vision Specialty Associates PA Zephyrhills, FL 33542 10041 A US Hwy 19 N (813) 788-2020 Port Richey, FL 34668 Fax: (813) 788-2044 (727) 868-0780 05 Yrs/99 Yrs Fax: (727) 857-4365 Languages: Spanish 05 Yrs/99 Yrs MTH 8:00 AM - 7:00 PM Languages: Spanish TW 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM F 8:00 AM - 5:30 PM Sat 9:00 AM - 2:00 PM Sat 9:00 AM - 12:00 PM PCMH: No PCMH: No Merlino, Brian OD Miller, Matthew OD Provider ID: TPV1841418555-1 Provider ID: TPV1669603130-0 Gender: Male Gender: Male Vision Specialty Associates PA Larry M Perich DO PA 7400 Gall Blvd 2621 Windguard Cir Zephyrhills, FL 33541 Wesley Chapel, FL 33544 (813) 782-4546 (727) 860-8060 Fax: (813) 702-4054 Fax: (727) 372-7866 05 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 4:00 PM PCMH: No PCMH: No Miller, Matthew OD Provider ID: TPV1669603130-0 Gender: Male Larry M Perich DO PA 2020 Seven Springs Blvd New Port Richey, FL 34655 (727) 372-1311 Fax: (727) 372-1972 05 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Miller, Matthew OD Provider ID: TPV1669603130-0 Gender: Male Larry M Perich DO PA 6905 Medical View Ln Zephyrhills, FL 33542 (813) 788-2020 Fax: (813) 788-2044 05 Yrs/99 Yrs Languages: Spanish MTH 8:00 AM - 7:00 PM TW 8:00 AM - 5:00 PM F 8:00 AM - 5:30 PM Sat 9:00 AM - 12:00 PM PCMH: No

Parsons, Brent OD Provider ID: TPV1275501199-0 Gender: Male Parsons Eye Associates PA 8936 US Hwy 19 Port Richey, FL 34668 (727) 844-3400 Fax: (727) 848-6641 05 Yrs/99 Yrs MTH 8:00 AM - 8:00 PM TW 8:00 AM - 6:00 PM F 8:00 AM - 12:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Parsons, Nicole OD Provider ID: TPV1053388215-0 Gender: Female Parsons Eye Associates PA 8936 US Hwy 19 Port Richey, FL 34668 (727) 844-3400 Fax: (727) 848-6641 05 Yrs/99 Yrs MTH 8:00 AM - 8:00 PM TW 8:00 AM - 6:00 PM F 8:00 AM - 12:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Murphy, Kenneth OD Provider ID: TPV1700870854-0 Passaro, Jr, Vincent OD Gender: Male Margaret A Dhima PA Provider ID: TPV1750425948-0 9644 Scenic Dr Gender: Male Port Richey, FL 34668 Passaro Eyecare (727) 845-0082 6847 State Rd 54 Fax: (727) 847-3525 New Port Richey, FL 34653 18 Yrs/99 Yrs (727) 848-2020 M-F 9:00 AM - 6:00 PM Fax: (727) 847-3937 Sat 9:00 AM - 5:00 PM 05 Yrs/99 Yrs Sun 12:00 AM - 4:00 PM Languages: Spanish PCMH: No MTTH 9:00 AM - 5:00 PM W 9:00 AM - 6:00 PM Ocasio, John OD F 1:00 AM - 5:00 PM Provider ID: TPV1679534911-0 PCMH: No Gender: Male Eye Doctors Optical Outlets Passaro, Jr, Vincent OD PA Provider ID: TPV1750425948-0 6844 Gall Blvd Gender: Male Zephyrhills, FL 33542 Passaro Eyecare (813) 603-3479 13712 Little Rd Fax: (813) 333-7990 Hudson, FL 34667 05 Yrs/99 Yrs (727) 848-2020 M-F 9:00 AM - 6:00 PM Fax: (727) 847-3937 Sat 9:00 AM - 3:00 PM 05 Yrs/99 Yrs PCMH: No M 12:00 AM - 5:00 PM T 10:00 AM - 1:00 PM PCMH: No

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Payne, Tessa OD Provider ID: TPV1518198027-0 Gender: Female Larry M Perich DO PA 2020 Seven Springs Blvd New Port Richey, FL 34655 (727) 372-1311 Fax: (727) 372-1972 01 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Payne, Tessa OD Provider ID: TPV1518198027-0 Gender: Female Larry M Perich DO PA 6905 Medical View Ln Zephyrhills, FL 33542 (813) 788-2020 Fax: (813) 788-2044 01 Yrs/99 Yrs Languages: Spanish MTH 8:00 AM - 7:00 PM TW 8:00 AM - 5:00 PM F 8:00 AM - 5:30 PM Sat 9:00 AM - 12:00 PM PCMH: No Payne, Tessa OD Provider ID: TPV1518198027-0 Gender: Female Larry M Perich DO PA 2621 Windguard Cir Wesley Chapel, FL 33544 (727) 860-8060 Fax: (727) 372-7866 01 Yrs/99 Yrs M-F 8:00 AM - 4:00 PM PCMH: No Ramsay, William OD Provider ID: TPV1821093873-0 Gender: Male Larry M Perich DO PA 2621 Windguard Cir Wesley Chapel, FL 33544 (727) 860-8060 Fax: (727) 372-7866 05 Yrs/99 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Optometry - cont.

Scamard, David OD Tran-Lockwood, Julie OD Provider ID: TPV1790900694-0 Provider ID: TPV1639377104-0 Ruckman, Carli OD Gender: Male Gender: Female Provider ID: TPV1891075578-0 Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA Gender: Female 6844 Gall Blvd 9409 US Hwy 19 Ste 443 Margaret A Dhima PA Zephyrhills, FL 33542 Port Richey, FL 34668 9644 Scenic Dr (813) 603-3479 (727) 848-2978 Port Richey, FL 34668 Fax: (813) 333-7990 Fax: (727) 213-9018 (727) 845-0082 05 Yrs/99 Yrs 05 Yrs/99 Yrs Fax: (727) 847-3525 M-F 9:00 AM - 6:00 PM Languages: Vietnamese 04 Yrs/99 Yrs Sat 9:00 AM - 3:00 PM MTWTHFSat 10:00 AM - 7:00 M-F 9:00 AM - 6:00 PM PM PCMH: No Sat 9:00 AM - 5:00 PM PCMH: No Sun 12:00 AM - 4:00 PM Shah, Shital OD PCMH: No Provider ID: TPV1124409222-0 Williams, John OD Provider ID: TPV1205977295-0 Saint Jean, Caleb OD Gender: Female Gender: Male Provider ID: TPV1942650924-0 Lutz Anderson Inc Rowan Eye Center Inc 29154 Chapel Park Dr Gender: Male 5305 Grand Blvd Wesley Chapel, FL 33543 Vision Specialty Associates PA New Port Richey, FL 34652 (813) 949-7274 7400 Gall Blvd (727) 847-0889 Fax: (813) 994-1457 Zephyrhills, FL 33541 Fax: (727) 846-8458 05 Yrs/99 Yrs (813) 782-4546 05 Yrs/99 Yrs M 9:30 AM 7:00 PM Fax: (813) 702-4054 Languages: Spanish TW 9:30 AM - 6:00 PM 03 Yrs/99 Yrs M 8:30 AM - 4:00 PM TH 8:30 AM - 4:00 PM M-F 8:00 AM - 5:00 PM TWTHF 8:00 AM - 4:00 PM PCMH: No PCMH: No PCMH: No Smith, Kevin OD Saint Jean, Caleb OD Oral & Maxillofacial Provider ID: TPV1518945179-0 Provider ID: TPV1942650924-1 Surgery Gender: Male Gender: Male Vision Specialty Associates PA Dr Kevin L Smith OD and Associates Inc Chuong, Robert DMD 10041 A US Hwy 19 N 5420 Land O Lakes Blvd Provider ID: 17804 Port Richey, FL 34668 Land O Lakes, FL 34639 Gender: Male (727) 868-0780 (813) 803-4515 8804 Hawbuck St Fax: (727) 857-4365 Fax: (813) 803-4313 Trinity, FL 34655 03 Yrs/99 Yrs 05 Yrs/99 Yrs (727) 894-1442 Languages: Spanish M-F 9:00 AM - 6:00 PM Fax: (727) 823-0466 M-F 9:00 AM - 5:00 PM PCMH: No 00 Yrs/130 Yrs Sat 9:00 AM - 2:00 PM Bayfront Medical Center PCMH: No Sterling, Peggy OD M 8:00 AM - 4:00 PM Provider ID: TPV1427105410-0 Saint Jean, Caleb OD PCMH: No Gender: Female Provider ID: TPV1942650924-1 Peggy J Sterling OD Gender: Male 29154 Chapel Park Dr Eye Doctors Optical Outlets Wesley Chapel, FL 33543 PA (813) 996-2020 6844 Gall Blvd Fax: (813) 994-1457 Zephyrhills, FL 33542 05 Yrs/99 Yrs (813) 603-3479 MT 9:00 AM - 5:00 PM Fax: (813) 333-7990 WTH 12:00 AM - 8:00 PM 03 Yrs/99 Yrs F 9:00 AM - 4:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 341

Orthopaedic Surgery Higgins, Michael DO Provider ID: 275969 Gender: Male Hernando Orthopedic Spinal Surger 13020 Fort King Rd Ste 102 Dade City, FL 33525 (352) 688-6035 Fax: (352) 688-6219 05 Yrs/130 Yrs All Saints Surgery Center Bayfront Health Brooksville Bayfront Health Spring Hill Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Knight, Randolph MD Provider ID: 188914 Gender: Male 38022 Medical Center Ave Zephyrhills, FL 33540 (813) 782-5543 Fax: (813) 788-9342 00 Yrs/130 Yrs Florida Hospital Zephyrhills Memorial Hospital of Tampa Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Pain Management De LA Garza, Miguel MD Provider ID: 361281 Gender: Male Comprehensive Pain Mgmt 5413 George St New Port Richey, FL 34652 (727) 846-7618 Fax: (727) 697-0646 18 Yrs/130 Yrs Tampa Bay Surgery Center Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Pediatric Cardiology Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 4443 Rowan Rd New Port Richey, FL 34653 (727) 846-9990 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Crawford, Marguerite MD Provider ID: 314170 Gender: Female 4443 Rowan Rd New Port Richey, FL 34653 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Hardin, Joel MD Provider ID: 1311775 Gender: Male Ppediatrix Medical Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No Huhta, James MD Provider ID: 225655 Gender: Male Pediatric Cardiology Associates 4443 Rowan Rd New Prt Rchy, FL 34653 (727) 892-4200 Fax: (727) 502-8047 00 Yrs/19 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (813) 973-1978 Fax: (727) 821-2461 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatric Cardiology Associates 4443 Rowan Rd New Prt Rchy, FL 34653 (727) 892-4200 Fax: (727) 502-8047 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatric Cardiology Associates 4443 Rowan Rd New Prt Rchy, FL 34653 (727) 322-4830 Fax: (727) 502-8047 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Stapleton, Gary MD Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 4443 Rowan Rd New Port Richey, FL 34653 (727) 767-3333 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Ear, Nose & Throat Cressman, Wade MD Provider ID: 8265 Gender: Male Pediatric Otolaryngology 14111 State Rd 54 Odessa, FL 33556 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Trowbridge, Rose MD Provider ID: 912630 Gender: Female Pediatric Otolaryngology Head and N 14111 State Rd 54 Odessa, FL 33556 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Gastroenterology McClenathan, Daniel MD Provider ID: 1347 Gender: Male 5640 Main St New Prt Rchy, FL 34652 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 342

Wilsey Jr, Michael MD Provider ID: 200955 Gender: Male 5640 Main St New Prt Rchy, FL 34652 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Infectious Disease Gellady, Andrew MD Provider ID: 27122 Gender: Male 4738 Grand Blvd Ste C New Port Richey, FL 34652 (727) 807-7800 Fax: (727) 807-7878 00 Yrs/18 Yrs Medical Center of Trinity M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Orthopaedics Benfanti, Paul MD Provider ID: 587667 Gender: Male Childrens Orthopaedic and Scoliosis 4443 Rowan Rd New Port Richey, FL 34653 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish MT 1:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Pediatric Orthopaedics cont. Warnick, Drew MD Provider ID: 557201 Gender: Male Childrens Orthopaedic and Scoliosis 4443 Rowan Rd New Port Richey, FL 34653 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Urology Kolligian, Mark MD Provider ID: 164682 Gender: Male New Port Richey At All Childrens S 4443 Rowan Rd New Port Richey, FL 34653 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Polsky, Ethan MD Provider ID: 341141 Gender: Male New Port Richey At All Childrens S 4443 Rowan Rd New Port Richey, FL 34653 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Pedodontics Bezerra, Francisco DDS Provider ID: TPVP15242-01 Gender: Male Francisco H Bezerra DDS PA 2242 Ashley Oaks Cir Wesley Chapel, FL 33544 (813) 991-5300 Fax: (888) 520-4252 00 Yrs/99 Yrs Languages: Portuguese M-F 8:00 AM - 5:00 PM PCMH: No Bezerra, Francisco DDS Provider ID: TPVP15242-03 Gender: Male Dr Bee Pediatric Dentistry 6935 Land O Lakes Blvd Land O Lakes, FL 34638 (813) 530-3300 Fax: (855) 820-1235 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cobbe, Michael DDS Provider ID: TPVP43801-04 Gender: Male Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Jafarnia, Bahareh DDS Provider ID: TPVP45042-04 Gender: Female Great Expressions Dental Centers 1748 Bruce B Downs Blvd Ste 125 Wesley Chapel, FL 33543 (813) 907-1151 Fax: (813) 973-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-02 Gender: Female Provider ID: TPVP119979-01 Great Expressions Dental Gender: Male No Sugar Bugs Club Childrens Centers 1748 Bruce B Downs Blvd Ste Dentistry 125 8804 Hawbuck St Wesley Chapel, FL 33543 Trinity, FL 34655 (813) 907-1151 (727) 478-3210 Fax: (813) 973-1728 Fax: (727) 255-5402 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM F 8:00 AM - 1:00 PM PCMH: No PCMH: No

Chuong, Christopher DDS

Cobbe, Michael DDS Provider ID: TPVP43801-02 Gender: Male Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Naoom, Jennifer DDS Provider ID: TPVP102299-05 Gender: Female Great Expressions Dental Centers 7950 Gall Blvd Zephyrhills, FL 33541 (813) 715-1271 Fax: (813) 715-1402 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Nensey, Zara DDS Provider ID: TPVP157378-01 Gender: Female Francisco H Bezerra DDS PA 2242 Ashley Oaks Cir Wesley Chapel, FL 33544 (813) 991-5300 Fax: (888) 520-4252 00 Yrs/99 Yrs Languages: Spanish, Portuguese M-F 8:00 AM - 5:00 PM PCMH: No Nensey, Zara DDS Provider ID: TPVP157378-02 Gender: Female Dr Bee Pediatric Dentistry 6935 Land O Lakes Blvd Land O Lakes, FL 34638 (813) 530-3300 Fax: (855) 820-1235 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Poustchi-Amin, Farah DDS Provider ID: TPVP43789-02 Gender: Female Cobbe Dental 5120 US Hwy 19 North New Port Richey, FL 34652 (727) 847-3113 Fax: (727) 847-2904 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Poustchi-Amin, Farah DDS Provider ID: TPVP43789-04 Gender: Female Cobbe Dental 6606 Forest Ave New Port Richey, FL 34653 (727) 849-2454 Fax: (727) 847-2386 00 Yrs/99 Yrs M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Pedodontics - cont. Rosen, David DMD Provider ID: TPVP102277-03 Gender: Male Great Expressions Dental Centers 1748 Bruce B Downs Blvd Ste 125 Wesley Chapel, FL 33543 (813) 907-1151 Fax: (813) 973-1728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Theogene, Dorothy DDS Provider ID: TPVP134951-18 Gender: Female Smile Design Port Richey 10806 US Hwy 19 Ste 101 Port Richey, FL 34668 (727) 863-2497 Fax: (727) 862-7862 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Theogene, Dorothy DDS Provider ID: TPVP134951-22 Gender: Female Smile Design New Port Richey 4104 Little Rd New Port Richey, FL 34655 (727) 376-2666 Fax: (888) 582-0179 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Physical Medicine & Rehabilitation Epting, Stephanie DO Provider ID: 1227938 Gender: Female Advanced Pain Management, Inc. 38011 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 395-5127 Fax: (813) 355-3085 00 Yrs/130 Yrs Languages: French, Creole M-F 9:00 AM - 5:00 PM PCMH: No Jassal, Navdeep MD Provider ID: 1136254 Gender: Male Advanced Pain Management Inc 38011 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 395-5127 Fax: (813) 355-3085 18 Yrs/130 Yrs M-F 7:30 AM - 4:30 PM PCMH: No Patel, Arpit DO Provider ID: 1217416 Gender: Male Advanced Pain Management Inc 38011 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 395-5127 Fax: (813) 355-3085 18 Yrs/130 Yrs M-F 7:30 AM - 4:30 PM PCMH: No

Syed, Asma MD Roach, John DO Provider ID: 244713 Provider ID: 367379 Gender: Female Gender: Male Mid Florida Physical Medicine Sundari Plastics LLC PA 17723 Hunting Bow Cir Ste 101 5808 Old Pasco Rd Lutz, FL 33558 Wesley Chapel, FL 33544 (813) 528-8744 (813) 907-0033 Fax: (813) 528-8791 Fax: (813) 992-7920 00 Yrs/130 Yrs 00 Yrs/130 Yrs CRMC At Bayonet Point Florida Hospital At Connerton M-TH 9:00 AM - 5:00 PM Long Term F 9:00 AM - 4:00 PM Florida Hospital Wesley PCMH: No Chapel M-F 9:00 AM - 5:00 PM Podiatry PCMH: No Barrett, Brendan DPM Plastic & Reconstructive Provider ID: 1320116 Surgery Gender: Male New Tampa Foot and Ankle Dipasquale, Paul DO 26827 Foggy Creek Rd Ste 104 Wesley Chapel, FL 33544 Provider ID: 909024 (813) 973-3535 Gender: Male Fax: (813) 907-2963 Vitale Institute Pl 00 Yrs/130 Yrs 27516 Cashford Cir Ste 101 M-F 8:00 AM - 5:00 PM Wesley Chapel, FL 33544 PCMH: No (813) 406-4400 Fax: (813) 929-6633 Beltranwalshe, Maria DPM 00 Yrs/130 Yrs Florida Hospital Zephyrhills Provider ID: 1426116 New Tampa Surgery Center Gender: Female Tampa General Hospital Robert J Valins, DPM, PA/Total Languages: Spanish 2649 Windguard Circle Unit M-F 8:00 AM - 5:00 PM 101 PCMH: No Wesley Chapel, FL 33544 (813) 788-3600 Miller, Monica MD Fax: (813) 788-7010 Provider ID: 1324963 02 Yrs/130 Yrs Gender: Female M-F 9:00 AM - 4:00 PM Advanced Hand And Plastic PCMH: No Surgery C 2318 Greenbranch Dr Ste Beltranwalshe, Maria DPM 101-102 Bldg 2 Wesley Chapel, FL 33544 Provider ID: 1426116 (813) 866-4626 Gender: Female Fax: (813) 972-8866 Robert J Valins, DPM, PA/Total 00 Yrs/130 Yrs 6326 Fort King Rd M-F 8:30 AM - 4:30 PM Zephyrhills, FL 33542 PCMH: No (813) 788-3600 Fax: (813) 788-7010 02 Yrs/130 Yrs MWTHF 9:00 AM - 5:00 PM T 8:00 AM - 4:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pasco Podiatry - cont. Bratton, Edward DPM Provider ID: 285934 Gender: Male Edward E Bratton DPM 10746 Firebrick Ct New Port Richey, FL 34655 (727) 455-5613 Fax: (727) 372-1402 02 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No

Port, Martin DPM Provider ID: 194466 Gender: Male Stephen F Levin DPM PA 26827 Foggy Creek Rd Ste 104 Wesley Chapel, FL 33544 (813) 973-3535 Fax: (813) 907-2963 00 Yrs/130 Yrs Languages: Spanish M 8:30 AM - 12:00 PM PCMH: No Stelnicki, James DPM

Donate, Guillermo DPM Provider ID: 209183 Gender: Male 2621 Windguard Cir Ste 102 Wesley Chapel, FL 33544 (813) 994-0213 Fax: (813) 994-0105 00 Yrs/130 Yrs Languages: Spanish M 8:30 AM - 12:00 PM TW 8:30 AM - 6:00 PM THF 4:30 AM - 6:00 PM PCMH: No Kales, Lawrence DPM Provider ID: 18227 Gender: Male 7117 State Rd 52 Hudson, FL 34667 (727) 868-2128 Fax: (727) 868-7491 05 Yrs/130 Yrs CRMC At Bayonet Point M-F 8:00 AM - 5:00 PM PCMH: No Levin, Stephen DPM Provider ID: 454716 Gender: Male Stephen F Levin DPM PA 26827 Foggy Creek Rd Wesley Chapel, FL 33544 (813) 973-3535 Fax: (813) 907-2963 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 28532 Gender: Male The Foot and Leg Specialty Center 6543 Madison St New Port Richey, FL 34652 (727) 842-9504 Fax: (727) 842-9505 00 Yrs/130 Yrs Medical Center of Trinity Morton Plant North Bay Hospital M-TH 8:00 AM - 4:30 PM F 7:30 AM - 3:00 PM PCMH: No Valins, Robert DPM Provider ID: 535 Gender: Male Robert J Valins DPM PA 6326 Fort King Rd Zephyrhills, FL 33542 (813) 788-3600 Fax: (813) 788-7010 00 Yrs/130 Yrs Columbia South Bay Hospital Florida Hospital Zephyrhills Tampa Bay Surgery Center Languages: Spanish, French, Italian M-F 9:00 AM - 5:00 PM PCMH: No

Pulmonary Disease

Kumar, Alok MD Provider ID: 27199 Britos-Bray, Martin MD Gender: Male Comprehensive Medical Care 5453 Gulf Dr Ste 3 Provider ID: 583931 New Prt Rchy, FL 34652 Gender: Male (727) 847-2214 Fhpg Pumlonology of Wesley Chapel Fax: (727) 846-0923 2700 Healing Way Ste 308 18 Yrs/130 Yrs Wesley Chapel, FL 33543 CRMC At Bayonet Point Medical Center of Trinity (813) 929-5226 Morton Plant North Bay Fax: (813) 929-5332 Hospital 00 Yrs/130 Yrs Languages: Hindi Florida Hospital Wesley M-TH 8:30 AM - 5:00 PM Chapel F 8:30 AM - 4:30 PM Memorial Hospital of Tampa South Florida Baptist Hospital PCMH: No Languages: Spanish Martinez, Rafael MD M-F 8:00 AM - 5:00 PM Provider ID: 205497 PCMH: No Gender: Male Chakola, Paul MD Pulmonary and Sleep of Tampa Bay Provider ID: 13226 2329 Crestover Ln Ste 101 Gender: Male Wesley Chapel, FL 33544 East Pasco Pulmonary and Critical C (813) 490-9495 38152 Medical Center Ave Fax: (813) 874-0099 Zephyrhills, FL 33540 00 Yrs/130 Yrs (813) 782-4560 Brandon Regional Hospital Fax: (813) 788-9202 Languages: Spanish 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Bayfront Health Dade City PCMH: No Florida Hospital Zephyrhills Quefatieh, Amir MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 340332 Furman, Alexandre MD Gender: Male Fhz Advanced Pulmonary and Provider ID: 681090 Critical Gender: Male 6748 Gall Blvd Sleep of Tampa Bay Zephyrhills, FL 33542 2329 Crestover Ln Ste 101 (813) 788-0705 Wesley Chapel, FL 33544 Fax: (813) 788-2567 (813) 490-9495 16 Yrs/130 Yrs Fax: (813) 874-0099 Florida Hospital Zephyrhills 12 Yrs/130 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 345

Last update 08/14/2017

Specialty Physicians Pasco Pulmonary Disease - cont. Quefatieh, Amir MD Provider ID: 340332 Gender: Male Fhz Wc Mob Multi Specialty Practice 2700 Healing Way Ste 308 Wesley Chapel, FL 33543 (813) 929-5310 Fax: (813) 929-5313 16 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No Restrepo Jaramillo, Ricardo MD Provider ID: 1093496 Gender: Male Pulmonary and Sleep of Tampa Bay 2329 Crestover Ln Ste 101 102 Wesley Chapel, FL 33544 (813) 490-9495 Fax: (813) 874-0099 18 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Vydyula, Ravikanth MD Provider ID: 1207462 Gender: Male Florida Medical Clinic PA 2100 Via Bella Blvd Ste 203 Land O Lakes, FL 34639 (813) 528-4960 Fax: (813) 355-5088 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Radiation Oncology Bishay, Sawsan MD Provider ID: 10410 Gender: Female Florida Cancer Institute PA 38010 Medical Center Ave Zephyrhills, FL 33540 (813) 783-1676 Fax: (813) 783-1929 18 Yrs/130 Yrs Bayfront Health Brooksville Bayfront Health Spring Hill Florida Hospital Wesley Chapel Languages: Arabic MT 8:00 AM - 5:00 PM PCMH: No Gandle, Larry MD Provider ID: 3515 Gender: Male Florida Cancer Institute PA 38010 Medical Center Ave Zephyrhills, FL 33540 (813) 783-1676 Fax: (813) 783-1929 18 Yrs/130 Yrs Bayfront Health Dade City CRMC At Bayonet Point Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No Griffin, Vivian MD Provider ID: 275486 Gender: Female Florida Cancer Specialists 8763 River Crossing Blvd New Port Richey, FL 34655 (727) 842-8411 Fax: (727) 847-2923 18 Yrs/130 Yrs Morton Plant North Bay Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Hochman, Lawrence MD Provider ID: 9928 Gender: Male Ocala Oncology Center Pl 3611 Little Rd New Port Richey, FL 34655 (727) 372-9159 Fax: (727) 376-8703 00 Yrs/130 Yrs Bayfront Health Brooksville Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Matzkowitz, Arthur MD Provider ID: 1399 Gender: Male Florida Cancer Specialist Pl 38010 Medical Center Ave Zephyrhills, FL 33540 (813) 783-1676 Fax: (813) 783-1929 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Pena-Ponson, Max MD Provider ID: 227334 Gender: Male Cancer Center of Pasco Pinellas 3000 US Hwy 19 Holiday, FL 34691 (727) 942-7070 Fax: (727) 942-8628 18 Yrs/130 Yrs Florida Hospital North Pinellas Florida Hospital Tampa Tampa Community Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Ray, Geoffrey MD Provider ID: 1151460 Gender: Male Cancer Center of Pasco Pinellas 3000 US Hwy 19 Holiday, FL 34691 (727) 942-7070 Fax: (727) 934-9457 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sinha, Purendra MD Provider ID: 12561 Gender: Male 8763 River Crossing Blvd New Port Richey, FL 34665 (727) 842-8411 Fax: (877) 917-2336 00 Yrs/130 Yrs Mease Hospital Dunedin Medical Center of Trinity Morton Plant North Bay Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Sokol, Gerald MD Provider ID: 1398 Gender: Male Florida Cancer Institute PA 7651 Medical Dr Hudson, FL 34667 (727) 868-9208 Fax: (727) 868-6420 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Tampa General Hospital Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Reproductive Endocrinology Imudia, Anthony MD Provider ID: 789831 Gender: Male USF Physicians Group 2718 Windguard Cir Ste 101 Wesley Chapel, FL 33544 (813) 259-0692 Fax: (813) 259-0882 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sleep Medicine Comprehensive Medical Care Provider ID: 316284 5453 Gulf Dr Ste 3 New Port Richey, FL 34652 (727) 847-2214 Fax: (727) 846-0923 18 Yrs/130 Yrs M-F 8:30 AM - 6:30 PM PCMH: No

Sports Medicine Pescasio, Michele MD Provider ID: 1111933 Gender: Female Fhpg Tampa Bay Sports Medicine 2700 Healing Way Ste 110 Wesley Chapel, FL 33543 (813) 929-5350 Fax: (813) 929-5352 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Rankin Jr, George MD Provider ID: 1311837 Gender: Male Fhpg Trinity Tampa Bay Sports Medic 11103 Trinity Blvd Trinity, FL 34655 (727) 312-3355 Fax: (727) 312-3356 12 Yrs/130 Yrs Florida Hospital North Pinellas M-F 9:00 AM - 5:00 PM PCMH: No

Thoracic & Cardiovascular Hakki, A MD Surgery Provider ID: 6236 Belisle, Julian MD Provider ID: 579084 Gender: Male Fhpg Csa Zephyrhills 38039 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bronleewe, Scott MD Provider ID: 579082 Gender: Male Fhpg Csa Zephyrhills 38039 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Tampa Florida Hospital Zephyrhills M-F 9:00 AM - 5:00 PM PCMH: No Desantis, Marshall MD Provider ID: 5632 Gender: Male Bayonet PT Cardiac Surg Associates 14100 Fivay Rd Ste 300 Hudson, FL 34667 (727) 869-7497 Fax: (727) 869-7156 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity M-TH 10:00 AM - 4:00 PM PCMH: No

Gender: Male Cvt Surgical Specialists 36739 State Rd 52 Ste 103A Dade City, FL 33525 (352) 437-4840 Fax: (352) 437-4828 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Arabic, Kurdish M-F 9:00 AM - 4:00 PM PCMH: No Mellor, Ryan MD Provider ID: 1119122 Gender: Male Fhpg Csa Zephyrhills 38039 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 910-0027 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Morrison, Richard MD Provider ID: 579083 Gender: Male Fhpg Csa Zephyrhills 38039 Arbor Ridge Dr Zephyrhills, FL 33540 (813) 788-5870 Fax: (813) 971-1286 18 Yrs/130 Yrs Florida Hospital Zephyrhills Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Rattehalli, Narayana MD Provider ID: 10723 Gender: Male Gulf To Bay Cardio/Thor Surgery 14100 Fivay Rd Ste 320 Hudson, FL 34667 (727) 861-2822 Fax: (813) 254-4697 00 Yrs/130 Yrs CRMC At Bayonet Point Oak Hill Hospital M-F 8:00 AM - 5:00 PM PCMH: No Wahl, Michael MD Provider ID: 213900 Gender: Male 13910 Lakeshore Blvd Ste 140 Hudson, FL 34667 (727) 869-9300 Fax: (727) 869-0636 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Morton Plant North Bay Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Urology Highshaw, Ralph MD Provider ID: 1356558 Gender: Male Fhz Multi Specialty Practice 27415 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 929-5300 Fax: (813) 929-5323 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pasco Urology - cont. Highshaw, Ralph MD Provider ID: 1356558 Gender: Male Fhz Urology Associates of East Pasc 6748 Gall Blvd Zephyrhills, FL 33542 (813) 779-1209 Fax: (813) 779-1216 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lewis Jr, Bertram MD Provider ID: 529993 Gender: Male Fhz Urology Associates of East Pasc 6748 Gall Blvd Zephyrhills, FL 33542 (813) 779-1209 Fax: (813) 779-1216 00 Yrs/130 Yrs Florida Hospital Zephyrhills M-W 8:00 AM - 5:00 PM THF 8:00 AM - 5:30 PM PCMH: No

Shames, Murray MD Provider ID: 200041 Gender: Male USF Physicians Group 2700 Healing Way Ste 300 Wesley Chapel, FL 33543 (813) 974-1456 Fax: (813) 907-8584 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Zuzga, Mark MD Provider ID: 306655 Gender: Male 8101 Ste Rd 54 New Port Richey, FL 34655 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs M 1:00 AM - 4:30 PM PCMH: No

Vascular Surgery Mathew, Jeff MD Provider ID: 1268317 Gender: Male Florida Medical Clinic PA 38135 Market Sq Zephyrhills, FL 33542 (813) 788-8160 Fax: (813) 355-5065 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 348

Last update 08/14/2017

Specialty Physicians Pinellas Adolescent Medicine Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No

Meyer, Laura MD Provider ID: 925434 Gender: Female Partners In Pediatrics 401 Corbett St Ste 210 Belleair, FL 33756 (727) 446-1161 Fax: (727) 446-8212 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Morton Plant Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Upadhya, Krishna MD Provider ID: 1223177 Gender: Female Pediatric Physician Services Inc 601 5th St S Dept 7835 Saint Petersburg, FL 33701 (727) 767-8917 Fax: (727) 767-8482 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Allergy & Immunology Ballow, Mark MD Provider ID: 787027 Gender: Male USF Physicians Group 601 5th St S Saint Petersburg, FL 33701 (727) 767-4150 Fax: (727) 767-8532 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Chamarthy, Latha MD Degala, Ami MD Provider ID: 28023 Provider ID: 970029 Gender: Female Gender: Female Advance Allergy Asthma & Advanced Allergy Asthma Immunology Care 6233 66th St N 6233 66th St N Pinellas Park, FL 33781 Pinellas Park, FL 33781 (727) 544-8100 (727) 544-8100 Fax: (727) 544-8200 Fax: (727) 544-8200 00 Yrs/130 Yrs 02 Yrs/130 Yrs Bayfront Medical Center Languages: Gujarati Florida Hospital North Pinellas M-TH 9:00 AM - 5:00 PM Johns Hopkins All Childrens F 9:00 AM - 1:00 PM Hospital Inc PCMH: No Languages: Tamil, Telugu M-F 9:00 AM - 5:00 PM Gubernick, Samuel DO PCMH: No Provider ID: 1385 Gender: Male Chamarthy, Latha MD Gubernick Allergy Asthma & Imm Provider ID: 28023 13145 66th St Gender: Female Largo, FL 33773 Advanced Allergy and Asthma (727) 530-0700 Care Fax: (727) 530-0777 2323 Curlew Rd Ste 6D 00 Yrs/18 Yrs Dunedin, FL 34698 CRMC At Bayonet Point (727) 544-8100 Johns Hopkins All Childrens Fax: (727) 544-8200 Hospital Inc Morton Plant Hospital 00 Yrs/130 Yrs MTH 8:30 AM - 7:00 PM Bayfront Medical Center Florida Hospital North Pinellas T 8:30 AM - 3:00 PM Johns Hopkins All Childrens W 8:30 AM - 5:00 PM Hospital Inc F 8:30 AM - 1:00 PM Languages: Tamil, Telugu PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Kim, Dennis MD Provider ID: 918180 Degala, Ami MD Gender: Male Provider ID: 970029 Dennis H Kim MD LLC Gender: Female 34041 US Hwy 19 N Ste D Advanced Allergy Asthma Palm Harbor, FL 34684 Care (727) 787-6744 2323 Curlew Rd Unit 6D Fax: (727) 786-3561 Dunedin, FL 34698 00 Yrs/130 Yrs (727) 544-8100 Northside Hospital Fax: (727) 544-8200 St Petersburg General 02 Yrs/130 Yrs Hospital Languages: Gujarati M-F 8:00 AM - 5:00 PM M-TH 9:00 AM - 5:00 PM PCMH: No F 9:00 AM - 1:00 PM PCMH: No

www.wellcare.com/Florida | 349

Last update 08/14/2017

Specialty Physicians Pinellas Allergy & Immunology cont. Kornfeld, Stephen MD

Phillips, J Wayne MD Provider ID: 1430 Gender: Male 708 Druid Rd E Clearwater, FL 33756 (727) 446-1097 Fax: (727) 441-2195 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-TH 9:00 AM - 5:00 PM PCMH: No

Tang, Nathan MD Provider ID: 408836 Gender: Male Allery Asthma Associates PA 333 Dr MLK Jr St N Saint Petersburg, FL 33701 (727) 825-0111 Fax: (727) 825-0011 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital Languages: Thai M-F 8:00 AM - 5:00 PM PCMH: No

Cassidy, Dennis MD Provider ID: 199201 Gender: Male West Florida Cardiology Network LLC 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 Fax: (727) 329-1694 18 Yrs/130 Yrs Lee Memorial Hospital Northside Hospital St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 205620 Gender: Male S J Kornfeld, MD Inc 34041 US Hwy 19 N Ste D Palm Harbor, FL 34684 (727) 787-6744 Fax: (727) 786-3561 00 Yrs/130 Yrs Florida Hospital North Pinellas Sanka, Madhurima DO Johns Hopkins All Childrens Hospital Inc Cardiac Electrophysiology Provider ID: 449909 Mease Countryside Hospital Gender: Female Languages: French Annoni-Suau, Luis MD Advance Allergy Asthma & M 9:00 AM - 5:30 PM Cassidy, Dennis MD Immunology Provider ID: 13504 TW 9:00 AM - 5:00 PM 6233 66th St N Gender: Male TH 9:00 AM - 6:00 PM Pinellas Park, FL 33781 Interventional Cardiac Provider ID: 199201 PCMH: No Consultants (727) 544-8100 Gender: Male 3251 N McMln Bth Rd Ste 100 Kornfeld, Stephen MD Fax: (727) 544-8200 West Florida Cardiology Clearwater, FL 33761 Network LLC 00 Yrs/130 Yrs Provider ID: 949333 (727) 784-6992 6006 49th St N Ste 200 Languages: Spanish Gender: Male Fax: (727) 781-0413 Saint Petersburg, FL 33709 M-F 9:00 AM 5:00 PM USF Physicians Group 18 Yrs/130 Yrs (727) 490-2100 PCMH: No 601 5th St S 3rd Fl Medical Center of Trinity Fax: (727) 544-7389 Saint Petersburg, FL 33701 Sanka, Madhurima DO Morton Plant Hospital 18 Yrs/130 Yrs (727) 767-4150 Morton Plant North Bay Lee Memorial Hospital Fax: (727) 767-8532 Hospital Northside Hospital Provider ID: 449909 00 Yrs/130 Yrs Languages: Spanish St Petersburg General Gender: Female M-F 8:00 AM - 5:00 PM MWTHF 9:00 AM 5:00 PM Hospital Advanced Allergy and Asthma PCMH: No T 8:00 AM - 5:00 PM Languages: Spanish Care PCMH: No M-F 8:00 AM - 5:00 PM Mangat, Mona MD 2323 Curlew Rd Ste 6D PCMH: No Dunedin, FL 34698 Provider ID: 266967 Cassidy, Dennis MD (727) 544-8100 Gender: Female Gandhi, Malay MD Fax: (727) 544-8200 Bay Area Allergy & Asthma Provider ID: 818220 Provider ID: 199201 00 Yrs/130 Yrs 4965 Central Ave Gender: Male Gender: Male Languages: Spanish Saint Petersburg, FL 33710 1201 7th Ave N West Florida Cardiology M-F 9:00 AM 5:00 PM (727) 327-5719 Network LLC Saint Petersburg, FL 33705 PCMH: No Fax: (727) 322-6146 1615 Pasadena Ave S Ste 300 (727) 544-1441 00 Yrs/130 Yrs Saint Petersburg, FL 33707 Fax: (727) 545-8263 M-TH 9:00 AM - 5:00 PM (727) 490-3030 18 Yrs/130 Yrs F 9:00 AM - 1:00 PM Fax: (727) 345-5972 Morton Plant Hospital PCMH: No Northside Hospital 18 Yrs/130 Yrs St Anthonys Hospital Lee Memorial Hospital Languages: Hindi Northside Hospital St Petersburg General M-F 8:00 AM - 5:00 PM Hospital PCMH: No Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Cardiac Electrophysiology - cont. Gandhi, Malay MD Provider ID: 818220 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Morton Plant Hospital Northside Hospital St Anthonys Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Shah, Shalin MD Provider ID: 294821 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Shah, Shalin MD Provider ID: 294821 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Cardiology

Annoni-Suau, Luis MD Provider ID: 13504 Abbott Jr, Norman MD Gender: Male Interventional Cardiac Consultants Provider ID: 1324977 3251 N McMln Bth Rd Ste 100 Gender: Male Clearwater, FL 33761 2626 Tampa Rd Ste 104 (727) 784-6992 Palm Harbor, FL 34684 Fax: (727) 781-0413 (727) 787-4875 18 Yrs/130 Yrs Fax: (727) 786-9623 Medical Center of Trinity 16 Yrs/130 Yrs Florida Hospital North Pinellas Morton Plant Hospital Morton Plant North Bay M-F 9:00 AM - 5:00 PM Hospital PCMH: No Languages: Spanish MWTHF 9:00 AM - 5:00 PM Abbott Jr, Norman MD T 8:00 AM - 5:00 PM PCMH: No Provider ID: 1324977 Gender: Male Avery, Samantha DO Fhpg Ts Palm Heart Center of Florid Provider ID: 1168865 1501 S Pinellas Ave Ste G Gender: Female Tarpon Springs, FL 34689 The Heart Institue (727) 937-3637 1615 Pasadena Ave S Ste 300 Fax: (727) 937-3018 Saint Petersburg, FL 33707 16 Yrs/130 Yrs Florida Hospital North Pinellas (727) 490-3030 Fax: (866) 200-9885 M-F 8:00 AM - 4:30 PM 18 Yrs/110 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Amin, Jay MD Provider ID: 796600 Avery, Samantha DO Gender: Male Baycare Medical Group Provider ID: 1168865 455 Pinellas St Ste 250 Gender: Female Clearwater, FL 33756 The Heart Institue (727) 462-3701 6006 49th St N Ste 200 Fax: (727) 298-6727 Saint Petersburg, FL 33709 18 Yrs/130 Yrs (727) 490-2100 Morton Plant Hospital Fax: (727) 544-7389 M-F 8:00 AM - 5:00 PM 18 Yrs/110 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Amin, Mahesh MD Provider ID: 1256805 Gender: Male Baycare Medical Group 1107 S Myrtle Ave Clearwater, FL 33756 (727) 441-8663 Fax: (727) 441-8859 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Bayron, Carlos MD Provider ID: 1437 Gender: Male Interventional Cardiac Consultants 3251 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 784-6992 Fax: (813) 327-6028 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Bhatia, Vikas MD Provider ID: 1163666 Gender: Male Bay Area Heart Center 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Black, Robert MD Provider ID: 193782 Gender: Male Baycare Medical Group 455 Pinellas St Ste 330 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 298-6278 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Blanco, George MD Provider ID: 408389 Gender: Male Cardiology Consultants 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 18 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Blanco, George MD Provider ID: 408389 Gender: Male Cardiology Consultants PA 1615 Pasadena Ave S Ste 300 Saint Petersburg, FL 33707 (727) 490-3030 18 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Blanco, George MD Provider ID: 408389 Gender: Male Cardiology Consultants PA 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Cardona, Francisco MD Provider ID: 214937 Gender: Male Cardiology Consultants 1615 Pasadena Ave S Ste 300 Saint Petersburg, FL 33707 (727) 490-3030 18 Yrs/130 Yrs Northside Hospital Palms of Pasadena Hospital St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Cardona, Francisco MD Provider ID: 214937 Gender: Male Cardiology Consultants PA 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 490-2100 18 Yrs/130 Yrs Northside Hospital Palms of Pasadena Hospital St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Cardona, Francisco MD Provider ID: 214937 Gender: Male West Florida Cardiology Network 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Northside Hospital Palms of Pasadena Hospital St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Cheng, Wayne MD Provider ID: 1145951 Gender: Male Baycare Medical Group 646 Virginia St Ste 200 Dunedin, FL 34698 (727) 724-8611 Fax: (727) 734-6654 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Chiu, Kathrine MD Provider ID: 709746 Gender: Female Bayfront Physician Specialty LLC 625 6th Ave S Ste 430 Saint Petersburg, FL 33701 (727) 893-6234 Fax: (727) 553-7197 00 Yrs/130 Yrs Bayfront Medical Center M-TH 8:30 AM - 4:00 PM F 8:30 AM - 12:00 PM PCMH: No Codolosa, Jose MD Provider ID: 1095322 Gender: Male Bay Area Heart Center 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Codolosa, Jose MD Provider ID: 1095322 Gender: Male Bay Area Heart Center 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Codolosa, Jose MD Provider ID: 1095322 Gender: Male Bay Area Heart Center 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Dagher, George MD Provider ID: 647494 Gender: Male Mpm Cardiology Service LLC 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 721-2049 16 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital Languages: Spanish, French, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Finn, John MD Provider ID: 590865 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Finn, John MD Provider ID: 590865 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No Finn, John MD Provider ID: 590865 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No Garner, Kevin MD Provider ID: 617876 Gender: Male SC Physicians LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8243 Fax: (727) 824-8233 00 Yrs/130 Yrs Bayfront Medical Center St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Hernandez, Felix MD Provider ID: 231356 Gender: Female Felix J Hernandez MD 4500 Central Ave Saint Petersburg, FL 33711 (727) 323-0757 Fax: (727) 327-3781 00 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Spanish, Portuguese M-F 9:00 AM - 5:00 PM PCMH: No Johnson, Alex MD Provider ID: 311721 Gender: Male Cardiology Consultants 1615 Pasadena Ave S Ste 300 South Pasadena, FL 33707 (727) 490-3030 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Johnson, Alex MD Provider ID: 311721 Gender: Male Cardiology Consultants PA 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Giannoni Delgado, Miguel MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 1241595 Gender: Female Bay Area Heart Center PA 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Kethireddy, Ravi MD Provider ID: 746 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Hindi M-F 8:00 AM - 5:00 PM PCMH: No Kethireddy, Ravi MD Provider ID: 746 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Kethireddy, Ravi MD Provider ID: 746 Gender: Male Bay Area Heart Center PA 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

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Klein, Jesse DO Provider ID: 515734 Gender: Male West Florida Cariodogy Network LLC 1345 W. Bay Dr Ste 101 Largo, FL 33770 (727) 581-3550 Fax: (727) 586-6190 18 Yrs/130 Yrs Largo Medical Center Mease Countryside Hospital Morton Plant Hospital M-F 8:30 AM - 5:00 PM PCMH: No Klonaris, John MD Provider ID: 30229 Gender: Male Baycare Medical Group Inc 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 721-2049 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Kohl, David MD Provider ID: 6261 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 544-1441 18 Yrs/130 Yrs Largo Medical Center Northside Hospital M-F 8:00 AM - 5:00 PM PCMH: No Kohl, David MD Provider ID: 6261 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Kohl, David MD Provider ID: 6261 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital M-F 9:00 AM - 5:00 PM PCMH: No Kokolis, Rodamanthos MD Provider ID: 765954 Gender: Male Hippocratic Medical Center LLC 1 N Pinellas Ave Tarpon Springs, FL 34689 (346) 774-6996 Fax: (727) 939-3091 00 Yrs/130 Yrs Languages: Spanish, Greek, Albanian M-F 9:00 AM - 6:00 PM Sat-Sun 11:00 AM - 2:00 PM PCMH: No Korabathina, Ravikiran MD Provider ID: 605103 Gender: Male Bayfront Physician Specialty Serivi 625 6th Ave S Ste 430 Saint Petersburg, FL 33701 (727) 893-6234 Fax: (727) 553-7197 18 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Kovach, Todd MD Provider ID: 164190 Gender: Male Baycare Medical Group 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 721-2049 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Levine, Jason MD Provider ID: 423733 Gender: Male Suncoast Medicl Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8243 Fax: (727) 824-8233 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 4:30 PM PCMH: No

Kunhardt, Rene MD Miller, Leslie MD Provider ID: 170974 Provider ID: 608848 Gender: Male Gender: Male Interventional Cardiac Consultants Baycare Medical Group 3251 N McMln Bth Rd Ste 100 455 Pinellas St Ste 250 Clearwater, FL 33761 Clearwater, FL 33756 (727) 784-6992 (727) 462-3701 Fax: (813) 327-6028 Fax: (727) 298-6707 18 Yrs/130 Yrs 16 Yrs/130 Yrs CRMC At Bayonet Point Morton Plant Hospital Florida Hospital North Pinellas M-F 8:00 AM - 5:00 PM Medical Center of Trinity PCMH: No Languages: Spanish M-F 9:00 AM - 5:00 PM Mishkin, Michael DO PCMH: No Provider ID: 1176429 Gender: Male Law, Trevor MD Bayfront Health Medical Provider ID: 173885 Group Gender: Male 625 6th Ave S Ste 430 St Petersburg Suncoast Med Saint Petersburg, FL 33701 701 6th St S (727) 893-6234 Saint Petersburg, FL 33701 Fax: (727) 553-7197 (727) 217-3900 18 Yrs/110 Yrs 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM Bayfront Medical Center F 8:00 AM - 12:00 PM St Anthonys Hospital PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Law, Trevor MD Provider ID: 173885 Gender: Male Suncoast Medical Company 1200 7th Ave N Saint Petersburg, FL 33705 (727) 825-1100 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Mokotoff, David MD Provider ID: 6256 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Petersburg General Hospital Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No Mokotoff, David MD Provider ID: 6256 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 441-1434 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Petersburg General Hospital Languages: Spanish, Italian M-F 9:00 AM - 5:00 PM PCMH: No Mokotoff, David MD Provider ID: 6256 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital St Petersburg General Hospital Languages: Spanish, Italian M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Moondra, Vaibhav MD Provider ID: 1145955 Gender: Male Baycare Medical Group 455 Pinellas St Ste 330 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Moreno, Patrice MD Provider ID: 791620 Gender: Female Patrice A Moreno MD 601 Main St Ste 208 Dunedin, FL 34698 (727) 734-6787 Fax: (727) 736-7458 18 Yrs/130 Yrs Mease Hospital Dunedin MTWF 8:00 AM - 2:00 PM TH 9:00 AM - 12:00 PM PCMH: No Moss, Brian DO Provider ID: 460974 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Moss, Brian DO Provider ID: 460974 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Mukayed, Usama MD Provider ID: 811618 Gender: Male Mukherjee and Mukayed MD PA 5880 49th St N Ste 203N Saint Petersburg, FL 33709 (727) 527-6464 Fax: (727) 521-1963 00 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Arabic M-F 9:00 AM - 5:30 PM PCMH: No Mukherjee, Dipak MD Provider ID: 174562 Gender: Male Mukherjee and Mukayed MD PA 5880 49th St N Ste 203N Saint Petersburg, FL 33709 (727) 527-6464 Fax: (727) 521-1963 18 Yrs/130 Yrs Northside Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Van MD Provider ID: 151876 Gender: Male Baycare Medical Group 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 721-2049 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Parikh, Ankit MD Provider ID: 1169454 Gender: Male The Heart Institute 560 Jackson St N Saint Petersburg, FL 33704 (727) 329-1600 Fax: (727) 329-1694 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Parikh, Ankit MD Provider ID: 1169454 Gender: Male The Heart Institute 6006 49th St N Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patel, Darshan MD Provider ID: 590587 Gender: Male Florida Cardiology Group LLC 2595 Tampa Rd Ste U Palm Harbor, FL 34684 (727) 789-3131 Fax: (727) 781-6288 18 Yrs/130 Yrs Languages: Spanish, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No Post, James MD Provider ID: 8338 Gender: Male West Florida Cardiology Network LL 1615 Pasadena Ave S Ste 300 Saint Petersburg, FL 33707 (727) 490-3030 Fax: (727) 345-5972 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

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Post, James MD Provider ID: 8338 Gender: Male West Florida Cardiology Network LL 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Post, James MD Provider ID: 8338 Gender: Male West Florida Cardiology Network LL 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 Fax: (727) 329-1694 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Quick, Kimberly MD Provider ID: 344715 Gender: Female Baycare Medical Group 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-6811 Fax: (727) 721-2049 18 Yrs/130 Yrs Largo Medical Center Largo Medical Center Indian Rocks Mease Hospital Dunedin M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Ramos, Geraldo MD Provider ID: 515398 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8243 Fax: (727) 824-8233 18 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No Reddy, Mohan MD Provider ID: 659702 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No Reddy, Mohan MD Provider ID: 659702 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Reddy, Mohan MD Provider ID: 659702 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM PCMH: No Rosenthal, Andrew MD Provider ID: 12428 Gender: Male The Heart and Vascular Institute of 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 Fax: (727) 329-1694 18 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rosenthal, Andrew MD Provider ID: 12428 Gender: Male The Heart and Vascylar Institute of 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Roskos, Melinda MD Provider ID: 1422896 Gender: Female West Florida Cardiology Network, LL 1615 Pasadena Ave S Ste 300 S Pasadena, FL 33707 (727) 490-3030 Fax: (866) 200-9885 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Salazar, Manuel MD Provider ID: 27239 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM PCMH: No Salazar, Manuel MD Provider ID: 27239 Gender: Male 1301 2nd Ave SW Ste 301 Largo, FL 33770 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No

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Salazar, Manuel MD Provider ID: 27239 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Sanchez, Robert MD Provider ID: 1611 Gender: Male 1615 Pasadena Ave S Ste 300 South Pasadena, FL 33707 (727) 490-3030 Fax: (727) 345-5972 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Sanchez, Robert MD Provider ID: 1611 Gender: Male 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 490-2100 Fax: (727) 329-1694 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Sanchez, Robert MD Provider ID: 1611 Gender: Male West Florida Cardiology Network, LL 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Schuyler, Gregg MD Provider ID: 146380 Gender: Male Cardiology Consultants PA 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 18 Yrs/130 Yrs Bayfront Medical Center Northside Hospital Palms of Pasadena Hospital M-F 8:00 AM - 5:00 PM PCMH: No Schuyler, Gregg MD Provider ID: 146380 Gender: Male West Florida Cardiology Network LLC 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Bayfront Medical Center Northside Hospital Palms of Pasadena Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Sharma, Rakesh MD Provider ID: 1209405 Gender: Male 1107 S Myrtle Ave Clearwater, FL 33756 (727) 441-8663 Fax: (727) 441-8859 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sheppard, Robert MD Provider ID: 12429 Gender: Male Cardiology Consultants 1615 Pasadena Ave S Ste 300 Saint Petersburg, FL 33707 (727) 490-3030 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sheppard, Robert MD Provider ID: 12429 Gender: Male Cardiology Consultants 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Sheppard, Robert MD Provider ID: 12429 Gender: Male West Florida Cardiology Network LLC 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Sodano, Dan MD Provider ID: 1331291 Gender: Male Baycare Medical Group Inc 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 712-0499 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sodano, Dan MD Provider ID: 1331291 Gender: Male Baycare Medical Group Inc 455 Pinellas St 330 Clearwater, FL 33756 (727) 489-2542 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sodano, Dan MD Provider ID: 1331291 Gender: Male Baycare Medical Group Inc 646 Virginia St Ste 200 Dunedin, FL 34698 (727) 728-1515 Fax: (727) 712-0499 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Sodano, Dan MD Provider ID: 1331291 Gender: Male Baycare Medical Group Inc 6633 Forest Ave Ste 300 Dunedin, FL 34698 (727) 376-3267 Fax: (727) 712-0499 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Srivastava, Amit MD Provider ID: 448067 Gender: Male 1201 7th Ave N Saint Petersburg, FL 33705 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Srivastava, Amit MD Provider ID: 448067 Gender: Male 5398 Park St N Saint Petersburg, FL 33709 (727) 544-1441 Fax: (727) 545-8263 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No Steinhoff, Jeff MD Provider ID: 241098 Gender: Male West Florida Cariodogy Network LLC 1345 W. Bay Dr Ste 101 Largo, FL 33770 (727) 258-2073 Fax: (727) 586-6190 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Cardiology - cont. Taylor, Marc MD Provider ID: 295662 Gender: Male 10033 MLK St N Ste 300 Saint Petersburg, FL 33716 (727) 498-8898 Fax: (727) 800-6959 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Turner, Angela DO Provider ID: 1276748 Gender: Female Bayfront Cardiovascular Associates 625 6th Ave S Ste 430 Saint Petersburg, FL 33701 (727) 893-6234 Fax: (727) 553-7197 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Walsh, John MD Provider ID: 9370 Gender: Male Cardiology Consultants 1615 Pasadena Ave S Ste 300 South Pasadena, FL 33707 (727) 490-3030 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Walsh, John MD Provider ID: 9370 Gender: Male Cardiology Consultants PA 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Walsh, John MD Provider ID: 9370 Gender: Male West Florida Cardiology Network LLC 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Walsh, Ronald DO Provider ID: 17265 Gender: Male West Florida Cardiology Network LLC 1345 W. Bay Dr Ste 101 Largo, FL 33770 (727) 581-3550 Fax: (727) 586-6190 18 Yrs/130 Yrs Largo Medical Center Indian Rocks Mease Hospital Dunedin Morton Plant Hospital M-F 8:30 AM - 5:00 PM PCMH: No Weston, Patrick MD Provider ID: 640041 Gender: Male Aria Health and Wellness Institute 115 1st St S Saint Petersburg, FL 33701 (727) 800-9886 Fax: (727) 800-9895 18 Yrs/130 Yrs Venice Regional Medical Center Languages: French M-F 9:00 AM - 5:00 PM PCMH: No

Wilson, Christopher DO Provider ID: 716273 Gender: Male Cardiology Consultants 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 490-2100 Fax: (727) 329-1694 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wilson, Christopher DO Provider ID: 716273 Gender: Male West Florida Cardiology Network LLC 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Woods, Andrea MD Provider ID: 192598 Gender: Female 620 10th St N Saint Petersburg, FL 33705 (727) 824-8243 Fax: (727) 824-8233 16 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 4:00 PM PCMH: No

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Child Neurology Andrews, Ena MD Provider ID: 335367 Gender: Female Pediatric Neurology Associates 625 6th Ave S Ste 405 Saint Petersburg, FL 33701 (727) 498-8994 Fax: (727) 346-1044 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Casadonte, Joseph MD Provider ID: 17777 Gender: Male Florida Pediatric Associates LLC 625 6th Ave S Ste 405 Saint Petersburg, FL 33701 (727) 498-8994 Fax: (727) 498-8982 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Huszar, Peter MD Provider ID: 1025245 Gender: Male Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8035 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Child Neurology - cont. Jayakody, Himali MD Provider ID: 1028050 Gender: Female Pediatric Physician Services Inc 601 5th St S Dept 7855 St Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nguyen, Colin MD Provider ID: 686240 Gender: Male Pediatric Physician Services 601 5th St S Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-4970 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 461042 Gender: Male 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 461042 Gender: Male 601 5th St S Ste 510 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Winesett, Steven MD Provider ID: 461042 Gender: Male Center For Pediatric Neurosurgery 880 6th St S Ste 310 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Chiropractic

Byrne, Steven DC Provider ID: TPV10341-01 Gender: Male Steven E Byrne Chiropractic 8831 49th St N Ste 5 Pinellas Park, FL 33782 (727) 541-1111 Fax: (727) 546-7294 02 Yrs/99 Yrs Languages: Spanish MWF 7:30 AM - 6:00 PM TTH 12:30 AM - 6:00 PM PCMH: No Chiro Alliance Corporation Provider ID: 554852 2323 Curlew Rd Ste 2C Dunedin, FL 34698 (727) 787-8387 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Bryan, Vincent DC Provider ID: TPV10339-01 Gender: Male Sunset Point Healthcare Clinic LLC 2329 Sunset Point Rd Ste 204 Clearwater, FL 33765 Collector, Murray DC (727) 799-3319 Provider ID: TPV10718-01 Fax: (727) 799-8859 Gender: Male 00 Yrs/99 Yrs Collector Chiropractic Care MWF 9:00 AM - 7:00 PM 6701 38th Ave N Ste A T 9:00 AM - 5:30 PM Saint Petersburg, FL 33710 TH 9:00 AM - 1:00 PM (727) 347-1556 PCMH: No Fax: (727) 347-1809 10 Yrs/99 Yrs Burke, James DC MWF 8:00 AM - 6:00 PM Provider ID: TPV10340-03 T 9:00 AM - 6:00 PM Gender: Male TH 9:00 AM - 12:00 PM Burke Chiropractic Clinic PCMH: No 6416 Dr ML King Jr. St N Saint Petersburg, FL 33702 Crandall, Charles DC (727) 527-7711 Provider ID: TPV10690-01 Fax: (727) 527-7722 Gender: Male 00 Yrs/99 Yrs Charles F Crandall DC MWF 8:00 AM - 6:00 PM 1501 Lakeview Rd T 2:00 AM - 6:00 PM Clearwater, FL 33756 TH 8:00 AM - 11:00 PM (727) 447-6779 PCMH: No Fax: (727) 462-2634 00 Yrs/99 Yrs MWF 9:00 AM - 7:00 PM TTH 9:00 AM - 2:00 PM PCMH: No

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Didonato, Louis DC Provider ID: TPV10343-01 Gender: Male Didonato Chiropractic Clinic 1200 S Pinellas Ave Ste 9 Tarpon Springs, FL 34689 (727) 934-5604 Fax: (727) 938-1873 00 Yrs/99 Yrs M-W 9:00 AM - 6:00 PM PCMH: No Farkas, Frank DC Provider ID: TPV10346-01 Gender: Male Farkas Chiropractic Clinic 3200 4th St N Saint Petersburg, FL 33704 (727) 823-3151 Fax: (727) 821-2419 00 Yrs/99 Yrs MTWF 8:00 AM - 6:00 PM TH 8:00 AM - 11:00 PM PCMH: No Frattalone, Sam DC Provider ID: TPV10348-01 Gender: Male Florida Chiropractic Institute 4641 Park St N Saint Petersburg, FL 33709 (727) 544-7878 Fax: (727) 546-9253 10 Yrs/80 Yrs MTWF 8:30 AM - 6:00 PM TH 8:30 AM - 12:00 PM PCMH: No Golden, Robert DC Provider ID: TPV10351-01 Gender: Male Oldsmar Chiropractic Center 3906 Tampa Rd Ste A Oldsmar, FL 34677 (813) 855-5986 Fax: (813) 855-6378 00 Yrs/80 Yrs Languages: Spanish MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Chiropractic - cont. Goodman, Jamie DC Provider ID: TPV10864-02 Gender: Male Goodman Chiropractic 2206 Curlew Rd Palm Harbor, FL 34683 (727) 772-7788 Fax: (727) 772-0400 00 Yrs/99 Yrs MWTH 8:00 AM - 6:00 PM TF 8:00 AM - 12:00 PM PCMH: No Gowing, Roy DC Provider ID: TPV10802-01 Gender: Male Professional Health Care Of Pinellas 5500 9th St N Saint Petersburg, FL 33703 (727) 525-5500 Fax: (727) 522-2574 00 Yrs/99 Yrs MTTH 8:00 AM - 6:00 PM W 8:00 AM - 12:00 PM PCMH: No Grimmel, Stanley DC Provider ID: TPV11182-01 Gender: Male St Pete Spinal Care 2201 58th St N Saint Petersburg, FL 33710 (727) 344-2225 Fax: (727) 344-2220 00 Yrs/99 Yrs M 9:00 AM - 5:30 PM T 1:00 AM - 5:30 PM WTH 9:00 AM - 7:00 PM PCMH: No Hayes, Christopher DC Provider ID: TPV17508-01 Gender: Male Hayes Family Chiropractic 516 Patricia Ave Dunedin, FL 34698 (727) 736-1000 Fax: (727) 736-3556 00 Yrs/99 Yrs M-W 8:00 AM - 6:00 PM PCMH: No

Hollstrom, Gregory DC Provider ID: TPV10353-01 Gender: Male Hollstrom Associates 11444 Seminole Blvd Largo, FL 33778 (727) 393-6100 Fax: (727) 393-5461 00 Yrs/99 Yrs M-TH 9:00 AM - 2:00 PM PCMH: No Hollstrom II, Gregory DC Provider ID: TPV10354-01 Gender: Male Hollstrom Associates 11444 Seminole Blvd Largo, FL 33778 (727) 393-6100 Fax: (727) 393-5461 00 Yrs/99 Yrs M-F 9:00 AM - 6:30 PM PCMH: No Horton-Bender, Kimberly DC Provider ID: TPV10338-01 Gender: Female Bender Chiropractic Center PA 321 Indian Rocks Rd N Ste C Belleair Bluffs, FL 33770 (727) 559-7881 Fax: (727) 559-7981 00 Yrs/99 Yrs MWF 8:00 AM - 6:00 PM TTHSat 8:00 AM - 1:00 PM PCMH: No Jennings, John DC Provider ID: TPV10355-01 Gender: Male St Petersburg Chiropractic Clinic 125 4th Ave NE Saint Petersburg, FL 33701 (727) 822-3694 Fax: (727) 823-7716 00 Yrs/99 Yrs M-W 8:00 AM - 6:00 PM PCMH: No

Jones, Roderick DC McBride, Paul DC Provider ID: TPV10359-01 Provider ID: TPV10368-01 Gender: Male Gender: Male Community Care Chiropractic, Paul V McBride DC Inc 800 Tarpon Woods Blvd Ste 12574 Indian Rocks Rd S F5 Largo, FL 33774 Palm Harbor, FL 34685 (727) 596-3601 (727) 785-2771 Fax: (727) 596-3602 Fax: (727) 785-2771 00 Yrs/99 Yrs 00 Yrs/99 Yrs MWF 9:00 AM - 5:00 PM MWF 9:00 AM - 7:00 PM TTH 9:00 AM - 4:00 PM TTH 9:00 AM - 1:00 PM PCMH: No PCMH: No Krippendorf, Donald DC Provider ID: TPV10362-01 Gender: Male Florida Chiropractic Institute 4641 Park St N Saint Petersburg, FL 33709 (727) 544-7878 Fax: (727) 546-9253 00 Yrs/99 Yrs MTWF 8:30 AM - 6:00 PM TH 8:30 AM - 12:00 PM PCMH: No

McCutcheon, Mark DC Provider ID: TPV10369-01 Gender: Male Dr Mark McCutcheon PA 660 Douglas Ave Dunedin, FL 34698 (727) 733-3420 Fax: (727) 734-1641 00 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM THSat 9:00 AM - 12:30 PM PCMH: No

Leverone, Andrew DC Provider ID: TPV11299-01 Gender: Male Healthworks 3950 3rd St N Ste C Saint Petersburg, FL 33703 (727) 823-4663 Fax: (727) 822-2329 00 Yrs/99 Yrs MW 7:00 AM - 11:00 PM TTHF 3:00 AM - 7:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

McGeehan, Cornelius DC Provider ID: TPV10558-01 Gender: Male Cornelius J McGeehan DC Inc 23 E Tarpon Ave Tarpon Springs, FL 34689 (727) 937-4223 Fax: (727) 937-4224 00 Yrs/99 Yrs MWF 9:00 AM - 1:00 PM TTH 3:00 AM - 6:00 PM Sat 9:00 AM - 11:00 PM PCMH: No

Marcell, Mike DC Melilli, Steven DC Provider ID: TPV10709-01 Provider ID: TPV10373-01 Gender: Male Gender: Male Complete Family Chiropractic Melilli Chiropractic and Rehab Health Care Inc Center 1244 S Pinellas Ave 2655 State Rd 580 Ste 204 Tarpon Springs, FL 34689 Clearwater, FL 33761 (727) 937-2086 (727) 723-9685 Fax: (727) 939-2554 Fax: (727) 723-1925 00 Yrs/99 Yrs 00 Yrs/99 Yrs MWTH 8:00 AM - 6:00 PM MWTH 8:00 AM - 7:00 PM T 9:00 AM - 6:00 PM T 8:00 AM - 1:00 PM F 9:00 AM - 5:00 PM F 9:00 AM - 11:00 PM PCMH: No PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Chiropractic - cont. Price-Mccarthy, Staci DC Provider ID: TPV10689-01 Gender: Female Staci L Price DC PA 1539 S Highland Ave Clearwater, FL 33756 (727) 585-8644 Fax: (727) 449-1981 00 Yrs/99 Yrs Languages: Spanish M 8:30 AM - 6:00 PM T 9:00 AM - 7:00 PM W 7:30 AM - 6:00 PM PCMH: No Price-Mccarthy, Staci DC Provider ID: TPV10689-02 Gender: Female Staci L Price DC PA 2909 4th St N Saint Petersburg, FL 33704 (727) 585-8644 Fax: (727) 824-8855 00 Yrs/99 Yrs Languages: Spanish MT 10:00 AM - 6:00 PM PCMH: No Raveling, Paul DC Provider ID: TPV10379-01 Gender: Male Raveling Chiropractic Center 1116 Belcher Rd Dunedin, FL 34698 (727) 733-0433 Fax: (727) 738-6187 00 Yrs/99 Yrs MWTH 8:00 AM - 6:00 PM T 9:00 AM - 4:00 PM PCMH: No Rebori, Brian DC Provider ID: TPV11156-01 Gender: Male Hollstrom Associates 11444 Seminole Blvd Largo, FL 33778 (727) 393-6100 Fax: (727) 393-5461 00 Yrs/99 Yrs M-F 9:00 AM - 6:30 PM PCMH: No

Schoeffel-Hayes, Diane DC Provider ID: TPV17509-01 Gender: Female Hayes Family Chiropractic 516 Patricia Ave Dunedin, FL 34698 (727) 736-1000 Fax: (727) 736-3556 00 Yrs/99 Yrs M-W 8:00 AM - 6:00 PM PCMH: No Thorpe, Lorraine DC Provider ID: TPV10935-01 Gender: Female Thorpe Chiropractic Rehab Center 5144 Central Ave Saint Petersburg, FL 33707 (727) 328-8442 Fax: (727) 328-1042 00 Yrs/99 Yrs MTH 7:30 AM - 6:00 PM T 2:00 AM - 6:00 PM W 8:30 AM - 6:00 PM F 7:00 AM - 12:00 PM PCMH: No Venis, Monte DC Provider ID: TPV10387-01 Gender: Male Back Neck Pain Center 2737 State Rd 580 Clearwater, FL 33761 (727) 726-4743 Fax: (727) 799-2391 00 Yrs/99 Yrs M-TH 9:00 AM - 6:00 PM PCMH: No

Colon & Rectal Surgery Santiago, Lourdes MD Provider ID: 712549 Gender: Female Lourdes T Santiago MD PA 1305 S Fort Harrison Ave Bldg A Clearwater, FL 33756 (727) 483-9188 Fax: (727) 412-8432 18 Yrs/130 Yrs Florida Hospital North Pinellas M-F 9:00 AM - 5:00 PM PCMH: No

Williams, James MD Provider ID: 1177096 Gender: Male Bayfront Health Medical Group 601 7th St S Ste 510 Saint Petersburg, FL 33701 (727) 553-7670 Fax: (727) 553-7671 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 4:30 PM PCMH: No

Dermatology

Armstrong, Frank DO Provider ID: 221341 Gender: Male Armstrong Dermatology & Skin Cancer 9170 Oakhurst Rd Ste 1 Seminole, FL 33776 (727) 517-3376 Fax: (727) 517-3370 00 Yrs/130 Yrs St Petersburg General Hospital Languages: Spanish M-TH 8:30 AM - 4:30 PM F 8:30 AM - 2:30 PM PCMH: No

Albergo, Robert MD Belongie, Iriana MD Provider ID: 2554 Gender: Male 4132 Woodlands Pkwy Provider ID: 755816 Palm Harbor, FL 34685 Gender: Female (727) 786-5100 Academic Alliance In Dermatology I Fax: (727) 789-8344 3165 N McMln Bth Rd Bldg B 00 Yrs/130 Yrs Florida Hospital North Pinellas Clearwater, FL 33761 Mease Hospital Dunedin (727) 258-9143 Morton Plant Hospital Fax: (727) 823-7043 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No Johns Hopkins All Childrens Hospital Inc Albergo, Robert MD Tampa Community Hospital Provider ID: 971936 Languages: Spanish Gender: Male M 8:00 AM - 5:00 PM Advanced Dermatology and PCMH: No Cosmetic S Bondar, George DO 4132 Woodlands Pkwy Palm Harbor, FL 34685 (727) 786-5100 Provider ID: 635581 Fax: (727) 789-8344 Gender: Male 00 Yrs/130 Yrs 2329 Sunset Point Rd Ste 201 Florida Hospital North Pinellas Clearwater, FL 33765 Mease Hospital Dunedin (727) 441-3376 M-TH 8:00 AM - 5:00 PM Fax: (727) 517-3370 F 8:00 AM - 12:00 PM 00 Yrs/130 Yrs PCMH: No Mease Hospital Dunedin Tampa General Hospital M-F 8:00 AM - 4:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Dermatology - cont. Bondar, George DO Provider ID: 635581 Gender: Male Armstrong Dermatology Skin Cancer 9170 Oakhurst Rd Ste 1 Seminole, FL 33776 (727) 517-3376 Fax: (727) 517-3370 00 Yrs/130 Yrs Mease Hospital Dunedin Tampa General Hospital M-TH 8:30 AM - 4:30 PM F 8:30 AM - 2:30 PM PCMH: No Connors, James MD Provider ID: 224430 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Ste 3A Saint Petersburg, FL 33705 (727) 824-7105 Fax: (727) 824-7125 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Dorton, David DO Provider ID: 1114683 Gender: Male Family Care At Walsingham 13540 Walsingham Rd Ste D Largo, FL 33774 (727) 593-5492 Fax: (855) 373-4415 00 Yrs/130 Yrs Largo Medical Center Indian Rocks Medical Center of Trinity Morton Plant North Bay Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Esguerra, David DO Provider ID: 1162092 Gender: Male Family Care At Walsingham 13540 Walsingham Rd Ste D Largo, FL 33774 (727) 593-5492 Fax: (855) 373-4415 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Garcia Cardona, Maria MD Provider ID: 720279 Gender: Female 1801 N Belcher Rd Ste B Clearwater, FL 33765 (727) 669-3676 Fax: (727) 669-3669 00 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-W 8:00 AM - 4:30 PM TH 9:00 AM - 1:00 PM PCMH: No Kelleher, Margaret MD Provider ID: 617632 Gender: Female 6110 MLK St N Saint Petersburg, FL 33703 (727) 821-3600 Fax: (727) 821-3611 02 Yrs/130 Yrs St Anthonys Hospital M-F 8:30 AM - 4:30 PM PCMH: No

Levitt, Stephan MD Provider ID: 1278588 Gender: Male Leavitt Medical Associates of Flori 6450 38th Ave N Ste 420 Saint Petersburg, FL 33710 (727) 344-6651 Fax: (727) 345-4716 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Maloney, Karen MD Provider ID: 1368399 Gender: Female Academic Alliance In Dermatology In 1201 S Myrtle Ave Clearwater, FL 33756 (727) 442-1917 Fax: (727) 446-3490 00 Yrs/130 Yrs MT 8:00 AM - 5:00 PM PCMH: No

Miller, Richard DO Provider ID: 1098704 Gender: Male Family Care At Walsingham 13540 Walsingham Rd Ste D Largo, FL 33774 (727) 593-5492 Fax: (855) 373-4415 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Soe, Kathleen DO Provider ID: 290719 Gender: Female Virginia Street Dermatology 725 Virginia St Dunedin, FL 34698 (727) 734-4551 Fax: (727) 736-8648 00 Yrs/130 Yrs Mease Hospital Dunedin MTTH 8:30 AM - 4:00 PM W 9:30 AM - 5:00 PM F 8:00 AM - 5:00 PM PCMH: No Torres-Bonilla, Gisela MD

Maloney, Karen MD Provider ID: 1368399 Gender: Female Academic Alliance In Dermatology In 3165 N McMullen Booth Rd Ste D Clearwater, FL 33761 (727) 258-9143 Fax: (727) 823-7043 00 Yrs/130 Yrs MT 8:00 AM - 5:00 PM PCMH: No

Lam, David MD Provider ID: 757529 Maloney, Karen MD Gender: Male Academic Alliance In Provider ID: 1368399 Dermatology, I Gender: Female 1005 E Boyer St Academic Alliance In Tarpon Springs, FL 34689 Dermatology In (727) 934-7638 646 Virginia St Ste 201 Fax: (727) 944-4052 Dunedin, FL 34698 00 Yrs/130 Yrs Florida Hospital North Pinellas (727) 270-7291 Fax: (727) 446-3490 Johns Hopkins All Childrens 00 Yrs/130 Yrs Hospital Inc Morton Plant Hospital M 8:00 AM - 5:00 PM M-W 7:00 AM - 5:00 PM PCMH: No PCMH: No

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Provider ID: 587234 Gender: Male SC Physicians 620 10th St N Saint Petersburg, FL 33705 (727) 894-1818 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Witfill, Kristin MD Provider ID: 1109332 Gender: Female Family Care At Walsingham 13540 Walsingham Rd Ste D Largo, FL 33774 (727) 593-5492 Fax: (855) 373-4415 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Dermatology - cont. Zook, Matthew MD Provider ID: 759269 Gender: Male Academic Alliance In Dermatology 1201 S Myrtle Ave Clearwater, FL 33756 (727) 442-1917 Fax: (727) 446-3490 00 Yrs/130 Yrs Tampa General Hospital MT 8:00 AM - 5:00 PM PCMH: No Zook, Matthew MD Provider ID: 759269 Gender: Male Academic Alliance In Dermatology 3950 3rd St N Ste A Saint Petersburg, FL 33703 (727) 821-0612 Fax: (727) 822-5507 00 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 5:00 PM PCMH: No Zook, Matthew MD Provider ID: 759269 Gender: Male Academic Alliance In Dermatology, I 1301 2nd Ave SW Fl 5 Largo, FL 33770 (727) 935-0500 Fax: (727) 935-0501 00 Yrs/130 Yrs Tampa General Hospital M 8:00 AM - 5:00 PM PCMH: No

Dermatopathology Belongie, Iriana MD Provider ID: 755816 Gender: Female Academic Alliance In Dermatology I 3165 N McMln Bth Rd Bldg B Clearwater, FL 33761 (727) 258-9143 Fax: (727) 823-7043 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Community Hospital Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Ear, Nose & Throat Berrios, Jose MD Provider ID: 2978 Gender: Male Gulfcoast ENT Associates 800 Tarpon Woods Blvd Ste D Palm Harbor, FL 34685 (727) 942-4005 Fax: (727) 934-1773 00 Yrs/130 Yrs Florida Hospital North Pinellas Palms of Pasadena Hospital Languages: Spanish, French M-F 8:30 AM - 4:30 PM PCMH: No

Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Ear, Nose and Throat Spec 601 5th St S Ste 701 Saint Petersburg, FL 33701 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 8:00 AM - 5:30 PM PCMH: No Wasylik, Kathleen MD

Budharaju, Venkata MD Provider ID: 802124 Gender: Male Florida Endocrinology and Diabetes 2763 1st Ave N Saint Petersburg, FL 33713 (727) 623-9913 Fax: (727) 803-4852 18 Yrs/130 Yrs Largo Medical Center St Anthonys Hospital St Petersburg General Hospital MTWTHSat 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Budharaju, Venkata MD

Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head & Nec 1700 N McMln Bth Rd Ste B1 Clearwater, FL 33759 (727) 329-5400 Fax: (727) 329-5401 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Margolin, Jerry MD Provider ID: 174736 Endocrinology, Diabetes, Gender: Male Metabolism 501 S Lincoln Ave Ste 26 Clearwater, FL 33756 Blanchard, Richard MD (727) 442-2193 Provider ID: 175718 Fax: (727) 466-6483 Gender: Male 00 Yrs/130 Yrs Florida Hospital North Pinellas Suncoast Medical Clinic LLC 620 10th St N Largo Medical Center Indian Saint Petersburg, FL 33705 Rocks (727) 824-8282 M-F 8:30 AM - 4:30 PM Fax: (727) 824-8271 PCMH: No 18 Yrs/130 Yrs MTHF 8:30 AM - 5:00 PM T 8:00 AM - 5:00 PM W 8:30 AM - 4:00 PM PCMH: No

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Provider ID: 802124 Gender: Male Florida Endocrinology and Diabetes 8839 Bryan Dairy Rd Ste 110 Largo, FL 33777 (727) 623-9913 Fax: (727) 230-0693 18 Yrs/130 Yrs Largo Medical Center St Anthonys Hospital St Petersburg General Hospital M 9:00 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Janicka, Ania DO Provider ID: 423400 Gender: Female Diabetes Care Center Inc 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs Languages: Polish M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Endocrinology, Diabetes, Penabad, Jesus MD Metabolism - cont. Provider ID: 14580 Nair, Govindan MD Provider ID: 716 Gender: Male 4820 5th Ave N Saint Petersburg, FL 33713 (727) 321-6768 Fax: (727) 327-8741 00 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:30 AM - 4:30 PM PCMH: No Parbhoo, Arvind MD Provider ID: 213120 Gender: Male 6409 Dr MLK Jr St N Saint Petersburg, FL 33702 (727) 528-1138 Fax: (727) 528-2295 18 Yrs/130 Yrs Bayfront Medical Center Palms of Pasadena Hospital St Anthonys Hospital Languages: Gujarati MTH 9:00 AM - 12:00 PM TW 9:00 AM - 3:00 PM PCMH: No Patel, Payal MD Provider ID: 914267 Gender: Female Baycare Medical Group 1840 Mease Dr Ste 104 Safety Harbor, FL 34695 (727) 725-6283 Fax: (813) 635-2186 18 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-TH 8:00 AM - 4:00 PM F 8:00 AM - 12:00 PM PCMH: No

Szafran Swietlik, Anna MD

Gender: Male Diabetes Care Center 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 450-1349 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 574625 Gender: Female Diabetes Care Center Inc 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 450-1349 Fax: (727) 862-0934 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No

Pinero-Pilona, Antonio MD

Gargasz, Bret DDS Provider ID: TPVP42269-07 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

Provider ID: 187645 Gender: Male Diabetes Care Center 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 869-7822 Fax: (727) 862-0934 18 Yrs/130 Yrs CRMC At Bayonet Point Mease Countryside Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Plazarte, Monica DO Provider ID: 1270914 Gender: Female Diabetes Care Center, Inc. 2531 Landmark Dr Clearwater, FL 33761 (727) 869-7822 Fax: (727) 862-0934 00 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM PCMH: No Siddiqui, Munira MD

Endodontics

Gargasz, Bret DDS Provider ID: TPVP42269-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Provider ID: 589449 Gender: Female Baycare Medical Group 1840 Mease Dr Ste 104 Safety Harbor, FL 34695 (727) 725-6283 Fax: (813) 635-2186 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Gargasz, Bret DDS Provider ID: TPVP42269-09 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-10 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Gargasz, Bret DDS Provider ID: TPVP42269-15 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Endodontics - cont. Gittess, Robert DDS Provider ID: TPVP42923-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Kan, Elena DDS Provider ID: TPVP128847-01 Gender: Female Coast Dental - Eastlake 3150 Tampa Rd Ste 4 Oldsmar, FL 34677 (727) 787-0202 Fax: (727) 785-2374 00 Yrs/99 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-03 Gender: Female Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No

Millstein, Ashley DMD Provider ID: TPVP139323-05 Gender: Female Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-42 Gender: Female Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-43 Gender: Female Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Family Practice Braun, Edward MD Provider ID: 1308264 Gender: Male Comprehensive Care Center Inc DBA C 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 321-3854 Fax: (727) 327-7670 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jenkins, Julia MD Provider ID: 1370315 Gender: Female Baycare Medical Group Inc 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2477 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ravindra, Chitra MD Provider ID: 959768 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ravindra, Chitra MD Provider ID: 959768 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 824-6900 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Ravindra, Chitra MD Provider ID: 959768 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ravindra, Chitra MD Provider ID: 959768 Gender: Female Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gastroenterology Ahn, John DO Provider ID: 105 Gender: Male West Central Gastroenterology LLP 1840 Mease Dr Ste 305 Safety Harbor, FL 34695 (727) 796-4166 Fax: (727) 669-5849 12 Yrs/130 Yrs North Pinellas Surgery Center M-F 8:30 AM - 5:00 PM PCMH: No Amin, Sanjiv DO Provider ID: 224343 Gender: Male Advanced Gastroenterology Associate 34041 US Hwy 19 N Ste A Palm Harbor, FL 34684 (727) 786-0017 Fax: (727) 786-7521 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin North Pinellas Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Gastroenterology - cont. Bontemps, Ernst MD Amin, Sanjiv DO Provider ID: 224343 Gender: Male Advanced Gastroenterology Associate 646 Virginia St Ste 201 Dunedin, FL 34698 (727) 786-0017 Fax: (727) 786-7521 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin North Pinellas Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No Bajwa, Neil MD Provider ID: 1030573 Gender: Male West Central Gastroenterology LLP 6225 66th St N Pinellas Park, FL 33781 (727) 521-0994 Fax: (727) 522-2671 18 Yrs/130 Yrs Northside Hospital St Petersburg Endoscopy Center St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 217005 Gender: Male 1609 Pasadena Ave S Ste 3M S Pasadena, FL 33707 (727) 384-2016 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Borislow, David MD Provider ID: 801 Gender: Male Center For Digestive Care Inc 1260 S ML King Ave Ste E Clearwater, FL 33756 (727) 443-2920 Fax: (727) 443-2726 18 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Choudhry, Umesh MD Provider ID: 7050 Gender: Male West Central Gastroenterology 920 S Myrtle Ave Ste A Clearwater, FL 33756 (727) 462-0444 Fax: (727) 462-0446 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Becker, David MD Provider ID: 214420 Gender: Male Gastroenterology Consultants of Cle 508 Jeffords St Ste D Clearwater, FL 33756 (727) 443-7700 Fax: (727) 461-4379 Daly Jr, Joseph MD 18 Yrs/130 Yrs Provider ID: 918574 Morton Plant Hospital Gender: Male M-F 8:30 AM - 5:00 PM 33920 US Hwy 19 N Ste 124 PCMH: No Palm Harbor, FL 34684 (727) 785-7654 Fax: (727) 787-0061 00 Yrs/130 Yrs North Pinellas Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No

Degala, Gourisankar MD Provider ID: 724500 Gender: Male 920 S Myrtle Ave Ste A Clearwater, FL 33756 (727) 462-0444 Fax: (727) 462-0446 18 Yrs/130 Yrs Languages: Telugu M-F 9:00 AM - 5:00 PM PCMH: No Desai, Chetan MD Provider ID: 1532 Gender: Male Center For Digestive Care Inc 1300 S Ft Harisn Ave Ste 100 Clearwater, FL 33756 (727) 447-3100 Fax: (727) 447-4466 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No Desai, Chetan MD Provider ID: 1532 Gender: Male Center For Digestive Care Inc 3901 66th St N Ste 201 Saint Petersburg, FL 33709 (727) 345-5500 Fax: (727) 302-0550 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No Glamour, Tejinder MD Provider ID: 26488 Gender: Male Advanced Gastro Liver Care PA 6225 66th St N Pinellas Park, FL 33781 (727) 521-0994 Fax: (727) 522-2671 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Millenia Surgery Center M-F 9:00 AM - 5:00 PM PCMH: No

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Iyunni, Venkata MD Provider ID: 9138 Gender: Male IVS Nath. MD, F.RCP., PA 6217 66th St N Pinellas Park, FL 33781 (727) 546-1680 Fax: (727) 546-9746 18 Yrs/130 Yrs Bayfront Medical Center Northside Hospital St Petersburg General Hospital Languages: Spanish, Hindi, Punjabi, Telugu M-F 8:30 AM - 5:00 PM PCMH: No Jacob, Pothen MD Provider ID: 1190 Gender: Male Center For Digestive Care Inc 1300 S Ft Harisn Ave Ste 100 Clearwater, FL 33756 (727) 447-3100 Fax: (727) 447-4466 18 Yrs/130 Yrs St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Jacob, Pothen MD Provider ID: 1190 Gender: Male Center For Digestive Care Inc 3901 66th St N Ste 201 Saint Petersburg, FL 33709 (727) 345-5500 Fax: (727) 302-0550 18 Yrs/130 Yrs St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Klein, Howard MD Provider ID: 148331 Gender: Male Gastroenterology Consultants of Cle 508 Jeffords St Ste D Clearwater, FL 33756 (727) 443-7700 Fax: (727) 461-4379 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Gastroenterology - cont. LA Camera, Richard MD Klibanoff, Alan MD Provider ID: 923582 Gender: Male 33920 US Hwy 19 N Ste 124 Palm Harbor, FL 34684 (727) 785-7654 Fax: (727) 787-0061 18 Yrs/130 Yrs Florida Hospital North Pinellas North Pinellas Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Kozlov, Nicholas MD Provider ID: 217776 Gender: Male St Anthony Hospital 1200 7th Ave N Saint Petersburg, FL 33705 (727) 217-3901 18 Yrs/130 Yrs Millenia Surgery Center St Anthonys Hospital St Petersburg Endoscopy Center PCMH: No Kozlov, Nicholas MD Provider ID: 217776 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-7116 Fax: (727) 824-7125 18 Yrs/130 Yrs Millenia Surgery Center St Anthonys Hospital St Petersburg Endoscopy Center M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Provider ID: 923600 Gender: Male 33920 US Hwy 19 N Ste 124 Palm Harbor, FL 34684 (727) 785-7654 Fax: (727) 787-0061 16 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin North Pinellas Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Luckey, Lisa DO Provider ID: 787132 Gender: Female Suncoast Internal Medicine Consulta 13644 Walsingham Rd Largo, FL 33774 (727) 595-2519 Fax: (727) 595-3872 18 Yrs/130 Yrs CRMC At Bayonet Point Languages: Spanish, German M-F 8:30 AM - 5:00 PM PCMH: No Narula, Rajan DO Provider ID: 1298699 Gender: Male St Peter Gastro Assocs 2763 1st Ave N Saint Petersburg, FL 33713 (727) 317-5957 Fax: (727) 822-8081 18 Yrs/110 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Mihir MD Provider ID: 224977 Gender: Male West Central Gastroenterology 3901 66th St N Ste 201 Saint Petersburg, FL 33709 (727) 345-5500 Fax: (727) 302-0550 18 Yrs/130 Yrs Largo Medical Center Millenia Surgery Center St Anthonys Hospital Languages: Hindi, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No Patel, Mihir MD Provider ID: 224977 Gender: Male West Gastroenterology 1300 S Ft Harisn Ave Ste 100 Clearwater, FL 33756 (727) 447-3100 Fax: (727) 447-4466 18 Yrs/130 Yrs Largo Medical Center Millenia Surgery Center St Anthonys Hospital Languages: Hindi, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No Patil, Abhitabh MD Provider ID: 698072 Gender: Male West Central Gastroenterology LLC 1201 5th Ave N Ste 308 Saint Petersburg, FL 33705 (727) 345-5500 Fax: (727) 302-0550 18 Yrs/130 Yrs Morton Plant Hospital Northside Hospital St Petersburg Endoscopy Center M-TH 9:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

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Patil, Abhitabh MD Provider ID: 698072 Gender: Male West Central Gastroenterology LLP 3901 66th St N Ste 201 Saint Petersburg, FL 33709 (727) 345-5500 Fax: (727) 541-6558 18 Yrs/130 Yrs Morton Plant Hospital Northside Hospital St Petersburg Endoscopy Center M-F 8:00 AM - 5:00 PM PCMH: No Peebles, Michael MD Provider ID: 918570 Gender: Male 33920 US Hwy 19 N Ste 124 Palm Harbor, FL 34684 (727) 785-7654 Fax: (727) 787-0061 18 Yrs/130 Yrs North Pinellas Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Sperber, Harry MD Provider ID: 1544 Gender: Male Suncoast Medical Clinic LLC 701 6th St S Saint Petersburg, FL 33701 (727) 823-1234 18 Yrs/130 Yrs Millenia Surgery Center St Anthonys Hospital St Petersburg Endoscopy Center M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Gastroenterology - cont. Taunk, Jawahar MD Steckler, Eric MD Provider ID: 174778 Gender: Male 33920 US Hwy 19 N Ste 124 Palm Harbor, FL 34684 (727) 785-7654 Fax: (727) 787-0061 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin North Pinellas Surgery Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Strickland, Amy MD Provider ID: 713485 Gender: Female Suncoast Medical Clinic LLC 1201 5th Ave N Ste 409 Saint Petersburg, FL 33705 (727) 825-1661 Fax: (727) 825-1361 18 Yrs/130 Yrs Millenia Surgery Center St Petersburg Endoscopy Center M-F 8:00 AM - 5:00 PM PCMH: No Taunk, Jawahar MD Provider ID: 1348 Gender: Male Advanced Gastroenterology Associate 34041 US Hwy 19 N Ste A Palm Harbor, FL 34684 (727) 786-0017 Fax: (727) 786-7521 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin North Pinellas Surgery Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1348 Gender: Male Advanced Gastroenterology Associate 646 Virginia St Dunedin, FL 34698 (727) 786-0017 Fax: (727) 786-7521 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin North Pinellas Surgery Center Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Weiss, Michael MD Provider ID: 591383 Gender: Male Gastroenterology Consulants of Clea 508 Jeffords St Ste D Clearwater, FL 33756 (727) 443-7700 Fax: (727) 461-4379 18 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 5:00 PM PCMH: No Wharton, Robert MD Provider ID: 8295 Gender: Male Robert H Wharton Jr MD 4855 1st Ave N Saint Petersburg, FL 33713 (727) 321-6450 Fax: (727) 327-2668 18 Yrs/130 Yrs M-F 9:00 AM - 5:30 PM PCMH: No

Zeitlin, Laurence MD

Adderly, Erica DDS Provider ID: TPVP131028-17 Gender: Female Provider ID: 918565 Greenberg Dental Gender: Male Orthodontics 33920 US Hwy 19 N Ste 124 10472 Roosevelt Blvd North Palm Harbor, FL 34684 Saint Petersburg, FL 33716 (727) 785-7654 (727) 399-6938 Fax: (727) 787-0061 Fax: (727) 914-6982 00 Yrs/130 Yrs Florida Hospital North Pinellas 00 Yrs/99 Yrs Languages: Spanish Mease Hospital Dunedin North Pinellas Surgery Center MT 7:00 AM - 3:00 PM M-F 8:00 AM - 5:00 PM WTH 11:00 AM - 7:00 PM PCMH: No PCMH: No

Gastroenterology & Hepatology Onea, Mirela MD Provider ID: 698894 Gender: Female Advanced Gastroenterology Associate 34041 US Hwy 19 N Ste A Palm Harbor, FL 34684 (727) 786-0017 Fax: (727) 786-0017 18 Yrs/130 Yrs Mease Countryside Hospital North Pinellas Surgery Center Languages: Romanian M-F 9:00 AM - 5:00 PM PCMH: No

General Dentistry Adderly, Erica DDS Provider ID: TPVP131028-06 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

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Adewunmi, Mopelola DDS Provider ID: TPVP125144-01 Gender: Male Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Adewunmi, Mopelola DDS Provider ID: TPVP125144-02 Gender: Male Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Adewunmi, Mopelola DDS Provider ID: TPVP125144-03 Gender: Male Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Alonso, Zenaida DDS Adewunmi, Mopelola DDS Provider ID: TPVP125144-04 Gender: Male Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Adewunmi, Mopelola DDS Provider ID: TPVP125144-05 Gender: Male Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Adewunmi, Mopelola DDS Provider ID: TPVP125144-06 Gender: Male Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No

Alter, Jason DMD Provider ID: TPVP127369-03 Provider ID: TPVP157399-02 Gender: Female Gender: Male Community Health Centers of Great Expressions Dental Pinellas Inc Centers 702 Jasmine Way 400 Carillon Pkwy Ste 120 Clearwater, FL 33756 Saint Petersburg, FL 33716 (727) 824-8181 (727) 299-0728 Fax: (727) 216-7040 Fax: (727) 209-1365 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish MTH 7:30 AM - 6:00 PM M-TH 8:00 AM - 5:00 PM TW 7:30 AM - 4:30 PM PCMH: No F 7:30 AM - 12:30 PM Arnedo, Johanna DDS PCMH: No Provider ID: TPVP146775-04 Alonso, Zenaida DDS Gender: Female Provider ID: TPVP127369-04 Tyrone Square Mall Dental PA Gender: Female 6747 Tyrone Square Community Health Centers of Saint Petersburg, FL 33710 Pinellas Inc (727) 345-6100 1344 22nd St S Fax: (727) 345-0793 Saint Petersburg, FL 33712 00 Yrs/99 Yrs (727) 824-8181 Languages: Russian Fax: (727) 551-9306 MTWTHFSat 10:00 AM - 5:00 00 Yrs/99 Yrs PM Languages: Spanish PCMH: No MT 7:30 AM - 6:00 PM Atkinson, William DDS WTH 7:30 AM - 4:30 PM Provider ID: TPVP44289-05 F 7:30 AM - 12:30 PM Gender: Male PCMH: No Tyrone Square Mall Dental PA Alter, Jason DMD 6747 Tyrone Square Provider ID: TPVP157399-01 Saint Petersburg, FL 33710 Gender: Male (727) 345-6100 Great Expressions Dental Fax: (727) 345-0793 Centers 00 Yrs/99 Yrs 6759 1st Ave South Languages: Russian Saint Petersburg, FL 33707 MTWTHFSat 10:00 AM - 5:00 (727) 381-1642 PM Fax: (727) 343-2017 PCMH: No 00 Yrs/99 Yrs Attie, Abelardo DMD M-F 8:00 AM - 5:00 PM Provider ID: TPVP156288-04 PCMH: No Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

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Bacchelli, Lara DMD Provider ID: TPVP156856-07 Gender: Female Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-08 Gender: Female Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-10 Gender: Female Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Baez Henry, Carlianette DMD Beach, Christopher DDS Bacchelli, Lara DMD Provider ID: TPVP156856-11 Gender: Female Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No Baez, Tomas DDS Provider ID: TPVP158350-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Beach, Christopher DDS

Provider ID: TPVP123839-01 Gender: Male Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No

Provider ID: TPVP123839-05 Gender: Male Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Baker, Wayne DDS Provider ID: TPVP43802-01 Gender: Male Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Beach, Christopher DDS Provider ID: TPVP123839-02 Gender: Male Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Beach, Christopher DDS Provider ID: TPVP123839-06 Gender: Male Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Barrett, Steven DDS Provider ID: TPV12124-60 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Beach, Christopher DDS Provider ID: TPVP123839-03 Gender: Male Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No

Beers, Eda DDS Provider ID: TPVP123815-01 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No

Provider ID: TPVP150151-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Barrett, Steven DDS Provider ID: TPV12124-65 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Beach, Christopher DDS Provider ID: TPVP123839-04 Gender: Male Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 370

Beers, Eda DDS Provider ID: TPVP123815-02 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Berk, Madeline DMD Beers, Eda DDS Provider ID: TPVP123815-03 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Beers, Eda DDS Provider ID: TPVP123815-04 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Beers, Eda DDS Provider ID: TPVP123815-05 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Beers, Eda DDS Provider ID: TPVP123815-06 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP134183-03 Gender: Female Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Biandudi, Odessa DDS Provider ID: TPVP120881-08 Gender: Female Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Boswell, Gibson DMD Provider ID: TPVP156855-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No Bradley, Ashley DMD Provider ID: TPVP153368-07 Gender: Female Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

Bradley, Ashley DMD Provider ID: TPVP153368-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Branscombe, Tyler DMD Provider ID: TPVP134684-15 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Branscombe, Tyler DMD Provider ID: TPVP134684-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Brito, Daryl DMD Provider ID: TPVP145792-17 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Branscombe, Tyler DMD Provider ID: TPVP134684-10 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 371

Budzinski, Volha DDS Provider ID: TPVP147349-01 Gender: Female Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Bushati, Ivo DMD Provider ID: TPVP134886-15 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Caputo, Michael DDS Caputo, Michael DDS Provider ID: TPVP156605-45 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-46 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-48 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-11 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Carter, Jade DDS Provider ID: TPVP155901-02 Gender: Female Community Health Centers of Pinellas Inc 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 551-9306 00 Yrs/99 Yrs Languages: Spanish MT 7:30 AM - 6:00 PM WTH 7:30 AM - 4:30 PM F 7:30 AM - 12:30 PM PCMH: No

Caputo, Michael DDS Provider ID: TPVP156605-52 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-14 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Carbonell, Kevin DMD Provider ID: TPVP152393-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Chapagain, Shweta DDS Provider ID: TPVP76164-01 Gender: Female Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Carter, Jade DDS Provider ID: TPVP155901-01 Charles, Jay II DDS Gender: Female Provider ID: TPVP156591-16 Community Health Centers of Gender: Male Pinellas Inc Cobbe Dental 702 Jasmine Way 2707 Tampa Rd Clearwater, FL 33756 Palm Harbor, FL 34684 (727) 824-8181 (727) 785-6521 Fax: (727) 216-7040 Fax: (727) 785-6237 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish MTH 7:30 AM - 6:00 PM M-TH 8:00 AM - 5:30 PM TW 7:30 AM - 4:30 PM F 8:00 AM - 5:00 PM F 7:30 AM - 12:30 PM PCMH: No PCMH: No Chase, Kely DMD Provider ID: TPVP137786-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP156605-49 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 372

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Chekan, Theodore DDS Chekan, Theodore DDS Provider ID: TPVP43857-11 Gender: Male Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-12 Gender: Male Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-13 Gender: Male Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-14 Gender: Male Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP43857-15 Gender: Male Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Chekan, Theodore DDS Provider ID: TPVP43857-16 Gender: Male Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Dao, Thieu DDS Provider ID: TPVP43794-01 Gender: Male Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Diaz, Jany DMD Provider ID: TPVP152982-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Dire, Anthony DMD Provider ID: TPVP42170-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-07 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

www.wellcare.com/Florida | 373

Dockus, Matthew DMD Provider ID: TPVP157263-10 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-11 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-14 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Durve, Aparna DMD Dolce, Vincent DMD Provider ID: TPVP145740-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153195-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Eckels, Shane DDS Provider ID: TPVP134881-44 Dougherty, Erin DMD Gender: Female Provider ID: TPVP121661-01 Greenberg Dental Orthodontics Gender: Female Community Health Centers of 3711 49th St North Pinellas Inc Saint Petersburg, FL 33710 702 Jasmine Way (727) 547-3603 Clearwater, FL 33756 Fax: (727) 551-4906 (727) 824-8181 00 Yrs/99 Yrs Fax: (727) 216-7040 Languages: Spanish 00 Yrs/99 Yrs PCMH: No Languages: Spanish El-Sherbini, Sara DDS MTH 7:30 AM - 6:00 PM Provider ID: TPVP145514-03 TW 7:30 AM - 4:30 PM Gender: Female F 7:30 AM - 12:30 PM Cobbe Dental PCMH: No 2707 Tampa Rd Dougherty, Erin DMD Palm Harbor, FL 34684 Provider ID: TPVP121661-02 (727) 785-6521 Gender: Female Fax: (727) 785-6237 Community Health Centers of 00 Yrs/99 Yrs Pinellas Inc Languages: Spanish 1344 22nd St S M-TH 8:00 AM - 5:30 PM Saint Petersburg, FL 33712 F 8:00 AM - 5:00 PM (727) 824-8181 PCMH: No Fax: (727) 551-9306 Engelman, Sharon DDS 00 Yrs/99 Yrs Languages: Spanish Provider ID: TPVP123850-01 MT 7:30 AM - 6:00 PM Gender: Female WTH 7:30 AM - 4:30 PM Doh - Pinellas County Health Department F 7:30 AM - 12:30 PM 205 Dr Martin Luther King St PCMH: No No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No

Engelman, Sharon DDS Provider ID: TPVP123850-02 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Engelman, Sharon DDS Provider ID: TPVP123850-06 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Engelman, Sharon DDS Provider ID: TPVP123850-03 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No

Fornos, Jorge DDS Provider ID: TPVP149429-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Engelman, Sharon DDS Provider ID: TPVP123850-04 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Fuller, Ellis DDS Provider ID: TPVP45413-14 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Engelman, Sharon DDS Provider ID: TPVP123850-05 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Gatons, Yelena DDS Provider ID: TPVP125134-01 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 374

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Gatons, Yelena DDS Gatons, Yelena DDS Provider ID: TPVP125134-02 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Gatons, Yelena DDS Provider ID: TPVP125134-03 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Gatons, Yelena DDS Provider ID: TPVP125134-04 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Gatons, Yelena DDS Provider ID: TPVP125134-05 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP125134-06 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-07 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Genninger, Jasen DMD Provider ID: TPVP148171-10 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-11 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Gilton, Amber DMD Provider ID: TPV19779-04 Gender: Female Great Expressions Dental Centers 35176 US Hwy 19 North Palm Harbor, FL 34684 (727) 723-1400 Fax: (727) 726-3611 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 375

Goldstein, Alexander DDS Provider ID: TPVP149777-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Gonzalez, Yanela DMD Provider ID: TPVP147283-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Green, George DDS Provider ID: TPVP44723-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Greenberg, Andrew DDS Provider ID: TPV7501-60 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Hall, Joshua DMD Gutu, Elena DMD Provider ID: TPVP42135-01 Gender: Female St Pete Modern Dentistry 5500 1st Ave N Saint Petersburg, FL 33710 (727) 954-4431 Fax: (727) 954-8042 00 Yrs/99 Yrs Languages: Russian MWTH 8:30 AM - 5:00 PM T 9:00 AM - 6:00 PM PCMH: No Hall, Joshua DMD Provider ID: TPVP156847-07 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Hall, Joshua DMD Provider ID: TPVP156847-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP156847-10 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Hall, Joshua DMD Provider ID: TPVP156847-11 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Hall, Joshua DMD Provider ID: TPVP156847-14 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Halttunen, Arthur DDS Provider ID: TPVP45056-01 Gender: Male Great Expressions Dental Centers 11701 Belcher Rd S Ste 103 Largo, FL 33773 (727) 531-7676 Fax: (727) 373-0034 00 Yrs/99 Yrs M 10:00 AM - 7:00 PM TTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No

Helmy, George DDS Provider ID: TPVP147885-01 Gender: Male Coast Dental - St Petersburg 7801 Dr Martin Luther King Jr St N Saint Petersburg, FL 33702 (727) 525-4499 Fax: (727) 525-9683 00 Yrs/99 Yrs Languages: Polish M-F 8:30 AM - 5:00 PM PCMH: No

Helmy, George DDS Provider ID: TPVP147885-02 Hanna, Mina DMD Gender: Male Provider ID: TPVP121412-01 Coast Dental - Pasadena Gender: Male Community Health Centers of 6882 Gulfport Blvd South Saint Petersburg, FL 33707 Pinellas Inc (727) 384-9655 702 Jasmine Way Fax: (727) 384-9855 Clearwater, FL 33756 00 Yrs/99 Yrs (727) 824-8181 MTTHF 8:00 AM - 5:00 PM Fax: (727) 216-7040 W 8:00 AM - 8:00 PM 00 Yrs/99 Yrs PCMH: No Languages: Spanish, Arabic MTH 7:30 AM - 6:00 PM Immadi, Lakshmi DDS TW 7:30 AM - 4:30 PM Provider ID: TPVP107938-13 F 7:30 AM - 12:30 PM Gender: Female PCMH: No Great Expressions Dental Centers Hanna, Mina DMD 2938 W Bay Dr Ste C Provider ID: TPVP121412-02 Belleair Bluffs, FL 33770 Gender: Male Community Health Centers of (727) 584-5548 Fax: (727) 559-9685 Pinellas Inc 00 Yrs/99 Yrs 1344 22nd St S MTTH 8:00 AM - 5:00 PM Saint Petersburg, FL 33712 W 10:00 AM - 6:00 PM (727) 824-8181 PCMH: No Fax: (727) 551-9306 00 Yrs/99 Yrs Inaba, Caroline DDS Languages: Spanish, Arabic Provider ID: TPVP165330-04 MT 7:30 AM - 6:00 PM Gender: Female WTH 7:30 AM - 4:30 PM Tyrone Square Mall Dental PA F 7:30 AM - 12:30 PM 6747 Tyrone Square PCMH: No Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Kanach, Paul DMD Jensen, Stephen DDS Provider ID: TPVP43790-01 Gender: Male Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-22 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-23 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Provider ID: TPVP137705-25 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-26 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Kanach, Paul DMD Provider ID: TPVP137705-29 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Katsur, Justin DDS Provider ID: TPV16372-77 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No Kiani, Kamran DMD Provider ID: TPVP139839-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Kohn, Heather DDS Provider ID: TPVP137917-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Kopynets, Viktor DDS Provider ID: TPVP134963-09 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

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Krasnov, Rostislav DDS Provider ID: TPV16377-19 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Kuntsmann, Vivian DDS Provider ID: TPVP45145-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Lense, Pedro DDS Provider ID: TPVP127448-03 Gender: Male Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Lense, Pedro DDS Provider ID: TPVP127448-04 Gender: Male Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Lipton, Barry DDS Lense, Pedro DDS Provider ID: TPVP127448-05 Gender: Male Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Lense, Pedro DDS Provider ID: TPVP127448-06 Gender: Male Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lense, Pedro DDS Provider ID: TPVP127448-07 Gender: Male Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Lense, Pedro DDS Provider ID: TPVP127448-08 Gender: Male Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP138203-05 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Lopez, Grace DMD Provider ID: TPVP126209-10 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Spanish, Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Luce, Amy DMD Provider ID: TPVP126189-01 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Luce, Amy DMD Provider ID: TPVP126189-02 Gender: Female Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Magazine, Joanna DMD Provider ID: TPVP45096-01 Gender: Female Great Expressions Dental Centers 5002 73rd Ave North Pinellas Park, FL 33781 (727) 544-7733 Fax: (727) 544-3869 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Martinez, Gustavo DMD Provider ID: TPVP156290-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Spanish, Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Mann, Nicholas DMD Provider ID: TPVP134710-04 Gender: Male Mann Orthodontics PA 8588 Starkey Rd Ste C Largo, FL 33777 (727) 392-7734 Fax: (727) 319-3828 00 Yrs/99 Yrs M 9:00 AM - 5:30 PM PCMH: No

Martinez, Magela DMD Provider ID: TPVP137758-43 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Manzur, Kasim DDS Provider ID: TPVP137303-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Matthews, Irina DMD Provider ID: TPVP127504-03 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Marshall, Kristine DDS Provider ID: TPVP42582-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Mauricio, Margaret DDS Provider ID: TPVP43119-07 Gender: Male Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Mazariegos, Stephanie DMD Mazariegos, Stephanie DMD Provider ID: TPVP156700-08 Gender: Female Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-10 Gender: Female Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Mazariegos, Stephanie DMD Provider ID: TPVP156700-11 Gender: Female Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No

Provider ID: TPVP156700-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No Miller, Dwayne DDS Provider ID: TPVP44489-08 Gender: Male E G Family Dentistry Inc 28913 US Hwy 19 N Clearwater, FL 33761 (727) 772-8772 Fax: (727) 772-9583 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 6:00 PM TWTH 9:00 AM - 3:00 PM PCMH: No Morell, Omar DMD Provider ID: TPVP165512-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Nakarmi, Bibek DDS Provider ID: TPVP147282-01 Gender: Male Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish, Bengali M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Ngo, Denise DDS Provider ID: TPVP134878-15 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Park, James DDS Provider ID: TPVP153012-15 Gender: Male Coast Dental - Largo 10427 Ulmerton Rd Ste B-3 Largo, FL 33771 (727) 535-9993 Fax: (727) 530-1958 00 Yrs/99 Yrs Languages: Korean M-F 8:30 AM - 5:00 PM PCMH: No

Nguyen, David DMD Provider ID: TPVP138472-23 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Patel, Guarangi DDS Provider ID: TPVP44007-01 Gender: Female A-1 Dental 29605 US 19 N Ste 350 Clearwater, FL 33761 (727) 786-6649 Fax: (727) 789-9454 00 Yrs/99 Yrs MTH 9:00 AM - 5:00 PM TW 10:00 AM - 6:00 PM PCMH: No

Pansuriya, Dharmendra DMD Provider ID: TPVP159199-03 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Park, James DDS Provider ID: TPVP153012-14 Gender: Male Coast Dental - St Petersburg 7801 Dr Martin Luther King Jr St N Saint Petersburg, FL 33702 (727) 525-4499 Fax: (727) 525-9683 00 Yrs/99 Yrs Languages: Korean, Polish M-F 8:30 AM - 5:00 PM PCMH: No

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Patel, Kinjalben DMD Provider ID: TPVP137746-44 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No Paula, Kelly DMD Provider ID: TPVP157406-04 Gender: Female Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Qadri, Subuhi DMD Provider ID: TPVP148112-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Reed, Samantha DDS Provider ID: TPVP43792-25 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Quevedo, Fernando DDS Provider ID: TPVP147279-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Ribot, Aliana DMD Provider ID: TPVP145397-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Porter, Thomas DDS Provider ID: TPVP132978-01 Gender: Male St Petersburg Dental Clinic 9200 113th St N Seminole, FL 33772 (727) 394-6064 Fax: (727) 394-6098 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No

Quevedo, Rachel DDS Provider ID: TPVP150163-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Rivera, Jade DMD Provider ID: TPVP155459-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Prato-Guia, Yelena DDS Provider ID: TPVP141347-05 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Raffoul, Georges DMD Provider ID: TPVP156867-01 Gender: Male Coast Dental - St Petersburg 7801 Dr Martin Luther King Jr St N Saint Petersburg, FL 33702 (727) 525-4499 Fax: (727) 525-9683 00 Yrs/99 Yrs Languages: Polish M-F 8:30 AM - 5:00 PM PCMH: No

Pham, Thi DDS Provider ID: TPVP43265-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Phan, Christine DMD Provider ID: TPVP127987-43 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Rizner, Amanda DMD Provider ID: TPVP131828-43 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

www.wellcare.com/Florida | 380

Saraydar, Haychell DDS Provider ID: TPVP123848-01 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Saraydar, Haychell DDS Provider ID: TPVP123848-02 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Saraydar, Haychell DDS Provider ID: TPVP123848-03 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Saraydar, Haychell DDS Provider ID: TPVP123848-04 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Selz, Amrita DMD Saraydar, Haychell DDS Provider ID: TPVP123848-05 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Saraydar, Haychell DDS Provider ID: TPVP123848-06 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Selz, Amrita DMD Provider ID: TPVP121160-01 Gender: Female Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP121160-02 Gender: Female Great Expressions Dental Centers 2938 W Bay Dr Ste C Belleair Bluffs, FL 33770 (727) 584-5548 Fax: (727) 559-9685 00 Yrs/99 Yrs MTTH 8:00 AM - 5:00 PM W 10:00 AM - 6:00 PM PCMH: No Siemiet, Erika DDS Provider ID: TPVP43793-01 Gender: Female Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish, Portuguese M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Stoici, Ioana DMD Provider ID: TPV18891-09 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Stoici, Ioana DMD Provider ID: TPV18891-10 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Stoici, Ioana DMD Provider ID: TPV18891-11 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No

Teresi, Kirsten DMD Provider ID: TPVP155452-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Stoici, Ioana DMD Provider ID: TPV18891-12 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Thomas, Kelly DMD Provider ID: TPVP134675-01 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No

Stoici, Ioana DMD Provider ID: TPV18891-13 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Thomas, Kelly DMD Provider ID: TPVP134675-02 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Stoici, Ioana DMD Provider ID: TPV18891-14 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Thomas, Kelly DMD Provider ID: TPVP134675-03 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Trivedi, Mehulkumar DMD Thomas, Kelly DMD Provider ID: TPVP134675-04 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Thomas, Kelly DMD Provider ID: TPVP134675-05 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No Thomas, Kelly DMD Provider ID: TPVP134675-06 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP153681-07 Gender: Male Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Trivedi, Mehulkumar DMD Provider ID: TPVP153681-08 Gender: Male Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No Trivedi, Mehulkumar DMD Provider ID: TPVP153681-10 Gender: Male Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-11 Gender: Male Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Trivedi, Mehulkumar DMD Provider ID: TPVP153681-14 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No Uzunova-Dimova, Kalina DDS Provider ID: TPVP145103-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Valdman, Vadim DDS Provider ID: TPV17761-17 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

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Viera, Gretel DDS Provider ID: TPVP43189-01 Gender: Female St Petersburg Dental Clinic 9200 113th St N Seminole, FL 33772 (727) 394-6064 Fax: (727) 394-6098 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 4:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-07 Gender: Female Greenberg Dental Orthodontics 36091 US Hwy 19 North Palm Harbor, FL 34684 (727) 330-2765 Fax: (727) 474-0215 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM TWTH 11:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-08 Gender: Female Greenberg Dental Orthodontics 10472 Roosevelt Blvd North Saint Petersburg, FL 33716 (727) 399-6938 Fax: (727) 914-6982 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Ward, Tasha DDS Wade, Brianne DMD Provider ID: TPVP156720-10 Gender: Female Greenberg Dental Orthodontics PA 2950 34th St Saint Petersburg, FL 33711 (727) 399-6890 Fax: (727) 399-6858 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM W 7:00 AM - 6:00 PM TH 11:00 AM - 7:00 PM F 7:30 AM - 3:30 PM Sat 8:00 AM - 3:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-11 Gender: Female Greenberg Dental Orthodontics 2045 Gulf To Bay Blvd Ste B Clearwater, FL 33765 (727) 474-0211 Fax: (727) 265-3386 00 Yrs/99 Yrs Languages: Spanish MTWF 7:00 AM - 3:00 PM TH 11:00 AM - 7:00 PM Sat 7:00 AM - 2:00 PM PCMH: No Wade, Brianne DMD Provider ID: TPVP156720-14 Gender: Female Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Provider ID: TPVP44296-01 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No Ward, Tasha DDS Provider ID: TPVP44296-02 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ward, Tasha DDS Provider ID: TPVP44296-03 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Ward, Tasha DDS Provider ID: TPVP44296-04 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Ward, Tasha DDS Provider ID: TPVP44296-05 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Weiskopf, Mark DDS Provider ID: TPVP44587-04 Gender: Male Great Expressions Dental Centers 2938 W Bay Dr Ste C Belleair Bluffs, FL 33770 (727) 584-5548 Fax: (727) 559-9685 00 Yrs/99 Yrs MTTH 8:00 AM - 5:00 PM W 10:00 AM - 6:00 PM PCMH: No

Ward, Tasha DDS Provider ID: TPVP44296-06 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Weisser, Ettie DDS Provider ID: TPVP148109-04 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Weiskopf, Mark DDS Provider ID: TPVP44587-02 Gender: Male Great Expressions Dental Centers 6759 1st Ave South Saint Petersburg, FL 33707 (727) 381-1642 Fax: (727) 343-2017 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Williams, Tosha DDS Provider ID: TPVP111140-13 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Weiskopf, Mark DDS Provider ID: TPVP44587-03 Gender: Male Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

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Wong, Elaine DDS Provider ID: TPVP123841-01 Gender: Female Doh - Pinellas County Health Department 205 Dr Martin Luther King St No Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4289 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Dentistry - cont. Wong, Elaine DDS Wong, Elaine DDS Provider ID: TPVP123841-02 Gender: Female Doh - Pinellas County Health Department 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 538-7290 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wong, Elaine DDS Provider ID: TPVP123841-03 Gender: Female Doh - Pinellas County Health Department 12420 130th Ave North Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4726 00 Yrs/99 Yrs Languages: Spanish M 9:00 AM - 5:00 PM PCMH: No Wong, Elaine DDS Provider ID: TPVP123841-04 Gender: Female Doh - Pinellas County Health Department 6350 76th Ave North Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 549-6440 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wong, Elaine DDS Provider ID: TPVP123841-05 Gender: Female Doh - Pinellas County Health Department 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 943-4817 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPVP123841-06 Gender: Female Doh - Pinellas County Health Department 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2796 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Woo, Kyung DDS Provider ID: TPVP147278-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian, Korean MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Worlinsky, Courtney DMD Provider ID: TPVP138542-17 Gender: Female Great Expressions Dental Centers 11701 Belcher Rd S Ste 103 Largo, FL 33773 (727) 531-7676 Fax: (727) 373-0034 00 Yrs/99 Yrs M 10:00 AM - 7:00 PM TTHF 8:00 AM - 5:00 PM W 7:00 AM - 4:00 PM PCMH: No Zand, Maximus DMD Provider ID: TPVP131010-13 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Zariffard, Ehsan DMD Provider ID: TPVP145622-04 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Spanish, Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

General Practice Philippe, Bernard MD Provider ID: 1186020 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Philippe, Bernard MD Provider ID: 1186020 Gender: Male Professional Health Care Of Pinella 5500 Dr MLK Saint Petersburg, FL 33703 (727) 525-5500 Fax: (727) 522-2574 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

General Surgery Allen, Kathleen MD Provider ID: 495854 Gender: Female Baycare Medical Group 400 Pinellas St Ste 200 Clearwater, FL 33756 (727) 462-2131 Fax: (727) 462-2115 12 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Berry, David MD Provider ID: 626560 Gender: Male 1840 Mease Dr Ste 301 Safety Harbor, FL 34695 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM T 9:00 AM - 4:00 PM PCMH: No Berry, David MD Provider ID: 626560 Gender: Male 646 Virginia St Ste 201 Dunedin, FL 34698 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM PCMH: No Blumencranz, Peter MD Provider ID: 389600 Gender: Male Baycare Medical Group 400 Pinellas St Ste 200 Clearwater, FL 33756 (727) 462-2131 Fax: (727) 462-2115 12 Yrs/130 Yrs Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bowers, William MD Provider ID: 693011 Gender: Male Gulf Coast Vein Center P A 4900 95th Ave N Pinellas Park, FL 33782 (727) 623-9999 Fax: (727) 350-5848 18 Yrs/130 Yrs St Anthonys Physicians Surgery St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Surgery - cont. Chandler, Nicole MD Provider ID: 461033 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Chandler, Nicole MD Provider ID: 461033 Gender: Female 601 5th St S Ste 306 Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Clarke, John MD Provider ID: 1176273 Gender: Male Palms Surgical Associates 1615 Pasadena Ave S Ste 330 Saint Petersburg, FL 33707 (727) 345-2929 Fax: (727) 345-0340 00 Yrs/130 Yrs Languages: French M-F 8:30 AM - 5:00 PM PCMH: No Collins, Paul MD Provider ID: 115 Gender: Male Bay Surgical Specialist 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital St Anthonys Physicians Surgery M-F 9:00 AM - 5:00 PM PCMH: No

Couch, Harold MD Provider ID: 556731 Gender: Male Pinellas Surgical Associates 4801 49th St N Saint Petersburg, FL 33709 (727) 526-3468 Fax: (727) 522-3369 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Anthonys Physicians Surgery M-F 9:00 AM - 5:00 PM PCMH: No Curiale, Steven MD Provider ID: 1092094 Gender: Male Bayfront Health Medical Group 601 7th St S Ste 530 Saint Petersburg, FL 33701 (727) 553-7450 Fax: (727) 553-7451 18 Yrs/110 Yrs Bayfront Medical Center M-F 8:00 AM - 4:00 PM PCMH: No Davidson, Robert MD Provider ID: 215087 Gender: Male 1840 Mease Dr Ste 301 Safety Harbor, FL 34695 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin MT 9:00 AM - 5:00 PM W 9:00 AM - 4:00 PM PCMH: No

Deshpande, Vilas MD Provider ID: 12746 Gender: Male 5880 49th St N Ste 101 N Saint Petersburg, FL 33709 (727) 528-0815 Fax: (727) 528-1724 00 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Northside Hospital Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM PCMH: No Epstein, Steven MD Provider ID: 355789 Gender: Male Bayfront Hma Physician Management 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 527-8047 Fax: (727) 527-8106 00 Yrs/130 Yrs M 8:30 AM - 12:00 PM PCMH: No Gozdanovic, Suzanne MD Provider ID: 1204849 Gender: Female Pinellas Surgical Associates, Inc 4801 49th St N Saint Petersburg, FL 33709 (727) 526-3468 Fax: (727) 522-3369 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Huguet, Kevin MD Provider ID: 424635 Gender: Male Collins & Hart MD FACS PA 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 00 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg Endoscopy Center M-F 8:00 AM - 5:00 PM PCMH: No Li, Albert MD Provider ID: 226234 Gender: Male Pinellas Surgical Associates 4801 49th St N Saint Petersburg, FL 33709 (727) 526-3468 Fax: (727) 525-8738 16 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Logan, Melissa MD Provider ID: 1019091 Gender: Female Pinellas Surgical Associates Inc 4801 49th St N Saint Petersburg, FL 33709 (727) 526-3468 Fax: (727) 522-3369 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Surgery - cont. McGuire, Margaret MD Provider ID: 1149215 Gender: Female Pediatric Physician Services 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Murphy, Eugene MD Provider ID: 507201 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8209 Fax: (727) 824-7154 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Anthonys Physicians Surgery M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No Osman Mohamed, Hussein MD Provider ID: 1096327 Gender: Male Transplant Surgical Specialists At 1301 2nd Ave SW Ste 315 Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 18 Yrs/130 Yrs Largo Medical Center Languages: Arabic MWTHF 9:00 AM - 5:00 PM T 7:30 AM - 5:00 PM PCMH: No

Ravindra, Nagella MD Provider ID: 3005 Gender: Male Pinellas Surgical Associates 4801 49th St N Saint Petersburg, FL 33709 (727) 526-3468 Fax: (727) 525-8738 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Reintgen, Douglas MD Provider ID: 7221 Gender: Male USF Physicians Group 1501 S Pinellas Ave Tarpon Springs, FL 34689 (727) 934-6797 Fax: (727) 942-6503 02 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rossidis, Georgios MD Provider ID: 1127054 Gender: Male Bay Surgical Specialists, PA 1615 Pasadena Ave S Ste 480 Saint Petersburg, FL 33707 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs St Anthonys Hospital M 8:00 AM - 12:00 PM PCMH: No

Rossidis, Georgios MD Provider ID: 1127054 Gender: Male Bay Surgical Specialists, PA 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs St Anthonys Hospital M 8:00 AM - 12:00 PM T 1:00 AM - 5:00 PM PCMH: No Roth, Robert MD Provider ID: 191604 Gender: Male 1840 Mease Dr Ste 301 Safety Harbor, FL 34695 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin St Josephs Hospital MT 9:00 AM - 5:00 PM W 9:00 AM - 4:00 PM PCMH: No Roth, Robert MD Provider ID: 191604 Gender: Male 646 Virginia St Dunedin, FL 34698 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin St Josephs Hospital M 1:30 AM - 4:30 PM PCMH: No Schmidt, Rick MD Provider ID: 626501 Gender: Male 1840 Mease Dr Ste 301 Safety Harbor, FL 34695 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs MT 9:00 AM - 5:00 PM W 9:00 AM - 4:00 PM PCMH: No

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Schmidt, Rick MD Provider ID: 626501 Gender: Male 646 Virginia St Ste 201 Dunedin, FL 34698 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs M 1:30 AM - 4:30 PM PCMH: No Shapiro, David MD Provider ID: 636467 Gender: Male David H Shapiro MD PA 1700 N McMullen Booth Rd Clearwater, FL 33759 (727) 724-4279 Fax: (727) 723-2950 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Shawchuck, Kay MD Provider ID: 1069024 Gender: Female 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 201-8820 Fax: (727) 201-8821 12 Yrs/130 Yrs St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Shawchuck, Kay MD Provider ID: 1069024 Gender: Female Women's Care Florida LLC 3055 5th Ave N Ste B Saint Petersburg, FL 33713 (813) 286-0033 Fax: (813) 282-1806 12 Yrs/130 Yrs St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas General Surgery - cont. Small, Theodore MD Provider ID: 665219 Gender: Male 1840 Mease Dr Ste 301 Safety Harbor, FL 34695 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin MT 9:00 AM - 5:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-4243 Fax: (727) 767-8612 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No

Westervelt, James MD Provider ID: 1226661 Gender: Male Bayfront Hma Physician Management 601 7th St S Ste 510 Saint Petersburg, FL 33701 (727) 553-7546 Fax: (727) 553-7671 00 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Westervelt, James MD Provider ID: 286717 Gender: Male 620 10th St N Saint Petersburg, FL 33705 (727) 824-8280 Fax: (727) 824-8281 18 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Genetic Counseling Zambrano, Regina MD Provider ID: 1272025 Gender: Female Pediatric Physician Services Inc. 601 5th St S Saint Petersburg, FL 33701 (727) 767-8917 Fax: (727) 767-8270 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gynecological Oncology Kamath, Geetha MD

Provider ID: 1189 Gender: Female Indermaur, Megan MD Florida Cancer Specialists Provider ID: 947980 1417 S Belcher Rd Ste A Gender: Female Bayfront Family Health Center Clearwater, FL 33764 (727) 443-4299 700 6th St S Fax: (727) 443-0255 Saint Petersburg, FL 33701 00 Yrs/130 Yrs (727) 893-6198 Largo Medical Center Fax: (727) 893-6978 Mease Hospital Dunedin 00 Yrs/130 Yrs St Anthonys Hospital Bayfront Medical Center Languages: Hindi, Kannada St Anthonys Hospital M-F 8:30 AM - 5:00 PM St Petersburg General PCMH: No Hospital M-F 9:00 AM - 5:00 PM Kamath, Geetha MD PCMH: No Provider ID: 1189 Gender: Female Hematology Florida Cancer Specialists 5767 49th St N Iyer, Ananth MD Saint Petersburg, FL 33709 Provider ID: 909742 (727) 522-0558 Gender: Male Fax: (727) 521-3605 Florida Cancer Specialists 00 Yrs/130 Yrs 1417 S Belcher Rd Ste A Largo Medical Center Clearwater, FL 33764 Mease Hospital Dunedin (727) 443-4299 St Anthonys Hospital Fax: (727) 443-0255 Languages: Hindi, Kannada 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Largo Medical Center PCMH: No M-F 8:30 AM - 5:00 PM PCMH: No Knipe, Richard MD Provider ID: 10735 Iyer, Ananth MD Gender: Male Provider ID: 909742 Florida Cancer Specialists Gender: Male 1201 5th Ave N Ste 505 Florida Cancer Specialists Saint Petersburg, FL 33705 5767 49th St N (727) 821-0017 Saint Petersburg, FL 33709 Fax: (727) 895-0328 (727) 522-0558 18 Yrs/130 Yrs Fax: (727) 521-3605 Bayfront Medical Center 00 Yrs/130 Yrs St Anthonys Hospital Largo Medical Center St Petersburg General M-F 8:00 AM - 5:00 PM Hospital PCMH: No Languages: Spanish, French, Russian, Chinese M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 10:00 PM PCMH: No

www.wellcare.com/Florida | 387

Last update 08/14/2017

Specialty Physicians Pinellas Hematology & Oncology Alemar, Jose MD Abid, Syed MD Provider ID: 300444 Gender: Male Pinellas Hematology and Oncology PA 5000 Park St N Ste 1017 Saint Petersburg, FL 33709 (727) 344-6569 Fax: (727) 384-4388 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 314386 Gender: Male Florida Cancer Specialists 400 Pinellas St Ste 300 Clearwater, FL 33756 (727) 447-8100 Fax: (727) 461-2603 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Alemar, Jose MD Provider ID: 314386 Gender: Male Florida Cancer Specialists 100 Highland Ave N Largo, FL 33770 (727) 683-2900 Fax: (727) 683-2901 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Alemar, Jose MD Provider ID: 314386 Gender: Male Florida Cancer Specialists Pl 1301 2nd Ave SW Ste 290 Largo, FL 33770 (727) 940-9580 Fax: (727) 940-9579 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Bergier, Gregoire MD Provider ID: 215903 Gender: Male Florida Cancer Specialists Pl 100 Highland Ave N Largo, FL 33770 (727) 683-2900 Fax: (727) 683-2901 18 Yrs/130 Yrs Languages: Spanish, French, German M-F 8:00 AM - 5:00 PM PCMH: No Betensky, Marisol MD Provider ID: 1317859 Gender: Female Pediatric Physician Services Inc. 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Byun, Sung MD Provider ID: 1162087 Ball, Jennifer DO Alemar, Jose MD Gender: Male Provider ID: 167966 Provider ID: 314386 Florida Cancer Specialists Pl Gender: Female Gender: Male 100 Highland Ave N Florida Cancer Specialists Florida Cancer Specialists Largo, FL 33770 3280 N McMln Bth Rd Ste 200 3280 N McMln Bth Rd Ste 200 (727) 683-2900 Clearwater, FL 33761 Clearwater, FL 33761 Fax: (727) 683-2901 (727) 216-1141 (727) 216-1141 18 Yrs/130 Yrs Fax: (727) 796-1590 Fax: (727) 796-1590 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs 18 Yrs/130 Yrs PCMH: No Largo Medical Center Largo Medical Center Mease Hospital Dunedin Mease Hospital Dunedin Byun, Sung MD Morton Plant Hospital Morton Plant Hospital Provider ID: 1162087 M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No PCMH: No Florida Cancer Specialists Pl 1301 2nd Ave SW Ste 290 Largo, FL 33770 (727) 940-9580 Fax: (727) 940-9579 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Byun, Sung MD Provider ID: 1162087 Gender: Male Florida Cancer Specialists Pl 8787 Bryan Dairy Rd Ste 210 Largo, FL 33777 (727) 397-9641 Fax: (727) 393-4194 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Chamberlain, Kerry DO Provider ID: 10298 Gender: Male 3280 N McMln Bth Rd Ste 200 Clearwater, FL 33761 (727) 216-1141 Fax: (727) 796-1590 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chamberlain, Kerry DO Provider ID: 10298 Gender: Male Florida Cancer Specialists 1201 5th Ave N Ste 505 Saint Petersburg, FL 33705 (727) 821-0017 Fax: (727) 822-7473 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chamberlain, Kerry DO Provider ID: 10298 Gender: Male Florida Cancer Specialists 1301 2nd Ave SW Ste 290 Largo, FL 33770 (727) 940-9580 Fax: (727) 940-9579 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Hematology & Oncology Desai, Pratibha MD - cont. Provider ID: 690666 Chamberlain, Kerry DO Provider ID: 10298 Gender: Male Florida Cancer Specialists 1615 Pasadena Ave S Ste 400 Saint Petersburg, FL 33707 (727) 341-1316 Fax: (727) 345-4000 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chamberlain, Kerry DO Provider ID: 10298 Gender: Male Florida Cancer Specialists 8787 Bryan Dairy Rd Ste 210 Largo, FL 33777 (727) 397-9641 Fax: (727) 393-4194 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No Desai, Pratibha MD Provider ID: 690666 Gender: Male Pinellas Hematology Oncology PA 5000 Park St N Ste 1017 Saint Petersburg, FL 33709 (727) 344-6569 Fax: (727) 384-4388 16 Yrs/130 Yrs Palms of Pasadena Hospital Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male Pinellas Hematology and Oncology PA 3253 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 725-8102 Fax: (727) 797-7995 16 Yrs/130 Yrs Palms of Pasadena Hospital Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Gadiyaram, Vijayakrishna MD Provider ID: 758048 Gender: Female Baycare Medical Group 400 Pinellas St Ste 220 Clearwater, FL 33756 (727) 462-3692 Fax: (727) 266-4935 18 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Diaz, Michael MD Provider ID: 336778 Gender: Male Florida Cancer Specialists 1615 Pasadena Ave S Ste 400 Saint Petersburg, FL 33707 (727) 341-1316 Fax: (727) 345-4000 18 Yrs/130 Yrs Palms of Pasadena Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Spanish, French, Vietnamese, Portuguese M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 10:00 PM PCMH: No

Ho, Vu Tran MD Provider ID: 241295 Gender: Male Florida Cancer Specialists, P.L. 1201 5th Ave N Ste 505 Saint Petersburg, FL 33705 (727) 821-0017 Fax: (727) 822-7473 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital Languages: Spanish, Chinese, Vietnamese, Polish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 10:00 PM PCMH: No

Gadiyaram, Vijayakrishna MD

Ho, Vu Tran MD Provider ID: 241295 Gender: Male Florida Cancer Specialists, P.L. 303 Pinellas St Ste 230 Clearwater, FL 33756 (727) 442-4188 Fax: (727) 446-3107 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital Languages: Spanish, Chinese, Vietnamese, Polish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 758048 Gender: Female Baycare Medical Group 3251 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 443-8450 Fax: (727) 533-5911 18 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 389

Hopman, Rusudan MD Provider ID: 1227957 Gender: Male Baycare Medical Group Inc 3251 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 443-8450 Fax: (727) 533-5911 18 Yrs/130 Yrs Languages: Georgian M-F 9:00 AM - 5:00 PM PCMH: No Jooma, Nurruddin MD Provider ID: 463986 Gender: Male Florida Cancer Specialists 1301 2nd Ave SW Ste 290 Largo, FL 33770 (727) 940-9580 Fax: (727) 940-9579 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital Languages: Hindi, Urdu M-F 9:00 AM - 5:00 PM PCMH: No Jooma, Nurruddin MD Provider ID: 463986 Gender: Male Florida Cancer Specialists 3280 N McMln Bth Rd Ste 200 Clearwater, FL 33761 (727) 216-1141 Fax: (727) 796-1590 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital Languages: Hindi, Urdu M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Hematology & Oncology Marte, Idelfia MD - cont. Provider ID: 27488

Rocha, Rafael MD Provider ID: 28231 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Ste 2E Saint Petersburg, FL 33705 (727) 824-8206 Fax: (727) 824-7110 00 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Spanish M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Ziegler, Lane DO Provider ID: 5511 Gender: Male 3280 N McMln Bth Rd Ste 200 Clearwater, FL 33761 (727) 216-1141 Fax: (727) 796-1590 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Female Luong, Don MD Florida Cancer Specialist Pl 8787 Bryan Dairy Rd Ste 210 Provider ID: 462569 Largo, FL 33777 Gender: Male 3280 N McMln Bth Rd Ste 200 (727) 344-6569 Fax: (727) 384-4388 Clearwater, FL 33761 18 Yrs/120 Yrs (727) 216-1141 Mease Countryside Hospital Fax: (727) 796-1590 Mease Hospital Dunedin 18 Yrs/130 Yrs Morton Plant Hospital Largo Medical Center Languages: Spanish Mease Countryside Hospital Ziegler, Lane DO M-F 9:00 AM - 5:00 PM Morton Plant Hospital PCMH: No Provider ID: 5511 Languages: Spanish, Vietnamese Gender: Male Patel, Hitesh MD M-F 9:00 AM - 5:00 PM Florida Cancer Specialists Provider ID: 3499 PCMH: No 100 Highland Ave N Yan, Ben MD Gender: Male Largo, FL 33770 Luong, Don MD 3280 N McMln Bth Rd Ste 200 Provider ID: 716232 (727) 683-2900 Gender: Male Provider ID: 462569 Clearwater, FL 33761 Fax: (727) 683-2901 Baycare Medical Group Gender: Male (727) 216-1141 18 Yrs/130 Yrs 3251 N McMln Bth Rd Ste 100 Florida Cancer Specialists Fax: (727) 796-1590 Largo Medical Center Clearwater, FL 33761 1301 2nd Ave SW Ste 290 00 Yrs/130 Yrs Morton Plant Hospital (727) 443-8450 Largo, FL 33770 Largo Medical Center M-F 8:00 AM - 5:00 PM Mease Countryside Hospital Fax: (727) 533-5911 (727) 940-9580 PCMH: No Mease Hospital Dunedin 18 Yrs/130 Yrs Fax: (727) 940-9579 HIV/AIDS Languages: Hindi Mease Hospital Dunedin 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Morton Plant Hospital Largo Medical Center PCMH: No Languages: Chinese, Mandarin Braun, Edward MD Mease Countryside Hospital Morton Plant Hospital M-F 8:00 AM - 5:00 PM Provider ID: 1308264 Patel, Hitesh MD Languages: Spanish, PCMH: No Gender: Male Vietnamese Provider ID: 3499 Comprehensive Care Center Yan, Ben MD M-F 9:00 AM - 5:00 PM Gender: Male Inc DBA C PCMH: No Florida Cancer Specialists Provider ID: 716232 3251 3rd Ave N 400 Pinellas St Ste 300 Gender: Male Saint Petersburg, FL 33713 Mace, Joseph MD Clearwater, FL 33756 Baycare Medical Group (727) 321-3854 Provider ID: 206095 (727) 447-8100 400 Pinellas St Ste 220 Fax: (727) 327-7670 Gender: Male Fax: (727) 442-2528 Clearwater, FL 33756 05 Yrs/130 Yrs Florida Cancer Specialists 00 Yrs/130 Yrs (727) 462-3692 M-F 8:00 AM - 5:00 PM 1201 5th Ave N Ste 505 Largo Medical Center Fax: (727) 266-4935 PCMH: No Saint Petersburg, FL 33705 Mease Countryside Hospital 18 Yrs/130 Yrs Mease Hospital Dunedin Infectious Disease (727) 821-0017 Mease Hospital Dunedin Languages: Hindi Fax: (727) 895-0328 Morton Plant Hospital M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs Languages: Chinese, Mandarin Asare, Kinglsey DO PCMH: No Bayfront Medical Center M-F 8:00 AM - 5:00 PM St Anthonys Hospital PCMH: No Provider ID: 925751 St Petersburg General Gender: Male Hospital 9555 Seminole Blvd Ste 100 Languages: Spanish, French, Seminole, FL 33772 Arabic, Polish (727) 729-9000 M-F 8:00 AM - 5:00 PM Fax: (866) 614-2548 Sat 8:00 AM - 10:00 PM 00 Yrs/130 Yrs PCMH: No Largo Medical Center M-TH 10:00 AM - 6:00 PM F 8:00 AM - 12:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Infectious Disease - cont. Dunn, Michael MD Balcacer-Estevez, Nery MD Provider ID: 575889 Gender: Female Advanced Bay Area Medical Associate 1700 66th St N Ste 510 Saint Petersburg, FL 33710 (727) 384-2479 Fax: (727) 384-3573 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Spanish M-TH 8:30 AM - 4:30 PM F 8:30 AM - 4:00 PM PCMH: No Balcacer-Estevez, Nery MD Provider ID: 575889 Gender: Female Advanced Bay Area Medical Associate 8207 113th St Seminole, FL 33772 (727) 397-3991 Fax: (727) 384-3573 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No Buhari, Mudathiru MD Provider ID: 505180 Gender: Male 5670 54th Ave N Ste A-1 Kenneth City, FL 33709 (727) 548-0260 Fax: (727) 548-0270 16 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No

Provider ID: 938262 Gender: Male Comprehensive Care Center 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 498-4969 Fax: (727) 826-0875 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Dunn, Michael MD Provider ID: 938262 Gender: Male Comprehensive Care Center Inc 2349 Sunset Point Rd Ste 405 Clearwater, FL 33765 (727) 216-6193 Fax: (941) 951-1795 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Elliott, Brian MD Provider ID: 1259238 Gender: Male Comprehensive Care Center Inc DBA C 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 498-4969 Fax: (727) 826-0875 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Ganga, Roopa MD Provider ID: 401296 Gender: Female Consultant In Infections Diseases 5670 54th Ave N Ste A-1 Kenneth City, FL 33709 (727) 548-0260 Fax: (727) 548-0270 00 Yrs/130 Yrs Mease Countryside Hospital M-F 9:00 AM - 4:00 PM PCMH: No

Kalra, Lalit MD Provider ID: 727510 Gender: Male Consultants In Infectious Diseases 5670 54th Ave N Ste A-1 Saint Petersburg, FL 33709 (727) 548-0260 Fax: (727) 548-0270 16 Yrs/130 Yrs St Petersburg General Hospital M-F 9:00 AM - 4:00 PM PCMH: No Levenson, Jeffrey MD Provider ID: 1029210 Gender: Male Advanced Bay Area Medical Associate 1700 66th St N Ste 510 Saint Petersburg, FL 33710 (727) 384-2479 Fax: (727) 384-3573 12 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Spanish, French, Arabic M-F 8:30 AM - 5:00 PM PCMH: No Levenson, Jeffrey MD Provider ID: 1029210 Gender: Male Advanced Bay Area Medical Associate 8207 113th St Seminole, FL 33772 (727) 397-3991 Fax: (727) 391-4746 12 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Spanish, French, Arabic M-F 8:30 AM - 4:30 PM PCMH: No

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Martinez, Juan MD Provider ID: 986512 Gender: Male Help US Help U 1700 22nd St S Saint Petersburg, FL 33712 (727) 223-1070 Fax: (727) 290-4175 05 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Parayath, Krishnan MD Provider ID: 203306 Gender: Male Consultants In Infectious Diseases 5670 54th Ave N Ste A1 Kenneth City, FL 33709 (727) 548-0260 Fax: (727) 548-0270 18 Yrs/130 Yrs Mease Countryside Hospital M-F 9:00 AM - 4:00 PM PCMH: No Sarai, Abey MD Provider ID: 209284 Gender: Female Consultants In Infectious Diseases 5670 54th Ave N Ste A-1 Saint Petersburg, FL 33709 (727) 548-0260 Fax: (727) 548-0270 16 Yrs/130 Yrs Mease Countryside Hospital Northside Hospital M-F 9:30 AM - 5:00 PM PCMH: No Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 2349 Sunset Point Rd 405 Clearwater, FL 33765 (941) 366-0134 Fax: (813) 234-3075 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-TH 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Infectious Disease - cont. Avery, Samantha DO Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 321-3854 Fax: (727) 327-7670 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-F 8:00 AM - 5:00 PM PCMH: No Walsh Sr, Douglas DO Provider ID: 1258892 Gender: Male Community Aids Network 3251 3rd Ave N Ste 125 Saint Petersburg, FL 33713 (727) 498-4969 Fax: (727) 826-0875 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Internal Medicine Abdelrahman, Layal MD Provider ID: 1169211 Gender: Female Community Hospital Family Practice 1301 2nd Ave SW Ste 315 Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Alkurdi, Basem MD Provider ID: 1352220 Gender: Male Transplant Surgical Specialists At 1301 2nd Ave SW Ste 315 Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1168865 Gender: Female The Heart Institue 1615 Pasadena Ave S Ste 300 Saint Petersburg, FL 33707 (727) 490-3030 Fax: (866) 200-9885 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Avery, Samantha DO Provider ID: 1168865 Gender: Female The Heart Institue 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cancel, Jeanette MD Provider ID: 1289475 Gender: Female Aids Healthcare Foundation Inc. 3135 State Rd 580 Ste 1 Safety Harbor, FL 34695 (727) 725-9931 Fax: (727) 725-8826 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Memon, Nabeel MD Provider ID: 1364309 Gender: Male West Florida Cardiology Network LLC 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Mukayed, Usama MD Provider ID: 811618 Gender: Male Mukherjee and Mukayed MD PA 5880 49th St N Ste 203N Saint Petersburg, FL 33709 (727) 527-6464 Fax: (727) 521-1963 00 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Arabic M-F 9:00 AM - 5:30 PM PCMH: No Romero, Joseph DO Provider ID: 969930 Gender: Male 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 443-0611 Fax: (727) 461-5493 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sanchez-Ponce, Rafael MD Provider ID: 405952 Gender: Male Interventional Cardiac Consultants 3251 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 784-6992 Fax: (727) 781-0413 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Schreibman, Tanya MD Provider ID: 286830 Gender: Female Community Aids Network 2349 Sunset Point Rd Ste 405 Clearwater, FL 33765 (727) 216-6193 Fax: (941) 951-1795 12 Yrs/130 Yrs Languages: Creole M-F 8:00 AM - 5:00 PM PCMH: No Schreibman, Tanya MD Provider ID: 286830 Gender: Female Community Aids Network 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 321-3854 Fax: (727) 327-7670 12 Yrs/130 Yrs Languages: Creole M-F 9:00 AM - 5:00 PM PCMH: No Steinhoff, Jeff MD Provider ID: 241098 Gender: Male West Florida Cariodogy Network LLC 1345 W. Bay Dr Ste 101 Largo, FL 33770 (727) 258-2073 Fax: (727) 586-6190 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Internal Medicine - cont. Interventional Cardiology Moondra, Vaibhav MD

Maternal Fetal Medicine

Turner, Angela DO

Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 3231 McMullen Booth Rd Safety Harbor, FL 34695 (727) 725-6111 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1276748 Gender: Female Bayfront Cardiovascular Associates 625 6th Ave S Ste 430 Saint Petersburg, FL 33701 (727) 893-6234 Fax: (727) 553-7197 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 2349 Sunset Point Rd 405 Clearwater, FL 33765 (941) 366-0134 Fax: (813) 234-3075 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-TH 9:00 AM - 4:00 PM PCMH: No Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 321-3854 Fax: (727) 327-7670 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-F 8:00 AM - 5:00 PM PCMH: No

Forcella, John DO Provider ID: 1356541 Gender: Male Fhpg Ph Palms Heart Center of Flori 2626 Tampa Rd Ste 104 Palm Harbor, FL 34684 (727) 787-4875 Fax: (727) 786-9623 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Krolick, Merrill DO Provider ID: 752966 Gender: Male West Florida Cariodogy Network LLC 1345 W. Bay Dr Ste 101 Largo, FL 33770 (727) 581-3550 Fax: (727) 586-6190 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital M-F 8:30 AM - 5:00 PM PCMH: No Lin, Lang MD Provider ID: 208881 Gender: Female Mpm Cardiology Service LLC 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 721-2049 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 701118 Gender: Male Baycare Medical Group 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 721-2049 18 Yrs/130 Yrs Mease Countryside Hospital M-F 8:00 AM - 5:00 PM PCMH: No Patel, Parag MD Provider ID: 694343 Gender: Male Baycare Medical Group 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-0611 Fax: (727) 721-2049 16 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Sanchez-Ponce, Rafael MD Provider ID: 405952 Gender: Male Interventional Cardiac Consultants 3251 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 784-6992 Fax: (727) 781-0413 18 Yrs/130 Yrs Medical Center of Trinity Morton Plant Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group of Florida 27509 Cashford Cir Clearwater, FL 33759 (727) 322-4830 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group of Florida 3231 McMullen Booth Rd Safety Harbor, FL 34695 (727) 725-6111 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 3231 McMullen Booth Rd Safety Harbor, FL 34695 (727) 725-6111 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Maternal Fetal Medicine - Raimer, Karen MD Provider ID: 25441 cont. Kalter, Craig MD Provider ID: 6302 Gender: Male Pediatrix Medical Group of Florida 27509 Cashford Cir Clearwater, FL 33759 (727) 322-4830 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Kalter, Craig MD Provider ID: 6302 Gender: Male Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Clearwater, FL 33759 (941) 371-8100 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No Raimer, Karen MD Provider ID: 25441 Gender: Female St Pete Maternal Fetal Medicine 603 7th St S Ste 520 Saint Petersburg, FL 33701 (727) 553-7903 Fax: (727) 553-7905 18 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Gender: Female St Pete Maternal Fetal Medicine 912 N McMullen Booth Rd Clearwater, FL 33759 (727) 553-7903 Fax: (727) 553-7905 18 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish M 8:30 AM - 4:30 PM T 1:30 AM - 6:30 PM W 1:30 AM - 4:30 PM PCMH: No

Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medical Group 2963 Gulf To Bay Blvd Ste 210 Clearwater, FL 33759 (727) 724-1949 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 3231 McMukken Booth Rd Safety Harbor, FL 34695 (813) 971-6909 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Medical Oncology Barakat, Ayman MD Provider ID: 1126047 Gender: Male Florida Cancer Specialists 1615 Pasadena Ave S Ste 400 Saint Petersburg, FL 33707 (727) 341-1316 Fax: (727) 345-4000 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Barakat, Ayman MD Provider ID: 1126047 Gender: Male Florida Cancer Specialists P L 1201 5th Ave N Ste 505 Saint Petersburg, FL 33705 (727) 821-0017 Fax: (727) 822-7473 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Byun, Sung MD Provider ID: 1162087 Gender: Male Florida Cancer Specialists Pl 100 Highland Ave N Largo, FL 33770 (727) 683-2900 Fax: (727) 683-2901 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Byun, Sung MD Provider ID: 1162087 Gender: Male Florida Cancer Specialists Pl 1301 2nd Ave SW Ste 290 Largo, FL 33770 (727) 940-9580 Fax: (727) 940-9579 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Byun, Sung MD Provider ID: 1162087 Gender: Male Florida Cancer Specialists Pl 8787 Bryan Dairy Rd Ste 210 Largo, FL 33777 (727) 397-9641 Fax: (727) 393-4194 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Iyer, Ananth MD Provider ID: 909742 Gender: Male Florida Cancer Specialists 1417 S Belcher Rd Ste A Clearwater, FL 33764 (727) 443-4299 Fax: (727) 443-0255 00 Yrs/130 Yrs Largo Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Iyer, Ananth MD Provider ID: 909742 Gender: Male Florida Cancer Specialists 5767 49th St N Saint Petersburg, FL 33709 (727) 522-0558 Fax: (727) 521-3605 00 Yrs/130 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Jones Jr, David MD Provider ID: 21604 Gender: Male Suncoast Medicl Clinic LLC 620 10th St N Ste 2E Saint Petersburg, FL 33705 (727) 824-8206 Fax: (727) 824-7110 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No Kamath, Geetha MD Provider ID: 1189 Gender: Female Florida Cancer Specialists 1417 S Belcher Rd Ste A Clearwater, FL 33764 (727) 443-4299 Fax: (727) 443-0255 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin St Anthonys Hospital Languages: Hindi, Kannada M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Medical Oncology - cont. Mizrachi, Alberto MD Kamath, Geetha MD Provider ID: 1189 Gender: Female Florida Cancer Specialists 5767 49th St N Saint Petersburg, FL 33709 (727) 522-0558 Fax: (727) 521-3605 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin St Anthonys Hospital Languages: Hindi, Kannada M-F 8:30 AM - 5:00 PM PCMH: No Knipe, Richard MD Provider ID: 10735 Gender: Male Florida Cancer Specialists 1201 5th Ave N Ste 505 Saint Petersburg, FL 33705 (727) 821-0017 Fax: (727) 895-0328 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital Languages: Spanish, French, Russian, Chinese M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 10:00 PM PCMH: No Miranda, Edgar MD Provider ID: 221136 Gender: Male Florida Cancer Specialists Pl 1609 Pasadena Ave S Ste 2E Saint Petersburg, FL 33707 (727) 344-6569 Fax: (727) 384-4388 18 Yrs/120 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 917169 Gender: Male Baycare Medical Group 3251 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 443-8450 Fax: (727) 533-5911 18 Yrs/130 Yrs Mease Hospital Dunedin Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Peterson, John MD Provider ID: 1266 Gender: Male Florida Cancer Specialists 1201 5th Ave N Ste 505 Saint Petersburg, FL 33705 (727) 821-0017 Fax: (727) 895-0328 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 10:00 PM PCMH: No Peterson, John MD Provider ID: 1266 Gender: Male Florida Cancer Specialists 1615 Pasadena Ave S Ste 400 Saint Petersburg, FL 33707 (727) 341-1316 Fax: (727) 345-4000 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 10:00 PM PCMH: No

Neonatal Perinatal Peterson, John MD Medicine Provider ID: 1266 Gender: Male Bayfront Neonatology Florida Cancer Specialists 3280 N McMln Bth Rd Ste 200 Services Provider ID: 170500 Clearwater, FL 33761 701 6th St S (727) 216-1141 Saint Petersburg, FL 33701 Fax: (727) 796-6159 (727) 822-6763 18 Yrs/130 Yrs 00 Yrs/03 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM St Anthonys Hospital St Petersburg General PCMH: No Hospital Fares, Iman MD Languages: Spanish M-F 8:00 AM - 5:00 PM Provider ID: 1033331 Sat 8:00 AM - 10:00 PM Gender: Female PCMH: No West Coast Neonatology 601 5th St S Ste 5 Peterson, John MD Saint Petersburg, FL 33701 Provider ID: 1266 (727) 767-4313 Gender: Male Fax: (727) 767-4971 Florida Cancer Specialists 00 Yrs/21 Yrs 8787 Bryan Dairy Rd Ste 210 Johns Hopkins All Childrens Largo, FL 33777 Hospital Inc (727) 397-9641 M-F 8:00 AM - 5:00 PM Fax: (727) 393-4194 PCMH: No 18 Yrs/130 Yrs Ong, Manuel MD Bayfront Medical Center St Anthonys Hospital Provider ID: 270195 St Petersburg General Gender: Male Hospital West Coast Neonatology Languages: Spanish 601 5th St S Occ 5th F Fl M-F 9:00 AM - 5:00 PM Saint Petersburg, FL 33701 PCMH: No (727) 767-4313 Fax: (727) 767-4391 Raiker, Anilkumar MD 00 Yrs/18 Yrs Provider ID: 1620 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Pinellas Cancer Center 6499 38th Ave N Ste G1 West Cst Neonatology Inc Saint Petersburg, FL 33710 Provider ID: 17622 (727) 381-3761 6500 38th Ave N Fax: (727) 347-9348 Saint Petersburg, FL 33710 18 Yrs/130 Yrs (727) 767-4313 Largo Medical Center Fax: (813) 892-4391 Northside Hospital 00 Yrs/03 Yrs St Petersburg General M-F 9:00 AM - 5:00 PM Hospital PCMH: No Languages: Hindi M-F 8:30 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Neonatal Perinatal Medicine - cont. West Cst Neonatology Inc Provider ID: 17622 All Childrens Hospital 801 6th St S Saint Petersburg, FL 33701 (727) 767-4313 Fax: (727) 767-4391 00 Yrs/03 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Nephrology Abdelrahman, Layal MD Provider ID: 1169211 Gender: Female Community Hospital Family Practice 1301 2nd Ave SW Ste 315 Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Awwad, Abraham DO Provider ID: 407982 Gender: Male Abraham I Awwad DO LLC 3622 Central Ave Saint Petersburg, FL 33711 (727) 322-0245 Fax: (727) 323-0994 21 Yrs/130 Yrs Largo Medical Center St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:30 PM PCMH: No

Brucculeri, Michael MD Provider ID: 378998 Gender: Male Renal Hypertension Center 1055 S Fort Harrison Ave Clearwater, FL 33756 (727) 442-6245 Fax: (727) 447-3793 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant North Bay Hospital Languages: Spanish, Dutch M-F 9:00 AM - 5:00 PM PCMH: No Brucculeri, Michael MD Provider ID: 378998 Gender: Male Renal Hypertension Center 29296 US Hwy 19 N Ste 3 Clearwater, FL 33761 (727) 712-0807 Fax: (727) 797-6973 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant North Bay Hospital Languages: Spanish, Dutch M-F 9:00 AM - 5:00 PM PCMH: No Dcunha, Prakas MD Provider ID: 245342 Gender: Male Renal Hypertension Center 29296 US Hwy 19 N Ste 3 Clearwater, FL 33761 (727) 712-0807 Fax: (727) 797-6973 18 Yrs/130 Yrs Bayfront Health Brooksville Mease Hospital Dunedin Morton Plant North Bay Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Dessani, Nehal MD Provider ID: 720300 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8274 Fax: (727) 824-8293 18 Yrs/130 Yrs St Anthonys Hospital Languages: Spanish, Gujarati M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Ham, Michael MD Provider ID: 696407 Gender: Male Nephrology Consultants of Pinellas 617 Lakeview Rd Ste C Clearwater, FL 33756 (727) 441-3724 Fax: (727) 442-2594 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Dewberry, Frederick MD Provider ID: 212046 Gender: Male Nephrology Consultants of Pinellas 617 Lakeview Rd Ste C Clearwater, FL 33756 (727) 441-3724 Fax: (727) 442-2594 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Lustig, Alan MD Provider ID: 122 Gender: Male 1201 5th Ave N Ste 302 Saint Petersburg, FL 33705 (727) 821-2388 Fax: (727) 821-0086 21 Yrs/130 Yrs Gulf Coast Medical Center Northside Hospital St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Fabelo II, Edward MD Provider ID: 396799 Gender: Male Suncoast Medical Clinic 620 10th St N Ste 3D Saint Petersburg, FL 33705 (727) 824-8274 Fax: (727) 824-8293 18 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Gupta, Ashwani MD Provider ID: 1236380 Gender: Male Renal Hypertension Center 635 4th St N 200 Saint Petersburg, FL 33701 (727) 201-4968 Fax: (727) 201-4971 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Matcha, Mrinalini MD Provider ID: 511340 Gender: Female Renal Hypertension Center 635 4th St N Ste 200 Saint Petersburg, FL 33701 (727) 201-4968 Fax: (727) 201-4971 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Telugu M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Nephrology - cont. Muthalakuzhy, George MD Provider ID: 1149214 Gender: Male V.J. Dilella, DO, LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 738-5037 18 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-F 8:00 AM - 4:30 PM PCMH: No Needham, Gerald DO Provider ID: 176058 Gender: Male Bay Area Nephrology 1305 S Fort Harrison Ave Bldg H Clearwater, FL 33756 (727) 441-0104 Fax: (727) 441-8272 18 Yrs/130 Yrs Largo Medical Center Largo Medical Center Indian Rocks Morton Plant Hospital M-F 8:00 AM - 4:00 PM PCMH: No Niaz, Nabila MD Provider ID: 278559 Gender: Female Florida Cancer Specialists 1201 5th Ave N Ste 302 Saint Petersburg, FL 33705 (727) 821-0017 Fax: (727) 822-7473 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital Languages: Urdu M-F 9:00 AM - 5:00 PM PCMH: No

Pudur, Sudhindra MD Provider ID: 511347 Gender: Male Renal Hypertension Center 1700 66th St N Ste 302 Saint Petersburg, FL 33710 (727) 290-9899 Fax: (727) 290-9898 18 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Pudur, Sudhindra MD Provider ID: 511347 Gender: Male Renal Hypertension Center 635 4th St N Ste 200 Saint Petersburg, FL 33701 (727) 201-4968 Fax: (727) 201-4971 18 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rizzo, Gerald MD Provider ID: 121 Gender: Male 1201 5th Ave N Ste 302 Saint Petersburg, FL 33705 (727) 821-2388 Fax: (727) 821-0078 21 Yrs/130 Yrs Gulf Coast Medical Center Northside Hospital St Anthonys Hospital M-F 8:30 AM - 5:30 PM PCMH: No

Sagar, Vidya MD Provider ID: 245844 Gender: Male 2196 Main St Ste H Dunedin, FL 34698 (727) 733-3500 Fax: (727) 734-3606 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital Languages: Hindi M-F 12:00 AM - 5:00 PM PCMH: No Shetye, Kedar MD Provider ID: 376848 Gender: Male Renal Hypertension Center 1301 2nd Ave SW Ste 303 Largo, FL 33770 (727) 442-6245 18 Yrs/130 Yrs Bayfront Health Brooksville Largo Medical Center Mease Hospital Dunedin M-F 9:00 AM - 5:00 PM PCMH: No Siedlecki, Michael MD Provider ID: 263 Gender: Male 1201 5th Ave N Ste 302 Saint Petersburg, FL 33705 (727) 821-2388 Fax: (727) 821-0079 18 Yrs/130 Yrs Gulf Coast Medical Center Northside Hospital St Anthonys Hospital Languages: Polish M-F 9:00 AM - 5:00 PM PCMH: No Sotolongo, Ignacio MD Provider ID: 507176 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Ste 3D Saint Petersburg, FL 33705 (727) 824-8274 Fax: (727) 824-8293 18 Yrs/130 Yrs Northside Hospital M-TH 9:00 AM - 5:00 PM F 9:00 AM - 2:00 PM PCMH: No

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Neuro Psychiatrist MD Wojas, Justyna MD Provider ID: 1362036 Gender: Female USF Physicicans Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Neurology Andriola, Michael MD Provider ID: 1189711 Gender: Male Morton Plant Hospital 430 Morton Plant St Ste 402 Clearwater, FL 33756 (727) 461-8635 Fax: (727) 333-6038 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Arora, Ajay MD Provider ID: 1189713 Gender: Female Morton Plant Hospital 430 Morton Plant St Ste 402 Clearwater, FL 33756 (727) 461-8635 Fax: (727) 333-6038 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Franklin, Michael MD Provider ID: 162735 Gender: Male Baycare Medical Group Inc 1201 5th Ave N Ste 202 Saint Petersburg, FL 33705 (727) 820-7701 Fax: (727) 820-7700 18 Yrs/130 Yrs St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Neurology - cont. Khamisani, Saleem MD Provider ID: 523048 Gender: Male Baycare Medical Group Inc 1201 5th Ave N Ste 202 Saint Petersburg, FL 33705 (727) 820-7701 Fax: (727) 820-7700 18 Yrs/130 Yrs St Anthonys Hospital Languages: Hebrew M-F 8:00 AM - 5:00 PM PCMH: No Kumar-Pelayo, Meghna MD Provider ID: 1029705 Gender: Female Baycare Medical Group Inc 1201 5th Ave N Ste 202 Saint Petersburg, FL 33705 (727) 820-7701 Fax: (727) 820-7700 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Patel, Pruthu MD Provider ID: 1349362 Gender: Male Pain Relief Centers 6640 78th Ave N Pinellas Park, FL 33781 (727) 518-8660 18 Yrs/130 Yrs Languages: Gujarati M-F 8:30 AM - 5:00 PM PCMH: No Patel, Pruthu MD Provider ID: 1349362 Gender: Male Pain Relief Centers 8839 Bryan Dairy Rd Ste 215 Largo, FL 33777 (727) 518-8660 Fax: (727) 518-8662 18 Yrs/130 Yrs Languages: Gujarati M-F 8:30 AM - 5:00 PM PCMH: No

Pirmohamed, Fermina MD Provider ID: 1350622 Gender: Female Pinellas Medical Associates 5880 49th St N Ste 104 Saint Petersburg, FL 33709 (727) 528-6100 Fax: (727) 528-7895 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Pizaro Otero, Jose MD Provider ID: 1326727 Gender: Male Baycare Medical Group Inc 10141 Big Bend Rd 206 Clearwater, FL 33756 (813) 879-4328 Fax: (813) 443-8152 18 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Rosario-Prieto, Michael MD Provider ID: 1029381 Gender: Male Baycare Medical Group Inc 1201 5th Ave N Ste 202 Saint Petersburg, FL 33705 (727) 820-7701 Fax: (727) 882-7700 18 Yrs/130 Yrs St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Scott, Gregory MD Provider ID: 217057 Gender: Male 2201 Central Ave Ste 200 Saint Petersburg, FL 33713 (727) 824-7132 Fax: (727) 824-7133 18 Yrs/130 Yrs Palms of Pasadena Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Shenkman, Carl MD Provider ID: 1096353 Gender: Male Baycare Medical Group 1201 5th Ave N Ste 202 Saint Petersburg, FL 33705 (727) 360-1784 Fax: (727) 360-1823 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sinoff, Stuart MD Provider ID: 1189718 Gender: Male Morton Plant Hospital 430 Morton Plant St Ste 402 Clearwater, FL 33756 (727) 461-8635 Fax: (727) 333-6038 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Umamaheswaran, Indira MD

Neurosurgery Colbassani, Harold MD Provider ID: 212101 Gender: Male 400 Pinellas St Ste 325 Clearwater, FL 33756 (727) 298-6121 Fax: (727) 533-5903 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital MT 9:00 AM - 4:00 PM PCMH: No Gobo, Dean MD Provider ID: 1226241 Gender: Male Baycare Medical Group Inc 430 Morton Plant St SUITE325 Clearwater, FL 33756 (727) 298-6121 Fax: (727) 298-6151 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 348276 Hall, Jonathan MD Gender: Female Provider ID: 696209 David W Malka MD Gender: Male 2595 Tampa Rd Ste J Bayfront Physician Specialty Palm Harbor, FL 34684 Servic (727) 442-6463 603 7th St S Ste 500 Fax: (727) 442-6463 Saint Petersburg, FL 33701 00 Yrs/130 Yrs (727) 954-7121 Bayfront Health Brooksville Florida Hospital North Pinellas Fax: (727) 824-0416 00 Yrs/130 Yrs Medical Center of Trinity Bayfront Medical Center M-F 9:00 AM - 5:00 PM Mease Countryside Hospital PCMH: No Northside Hospital M-TH 8:30 AM - 4:30 PM Weiss, Allan MD F 8:30 AM - 12:00 PM Provider ID: 168435 PCMH: No Gender: Male Baycare Medical Group Inc Haydon, Devon MD 1201 5th Ave N Ste 202 Provider ID: 1204846 Saint Petersburg, FL 33705 Gender: Female (727) 820-7701 430 Morton Plant St Ste 325 Fax: (727) 820-7700 Clearwater, FL 33756 18 Yrs/130 Yrs (727) 298-6121 St Anthonys Hospital Fax: (727) 298-6151 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 398

Last update 08/14/2017

Specialty Physicians Pinellas Neurosurgery - cont. Jallo, George MD Provider ID: 1141513 Gender: Male Pediatric Physician Services 601 5th St S Ste 511 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mickler, Christopher DO Provider ID: 526277 Gender: Male Baycare Medical Group 430 Morton Plant St Ste 325 Clearwater, FL 33756 (727) 298-6121 Fax: (727) 298-6151 25 Yrs/85 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Shulman, Carrie MD Provider ID: 790601 Gender: Female Baycare Medical Group 430 Morton Plant St Ste 401 Clearwater, FL 33756 (727) 298-6121 Fax: (727) 298-6151 18 Yrs/130 Yrs Mease Hospital Dunedin Morton Plant Hospital Languages: Spanish, Chinese M-F 8:30 AM - 4:30 PM PCMH: No Sincoff, Eric MD Provider ID: 1097167 Gender: Male David W Malka MD PA 2595 Tampa Rd Ste J Palm Harbor, FL 34684 (727) 442-6463 Fax: (727) 781-7273 00 Yrs/130 Yrs Morton Plant North Bay Hospital M-F 8:30 AM - 4:30 PM PCMH: No

Obstetrics Benson, Beth MD Provider ID: 8313 Gender: Female OB/GYN Associates 6450 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 767-6060 Fax: (727) 767-1285 12 Yrs/130 Yrs Bayfront Medical Center St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Biss, Kimberly MD Provider ID: 205383 Gender: Female Bay Gynecological Associates PA 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 553-7500 Fax: (727) 553-7596 12 Yrs/130 Yrs Bayfront Medical Center M 8:00 AM - 7:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Biss, Kimberly MD Provider ID: 324526 Gender: Female Tampa Bay Womens Healthcare 625 6th Ave S Ste 350 Saint Petersburg, FL 33701 (727) 456-0080 Fax: (727) 456-0089 12 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Dadisman, Katherine DO Provider ID: 203233 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM PCMH: No Dadisman, Katherine DO Provider ID: 203233 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-9922 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM PCMH: No Devanesan, Sheila MD Provider ID: 190329 Gender: Female OB/GYN Associates 6450 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 767-6060 Fax: (727) 767-1285 12 Yrs/130 Yrs Bayfront Medical Center St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No Diner, Beth MD Provider ID: 620419 Gender: Female Womens Care Florida 3268 66th St N Saint Petersburg, FL 33710 (727) 954-7121 Fax: (727) 954-7122 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Diner, Beth MD Provider ID: 620419 Gender: Female Womens Care Florida 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 456-6200 Fax: (727) 456-6218 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Fosnot, Susan DO Provider ID: 315009 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM PCMH: No Fosnot, Susan DO Provider ID: 315009 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM PCMH: No Gallagher, James MD Provider ID: 194135 Gender: Male James Gallagher MD LLC 1840 Mease Dr Ste 400 Safety Harbor, FL 34695 (727) 786-8678 Fax: (727) 786-6229 14 Yrs/95 Yrs Mease Countryside Hospital Languages: Spanish, Chinese M-TH 7:30 AM - 7:00 PM F 7:30 AM - 1:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics - cont. Gilby, Jennifer MD Provider ID: 297918 Gender: Female Womens Care Florida 1600 MLK St N Saint Petersburg, FL 33704 (727) 323-3838 Fax: (727) 456-0751 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No

McNeill, Thomas MD Provider ID: 632140 Gender: Male Womens Care Florida 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 893-9005 Fax: (727) 823-3494 12 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gilby, Jennifer MD Provider ID: 297918 Gender: Female Womens Care Florida 3055 5th Ave N Saint Petersburg, FL 33713 (727) 801-8800 Fax: (727) 201-8801 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Nolan, Christy DO Provider ID: 973534 Gender: Female Womens Care Florida 1840 Mease Dr Ste 110 Safety Harbor, FL 34695 (727) 376-7734 Fax: (727) 372-0644 12 Yrs/130 Yrs Mease Countryside Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No

Icely, Suzanne MD Provider ID: 27260 Gender: Female OB/GYN Associates 6450 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 767-6060 Fax: (727) 767-1285 12 Yrs/130 Yrs Bayfront Medical Center St Petersburg General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Reyes, Alexandria DO Provider ID: 961589 Gender: Female Womens Care Florida LLC 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No Reyes, Alexandria DO Provider ID: 961589 Gender: Female Womens Care Florida LLC 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No

Reyes, Carlos MD Provider ID: 496244 Gender: Male 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Ritter, Brooke DO Provider ID: 463524 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ritter, Brooke DO Provider ID: 463524 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM PCMH: No Taneja, Amy MD Provider ID: 924184 Gender: Female Womens Care Florida 3268 66th St N Saint Petersburg, FL 33710 (727) 954-7121 Fax: (727) 954-7122 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Taneja, Amy MD Provider ID: 924184 Gender: Female Womens Care Florida 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 456-6200 Fax: (727) 456-6218 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No Tijerino, Linda MD Provider ID: 246625 Gender: Female Bay Obstetrics Gynecology 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 456-6200 Fax: (727) 456-6218 12 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Tijerino, Linda MD Provider ID: 246625 Gender: Female Womens Care Florida 3268 66th St N Saint Petersburg, FL 33710 (727) 954-7121 Fax: (727) 954-7122 12 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Watson, Jennifer DO Provider ID: 618275 Gender: Female Womens Care Florida 1840 Mease Dr Safety Harbor, FL 34695 (727) 376-7734 Fax: (727) 372-0644 00 Yrs/130 Yrs Mease Countryside Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology Acosta Jr, Romeo MD Provider ID: 1352 Gender: Male Gulfcoast OB/GYN PA 2325 Ulmerton Rd Ste 1 Clearwater, FL 33762 (727) 540-0670 Fax: (727) 540-0640 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish M 8:30 AM - 5:00 PM TWTH 8:30 AM - 12:00 PM PCMH: No Acosta Jr, Romeo MD Provider ID: 1352 Gender: Male Gulfcoast OB/GYN PA 6700 Crosswinds Dr N Ste 200A Saint Petersburg, FL 33710 (727) 344-4651 Fax: (727) 347-6224 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish MWF 8:30 AM - 5:00 PM TTH 8:30 AM - 7:00 PM PCMH: No Acosta Jr, Romeo MD Provider ID: 1352 Gender: Male Gulfcoast OB/GYN PA 9677 Seminole Blvd Seminole, FL 33772 (727) 319-2303 Fax: (727) 398-3087 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish MTWF 8:30 AM - 5:00 PM TH 8:30 AM - 12:00 PM PCMH: No

Belle, Beverly MD Provider ID: 1312024 Gender: Female Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 532-1374 Fax: (737) 298-6354 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Benson, Beth MD Provider ID: 1419327 Gender: Male Womens Care Florida LLC 625 6th Ave S Ste 350 Saint Petersburg, FL 33701 (727) 456-0080 Fax: (727) 456-0089 18 Yrs/130 Yrs Bayfront Medical Center St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Burlison, Charles MD Provider ID: 1312025 Gender: Male Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 532-1374 Fax: (727) 298-6354 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Calderon, Guillermo MD Provider ID: 27552 Gender: Male Gulf Coast OB/GYN PA 2325 Ulmerton Rd Ste 1 Clearwater, FL 33762 (727) 540-0670 Fax: (727) 398-3087 00 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish M 8:30 AM - 5:00 PM TWTH 8:30 AM - 12:00 PM PCMH: No

Calderon, Guillermo MD Provider ID: 27552 Gender: Male Gulf Coast OB/GYN PA 9677 Seminole Blvd Seminole, FL 33772 (727) 319-2303 Fax: (727) 398-3087 00 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish MTWF 8:30 AM - 5:00 PM TH 8:30 AM - 12:00 PM PCMH: No Calderon, Guillermo MD Provider ID: 27552 Gender: Male Gulfcoast OB/GYN PA 6700 Crosswinds Dr N Ste 200A Saint Petersburg, FL 33710 (727) 344-4651 Fax: (727) 347-6224 00 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish MWF 8:30 AM - 5:00 PM TTH 8:30 AM - 7:00 PM PCMH: No Carlin, Faith MD Provider ID: 1365631 Gender: Female Baycare Medical Group Inc 303 Pinellas St Ste 23 Clearwater, FL 33756 (727) 462-3401 Fax: (727) 533-5994 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Cuadra, Deborah MD Provider ID: 1214315 Gender: Female Florida Woman Care LLC 10011 Seminole Blvd Ste A Seminole, FL 33772 (727) 393-2800 Fax: (727) 393-2801 00 Yrs/130 Yrs Morton Plant Hospital M-TH 9:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No Desper Jr, David MD Provider ID: 1463 Gender: Male Bayfront Family Health Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6116 Fax: (727) 893-6978 12 Yrs/130 Yrs Mease Hospital Dunedin Morton Plant Hospital St Anthonys Hospital M-F 8:30 AM - 5:00 PM PCMH: No Dookhan, Marlene MD Provider ID: 1370300 Gender: Female Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 461-8930 Fax: (727) 298-6354 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - Fdoh In Pinellas County cont. Fanarjian, Nicole MD Provider ID: 985158 Gender: Female Planned Parenthood of Southwest and 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Fdoh In Pinellas County

Provider ID: 496412 Pinellas County Health Dept 301 S Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 942-5467 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fdoh In Pinellas County Provider ID: 496412 Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Fdoh In Pinellas County Provider ID: 496412 Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fdoh In Pinellas County Provider ID: 496412 Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fdoh In Pinellas County

Fdoh In Pinellas County Provider ID: 496412 Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fdoh In Pinellas County

Provider ID: 496412 Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 496412 Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fdoh In Pinellas County

Fdoh In Pinellas County Provider ID: 496412 Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 496412 Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 496412 Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 402

Feldbaum, Victor MD Provider ID: 1418158 Gender: Male Bayfront Medical Center 700 6th St S Fl 2 Saint Petersburg, FL 33701 (727) 893-6198 Fax: (727) 893-6978 12 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Felski, Emil DO Provider ID: 1229396 Gender: Male Planned Parenthood of Southwest and 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (407) 677-1234 Fax: (407) 677-1001 12 Yrs/130 Yrs M-F 8:45 AM - 4:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Fuentes, Armando MD Provider ID: 1220702 Gender: Male Bayfront Hma Medical Center LLC 700 6th St S Saint Petersburg, FL 33701 (727) 893-6198 Fax: (727) 893-6978 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No Fuhrig, Lauren MD Provider ID: 984426 Gender: Female Womens Care Florida 1840 Mease Dr Ste 110 Safety Harbor, FL 34695 (727) 376-7734 Fax: (727) 408-5336 12 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - Guichard, Raphael MD cont. Provider ID: 617835 Gender: Male Gabriel, Amy MD Bayfront OB GYN Residency 701 6th St S Provider ID: 326268 Saint Petersburg, FL 33701 Gender: Female Community Health Centers of (727) 893-6198 Pinella Fax: (727) 553-7295 707 Druid Rd E 00 Yrs/130 Yrs Clearwater, FL 33756 Bayfront Medical Center (727) 824-8181 M-F 8:30 AM - 5:00 PM Fax: (727) 443-7230 PCMH: No 00 Yrs/130 Yrs Igel, G MD M-F 8:00 AM - 5:00 PM Provider ID: 1119108 PCMH: No Gender: Male Gabriel, Amy MD Florida Woman Care, LLC Provider ID: 326268 3007 Ridgeline Blvd Ste B Gender: Female Tarpon Springs, FL 34688 Community Health Cntrs At (727) 461-7611 Pinellas Pk Fax: (727) 461-2860 1344 22nd St S 12 Yrs/130 Yrs Saint Petersburg, FL 33712 Languages: Spanish, Greek, (727) 821-6701 Faroese, Polish Fax: (727) 824-8137 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No M-F 8:00 AM - 5:00 PM Igel, G MD PCMH: No Provider ID: 1119108 Gabriel, Amy MD Gender: Male Provider ID: 326268 Florida Woman Care, LLC Gender: Female 600 Lakeview Rd Community Health Cntrs At Clearwater, FL 33756 Pinellas Pk (727) 461-7611 701 6th St S Fax: (727) 461-2860 Saint Petersburg, FL 33701 12 Yrs/130 Yrs (727) 824-8181 Languages: Spanish, Greek, Fax: (727) 209-5619 Faroese, Polish 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM F 9:00 AM - 4:00 PM PCMH: No PCMH: No Gabriel, Amy MD Provider ID: 326268 Gender: Female Community Health Cntrs At Pinellas Pk 7550 43rd St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Jackson, Darwin MD Provider ID: 450510 Gender: Male All Womens Health Center Inc 4131 Central Ave Saint Petersburg, FL 33713 (727) 327-3300 Fax: (727) 321-8433 12 Yrs/130 Yrs M 8:30 AM - 8:30 PM TWTHF 8:30 AM - 5:30 PM PCMH: No Jackson, Darwin MD Provider ID: 901783 Gender: Male Womens OB/GYN Center of Countryside 28960 US 19 N Ste 110 Clearwater, FL 33761 (727) 785-2525 Fax: (727) 447-3797 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Jamison, Richard MD Provider ID: 1370298 Gender: Male Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 461-8930 Fax: (727) 298-6354 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Indermaur, Megan MD Provider ID: 947980 Gender: Female Bayfront Family Health Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6198 Fax: (727) 893-6978 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Javate, Emanuel MD Provider ID: 277823 Gender: Male Bayfront Family Health Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6198 Fax: (727) 553-7295 12 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Javate, Emanuel MD Provider ID: 477319 Gender: Male Gulfcoast OB/GYN PA 2325 Ulmerton Rd Ste 1 Clearwater, FL 33762 (727) 540-0670 Fax: (727) 540-0640 12 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish M 8:30 AM - 5:00 PM TWTH 8:30 AM - 12:00 PM PCMH: No Javate, Emanuel MD Provider ID: 477319 Gender: Male Gulfcoast OB/GYN PA 6700 Crosswinds Dr N Ste 200A Saint Petersburg, FL 33710 (727) 344-4651 Fax: (727) 343-6425 12 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish MWF 8:30 AM - 5:00 PM TTH 8:30 AM - 7:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - Jones, Malcolm MD cont. Provider ID: 859408 Javate, Emanuel MD Provider ID: 477319 Gender: Male Gulfcoast OB/GYN PA 9677 Seminole Blvd Seminole, FL 33772 (727) 319-2303 Fax: (727) 398-3087 12 Yrs/130 Yrs St Anthonys Hospital St Anthonys Physicians Surgery St Petersburg General Hospital Languages: Spanish MTWF 8:30 AM - 5:00 PM TH 8:30 AM - 12:00 PM PCMH: No Jean Baptiste, Stephanie DO

Gender: Male All Women's Health Center, Inc. 4131 Central Ave Saint Petersburg, FL 33713 (727) 327-3300 Fax: (727) 321-8433 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 2:30 PM PCMH: No Jubiz, Giovanni MD Provider ID: 1356567 Gender: Male Fhpg North Pinellas Medical Center 4705 Alt 19 Ste B Palm Harbor, FL 34683 (727) 935-6477 Fax: (727) 935-6478 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1340765 Gender: Female Bayfront Health St. Petersburg Jubiz, Giovanni MD 700 6th St S Saint Petersburg, FL 33701 (727) 893-6198 Provider ID: 689052 Fax: (727) 893-6978 Gender: Male 00 Yrs/130 Yrs Turley Maternal Health M-F 8:00 AM - 4:30 PM 807 N Myrtle Ave PCMH: No Clearwater, FL 33755 (727) 467-2400 Jones, Malcolm MD Fax: (727) 467-2578 Provider ID: 818460 12 Yrs/130 Yrs Gender: Male Morton Plant Hospital Women's OB/GYN Center of M-F 8:00 AM - 5:00 PM Countrysid PCMH: No 28960 US 19 N Ste 110 Clearwater, FL 33761 (727) 442-0445 Fax: (727) 447-3797 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Kuebel, Joseph MD Provider ID: 1238230 Gender: Male Community Health Centers At Johnnie 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 824-8150 18 Yrs/130 Yrs Bayfront Medical Center Morton Plant Hospital M 7:30 AM - 8:00 PM T 8:00 AM - 8:00 PM WTHF 7:30 AM - 5:00 PM PCMH: No

Lapolla, James MD Provider ID: 12200 Gender: Male Women's Care Florida LLC 600 8th St S Ste B Saint Petersburg, FL 33701 (727) 826-0795 Fax: (727) 258-4863 00 Yrs/130 Yrs Bayfront Medical Center Palms of Pasadena Hospital St Anthonys Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Lipton, Alexis MD Provider ID: 1201951 Gender: Female Lapolla, James MD Florida Woman Care LLC 10011 Seminole Blvd Ste A Provider ID: 12200 Seminole, FL 33772 Gender: Male Bayfront Family Health Center (727) 393-2800 Fax: (727) 456-1588 700 6th St S 00 Yrs/130 Yrs Saint Petersburg, FL 33701 Morton Plant Hospital (727) 893-6198 M-TH 9:00 AM - 4:00 PM Fax: (727) 553-7295 F 9:00 AM - 12:00 PM 00 Yrs/130 Yrs PCMH: No Bayfront Medical Center Palms of Pasadena Hospital Logeswaran, Prashanti MD St Anthonys Hospital M 1:00 AM - 5:00 PM PCMH: No Provider ID: 1326768 Gender: Female Lapolla, James MD Women's Care Florida Provider ID: 12200 603 7th St S Ste 300 Gender: Male Saint Petersburg, FL 33701 Bayfront Womens Childrens (727) 954-7121 7995 66th St N 12 Yrs/130 Yrs Pinellas Park, FL 33781 M-F 8:00 AM - 5:00 PM (727) 544-2284 PCMH: No 00 Yrs/130 Yrs Bayfront Medical Center Long, Molly MD Palms of Pasadena Hospital Provider ID: 440864 St Anthonys Hospital Gender: Female M-F 8:00 AM - 5:00 PM Womens Care Florida PCMH: No 3268 66th St N Saint Petersburg, FL 33710 (727) 954-7121 Fax: (727) 954-7122 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 404

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - McNeill, Thomas MD cont. Provider ID: 175393

Nutter, Jonathan MD Perez, Rafael MD Provider ID: 1349370 Provider ID: 1335738 Gender: Male Gender: Male Gender: Male Long, Molly MD 6237 66th St N Community Health Centers of Gulfcoast OB/GYN PA Pinella Pinellas Park, FL 33781 2325 Ulmerton Rd Ste 1 Provider ID: 440864 1344 22nd St S (727) 344-3027 Clearwater, FL 33762 Gender: Female Saint Petersburg, FL 33712 00 Yrs/130 Yrs (305) 665-2060 Womens Care Florida (727) 824-8181 Bayfront Medical Center 00 Yrs/130 Yrs 603 7th St S Ste 300 St Anthonys Hospital Fax: (727) 823-7429 M 8:30 AM - 5:00 PM Saint Petersburg, FL 33701 Languages: Spanish 12 Yrs/130 Yrs TWTH 8:30 AM - 12:00 PM (727) 456-6200 M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No Fax: (727) 456-6218 PCMH: No PCMH: No 00 Yrs/130 Yrs Perez, Rafael MD Bayfront Medical Center McNeill, Thomas MD Ortiz, Edwin MD Provider ID: 1335738 St Anthonys Hospital Provider ID: 175393 Provider ID: 783354 Gender: Male M-F 9:00 AM - 5:00 PM Gender: Male Gender: Male Gulfcoast OB/GYN PA PCMH: No Bayfront Family Health Center Planned Parenthood of SW 9677 Seminole Blvd and Centra Marsalisi, Frank MD 700 6th St S Seminole, FL 33772 8950 MLK St N Ste 102 Saint Petersburg, FL 33701 Provider ID: 12202 (305) 665-2060 Saint Petersburg, FL 33702 (727) 893-6198 Gender: Male 00 Yrs/130 Yrs (727) 898-8199 Bayfront Family Health Center Fax: (727) 553-7295 MTWF 8:30 AM - 5:00 PM Fax: (727) 898-9710 00 Yrs/130 Yrs 700 6th St S TH 8:30 AM - 12:00 PM 12 Yrs/130 Yrs Bayfront Medical Center Saint Petersburg, FL 33701 PCMH: No St Anthonys Hospital Sarasota Memorial Hospital (727) 893-6198 Languages: Spanish Languages: Spanish Prabhakaran, Sujatha MD Fax: (727) 553-7295 M-F 8:30 AM - 5:00 PM M 9:00 AM - 4:30 PM 00 Yrs/130 Yrs PCMH: No T 10:00 AM - 6:00 PM Bayfront Medical Center Provider ID: 796079 WF 9:00 AM - 3:00 PM Johns Hopkins All Childrens Gender: Female Michael, Jenny MD Hospital Inc TH 11:00 AM - 6:00 PM Planned Parenthood of SW Provider ID: 1101114 M-F 8:30 AM - 5:00 PM Sat 9:00 AM - 2:00 PM and Centra Gender: Female PCMH: No PCMH: No 8950 MLK St N Ste 102 Bafround Family Health Saint Petersburg, FL 33702 Marsalisi, Frank MD Center Perez, Hugo MD (727) 898-8199 700 6th St S Provider ID: 11031 Fax: (727) 898-9710 Saint Petersburg, FL 33701 Gender: Male Provider ID: 151634 12 Yrs/130 Yrs (727) 893-6198 All Femcare OB GYN Center Gender: Male Sarasota Memorial Hospital Fax: (727) 893-6978 28960 US Hwy 19 N Ste 109 Bayfront Physician Specialty Languages: Spanish, Arabic, 00 Yrs/130 Yrs Srvice Clearwater, FL 33761 Bengali, Armenian Bayfront Medical Center 603 7th St S Ste 101 (727) 785-7686 M 9:00 AM - 4:30 PM M-F 9:00 AM - 5:00 PM Saint Petersburg, FL 33701 Fax: (727) 785-9669 T 10:00 AM - 6:00 PM PCMH: No (727) 347-8039 12 Yrs/130 Yrs WF 9:00 AM - 3:00 PM Fax: (727) 341-2359 Mease Countryside Hospital TH 11:00 AM - 6:00 PM Miller, Sarah DO Mease Hospital Dunedin 00 Yrs/130 Yrs Sat 9:00 AM - 2:00 PM Provider ID: 1157109 Medical Center of Trinity Bayfront Medical Center PCMH: No Gender: Female Languages: Spanish Johns Hopkins All Childrens Hospital Inc Women's Care Florida LLC M-F 9:00 AM - 5:00 PM M-TH 8:30 AM - 4:00 PM 1600 MLK St N PCMH: No F 8:30 AM - 5:00 PM Saint Petersburg, FL 33704 PCMH: No (727) 323-3838 Fax: (727) 201-8801 12 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 405

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - Riestra, Jorge MD cont. Provider ID: 1041302 Gender: Male Prieto, Jose MD Community Health Centers At Bayfron Provider ID: 12208 701 6th St S Gender: Male Bayfront Family Health Center Saint Petersburg, FL 33701 (727) 824-8181 700 6th St S Fax: (727) 209-5619 Saint Petersburg, FL 33701 12 Yrs/130 Yrs (727) 893-6198 Bayfront Medical Center Fax: (727) 553-7295 Languages: Spanish 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Bayfront Medical Center PCMH: No Mease Hospital Dunedin Morton Plant Hospital Riestra, Jorge MD M-F 8:30 AM - 5:00 PM Provider ID: 1041302 PCMH: No Gender: Male Raimer, Karen MD Community Health Centers At Clearwa Provider ID: 12210 707 Druid Rd E Gender: Female Bayfront Family Health Center Clearwater, FL 33756 (727) 824-8181 700 6th St S Fax: (727) 443-7230 Saint Petersburg, FL 33701 12 Yrs/130 Yrs (727) 893-6198 Bayfront Medical Center Fax: (727) 553-7295 Languages: Spanish 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Bayfront Medical Center PCMH: No M-F 8:30 AM - 5:00 PM PCMH: No Riestra, Jorge MD Reyes, Carlos MD Provider ID: 1041302 Gender: Male Provider ID: 636959 Community Health Centers Gender: Male Bayfront Family Health Center At Johnnie 1344 22nd St S 700 6th St S Saint Petersburg, FL 33712 Saint Petersburg, FL 33701 (727) 824-8181 (727) 893-6198 Fax: (727) 541-7984 Fax: (727) 553-7295 12 Yrs/130 Yrs 00 Yrs/130 Yrs Bayfront Medical Center Bayfront Medical Center Languages: Spanish M-F 8:30 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Riestra, Jorge MD Provider ID: 1041302 Gender: Male Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 12 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Sanchez, Mark MD Provider ID: 175405 Gender: Male Bayfront Family Health Center 700 6th St S Saint Petersburg, FL 33701 (727) 893-6198 Fax: (727) 553-7295 00 Yrs/130 Yrs Bayfront Medical Center Tampa General Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Rosa, Hector MD Provider ID: 817797 Gender: Male Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM PCMH: No

Schneider, Erica DO Provider ID: 711629 Gender: Female Community Health Centers At Clearwa 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Salter, Jennifer DO Provider ID: 1149225 Gender: Female Women's Care Florida LLC 1600 MLK St N Saint Petersburg, FL 33704 (727) 323-3838 Fax: (727) 201-8801 12 Yrs/130 Yrs MW 8:00 AM - 5:00 PM TTH 8:00 AM - 6:30 PM F 9:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 406

Schneider, Erica DO Provider ID: 711629 Gender: Female Community Health Centers At Clearwa 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 209-5619 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Schneider, Erica DO Provider ID: 711629 Gender: Female Community Health Centers At Clearwa 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - Shamas, Christina MD cont. Provider ID: 615185 Schneider, Erica DO Provider ID: 711629 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Schneider, Erica DO Provider ID: 711629 Gender: Female Johnnie Ruth Clarke Health Center 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Schulman, Jeffrey MD Provider ID: 1312026 Gender: Male Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 532-1374 Fax: (727) 298-6354 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Female Florida Woman Care 6700 Crosswinds Dr N Ste 200A Saint Petersburg, FL 33710 (727) 344-4651 Fax: (727) 347-6224 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital MWF 8:30 AM - 5:00 PM TTH 8:30 AM - 7:00 PM PCMH: No Shamas, Christina MD Provider ID: 615185 Gender: Female Gulfcoast OB GYN PA 2325 Ulmerton Rd Ste 1 Clearwater, FL 33762 (727) 540-0670 Fax: (727) 540-0640 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Petersburg General Hospital M 8:30 AM - 5:00 PM TWTH 8:30 AM - 12:00 PM PCMH: No

Shamas, Christina MD Provider ID: 615185 Gender: Female Gulfcoast OB GYN PA 9677 Seminole Blvd Seminole, FL 33772 (727) 319-2303 Fax: (727) 398-3087 Schwartz, Rachelle DO 00 Yrs/130 Yrs Bayfront Medical Center Provider ID: 729088 St Anthonys Hospital Gender: Female St Petersburg General Bayfront Hma Medical Center, Hospital LLC MTWF 8:30 AM - 5:00 PM 700 6th St S TH 8:30 AM - 12:00 PM Saint Petersburg, FL 33701 PCMH: No (727) 893-6198 Fax: (727) 553-7295 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:30 AM - 5:00 PM PCMH: No

Snowball, Marcia MD Provider ID: 1316596 Gender: Female Baycare Medical Group Inc 303 Pinellas St Ste 23 Clearwater, FL 33756 (727) 462-3401 Fax: (727) 533-5994 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Taylor, Tara MD Provider ID: 1349365 Gender: Female West Coast Neonatology Inc 6450 38th Ave S Ste 200 Saint Petersburg, FL 33710 (727) 767-6060 Fax: (727) 767-1285 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Thinh, Nguyen MD Provider ID: 1103000 Gender: Male Bayfront OB GYN 700 6th St S Saint Petersburg, FL 33701 (727) 893-6198 Fax: (727) 893-6978 02 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Umstead, Thomas MD Provider ID: 8878 Gender: Male 136 Country Club Ct Tarpon Springs, FL 34689 (727) 376-2229 Fax: (727) 376-5456 00 Yrs/130 Yrs Florida Hospital North Pinellas Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Vallejo, Elvia MD Provider ID: 1035892 Gender: Female Baycare Medical Group 303 Pinellas St Ste 230 Clearwater, FL 33756 (727) 462-3401 Fax: (727) 533-5994 18 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Vallejo, Elvia MD Provider ID: 526837 Gender: Female 807 N Myrtle Ave Clearwater, FL 33755 (727) 467-2400 Fax: (727) 467-2578 00 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Vaz, Stephanie MD Provider ID: 1312031 Gender: Female Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 532-1374 Fax: (727) 298-6354 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Obstetrics/Gynecology - Young, Shelley MD cont. Provider ID: 371335 Waterman II, Philip MD Provider ID: 686208 Gender: Male Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs Lee Memorial Hospital M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Wouters, Anna MD Provider ID: 1324889 Gender: Female Women's Care Florida 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 954-7121 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Young, Shara MD Provider ID: 1312032 Gender: Female Baycare Medical Group Inc 300 Pinellas St Clearwater, FL 33756 (727) 462-7000 Fax: (727) 298-6354 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital MTF 8:30 AM - 4:30 PM WTH 9:00 AM - 4:30 PM PCMH: No Young, Shelley MD Provider ID: 371335 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM PCMH: No

Ophthalmology Berger, Todd MD Provider ID: TPV1205836418-0 Gender: Male Orlick Berger Kasper MD PA 5800 49th St N S-109 Saint Petersburg, FL 33709 (727) 522-1115 Fax: (727) 522-0018 18 Yrs/99 Yrs Northside Hospital Languages: Spanish, Hindi, Punjabi M-F 7:30 AM - 5:30 PM PCMH: No

Cook, Brittany MD Cope, Winston MD Provider ID: TPV1225329790-0 Provider ID: TPV1063609485-0 Gender: Female Gender: Male The Eye Physicians of Pinellas The Eye Physicians of Pinellas PA PA 3165 McMullen Booth Rd Bldg 3165 McMullen Booth Rd Bldg A Ste 1 A Ste 1 Clearwater, FL 33761 Clearwater, FL 33761 (727) 581-8706 (727) 581-8706 Fax: (727) 588-2447 Fax: (727) 588-2447 05 Yrs/99 Yrs 18 Yrs/99 Yrs Largo Medical Center No Hospital PrivilegesCovering Arrangem Languages: French, Romanian Languages: French, Romanian M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Cook, Brittany MD Provider ID: TPV1225329790-0 Cope, Winston MD Provider ID: TPV1063609485-0 Gender: Female Gender: Male The Eye Physicians of Pinellas PA The Eye Physicians of Pinellas PA 6133 Central Ave 6133 Central Ave Saint Petersburg, FL 33710 Saint Petersburg, FL 33710 (727) 581-8706 (727) 581-8706 Fax: (727) 588-2447 Fax: (727) 588-2447 05 Yrs/99 Yrs 18 Yrs/99 Yrs Largo Medical Center No Hospital PrivilegesLanguages: French, Romanian Covering Arrangem M-F 8:00 AM - 5:00 PM Languages: French, Romanian PCMH: No M-F 8:00 AM - 5:00 PM Cook, Brittany MD PCMH: No Provider ID: TPV1225329790-0 Cope, Winston MD Gender: Female Provider ID: TPV1063609485-0 The Eye Physicians of Pinellas Gender: Male PA The Eye Physicians of Pinellas 148 13th St SW Ste 200 PA Largo, FL 33770 148 13th St SW Ste 200 (727) 581-8706 Largo, FL 33770 Fax: (727) 588-2447 (727) 581-8706 05 Yrs/99 Yrs Fax: (727) 588-2447 Largo Medical Center 18 Yrs/99 Yrs Languages: French, Romanian No Hospital PrivilegesM-F 8:00 AM - 5:00 PM Covering Arrangem PCMH: No Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 408

Last update 08/14/2017

Specialty Physicians Pinellas Ophthalmology - cont.

Desai, Neel MD Diakonis, Vasilios MD Provider ID: TPV1609957786-0 Provider ID: TPV1902234172-0 Cope, Winston MD Gender: Male Gender: Male Provider ID: TPV1063609485-0 The Eye Physicians of Pinellas The Eye Physicians of Pinellas PA PA Gender: Male 148 13th St SW Ste 200 6133 Central Ave The Eye Physicians of Pinellas PA Largo, FL 33770 Saint Petersburg, FL 33710 955 54th Ave North (727) 581-8706 (727) 581-8706 Saint Petersburg, FL 33703 Fax: (727) 588-2447 Fax: (727) 588-2447 (727) 525-4700 05 Yrs/99 Yrs 05 Yrs/99 Yrs Fax: (727) 525-7331 Morton Plant Hospital No Hospital PrivilegesCovering Arrangem 18 Yrs/99 Yrs Languages: French, Romanian Languages: French, Romanian No Hospital PrivilegesM-F 8:00 AM - 5:00 PM Covering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Desai, Neel MD PCMH: No Provider ID: TPV1609957786-0 Diakonis, Vasilios MD Desai, Neel MD Provider ID: TPV1902234172-0 Gender: Male Provider ID: TPV1609957786-0 The Eye Physicians of Pinellas Gender: Male Gender: Male PA The Eye Physicians of Pinellas PA The Eye Physicians of Pinellas 955 54th Ave North PA 148 13th St SW Ste 200 Saint Petersburg, FL 33703 3165 McMullen Booth Rd Bldg (727) 525-4700 Largo, FL 33770 A Ste 1 (727) 581-8706 Fax: (727) 525-7331 Clearwater, FL 33761 Fax: (727) 588-2447 05 Yrs/99 Yrs (727) 581-8706 05 Yrs/99 Yrs Morton Plant Hospital Fax: (727) 588-2447 No Hospital PrivilegesM-F 8:00 AM - 5:00 PM 05 Yrs/99 Yrs Covering Arrangem PCMH: No Morton Plant Hospital Languages: French, Romanian Languages: French, Romanian Diakonis, Vasilios MD M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: TPV1902234172-0 PCMH: No Gender: Male The Eye Physicians of Pinellas Goldberg, Lawrence MD Desai, Neel MD PA Provider ID: TPV1609957786-0 3165 McMullen Booth Rd Bldg Provider ID: TPV1114931599-0 Gender: Male A Ste 1 Gender: Male The Eye Physicians of Pinellas Clearwater, FL 33761 Lawrence R Goldberg MD PA PA (727) 581-8706 4957 38th Ave N Ste D 6133 Central Ave Fax: (727) 588-2447 Saint Petersburg, FL 33710 Saint Petersburg, FL 33710 05 Yrs/99 Yrs (727) 521-4669 (727) 581-8706 No Hospital PrivilegesFax: (721) 527-8568 Fax: (727) 588-2447 Covering Arrangem 18 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: French, Romanian Saint Petersburg General Morton Plant Hospital M-F 8:00 AM - 5:00 PM Hospital Languages: French, Romanian PCMH: No M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Grabow, Harry MD Provider ID: TPV1356344188-0 Gender: Male Crystal River Eye Center LLC 1250 Belcher Rd Largo, FL 33771 (727) 535-2300 Fax: (727) 535-2330 05 Yrs/99 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Greenidge, Kevin MD Provider ID: TPV1174515118-0 Gender: Male The Eye Physicians of Pinellas PA 3165 McMullen Booth Rd Bldg A Ste 1 Clearwater, FL 33761 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs All Children's Hospital Northside Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Greenidge, Kevin MD Provider ID: TPV1174515118-0 Gender: Male The Eye Physicians of Pinellas PA 6133 Central Ave Saint Petersburg, FL 33710 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs All Children's Hospital Northside Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Ophthalmology - cont. Greenidge, Kevin MD Provider ID: TPV1174515118-0 Gender: Male The Eye Physicians of Pinellas PA 148 13th St SW Ste 200 Largo, FL 33770 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs All Children's Hospital Northside Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Greenidge, Kevin MD Provider ID: TPV1174515118-0 Gender: Male The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 18 Yrs/99 Yrs All Children's Hospital Northside Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Hairston, Richard MD Provider ID: TPV1871591065-0 Gender: Male The Eye Physicians of Pinellas PA 6133 Central Ave Saint Petersburg, FL 33710 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs Morton Plant Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Hairston, Richard MD Provider ID: TPV1871591065-0 Gender: Male The Eye Physicians of Pinellas PA 148 13th St SW Ste 200 Largo, FL 33770 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs Morton Plant Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

Hairston, Richard MD Provider ID: TPV1871591065-0 Gender: Male Hairston, Richard MD The Eye Physicians of Pinellas Provider ID: TPV1871591065-0 PA Gender: Male 955 54th Ave North The Eye Physicians of Pinellas Saint Petersburg, FL 33703 PA (727) 525-4700 3165 McMullen Booth Rd Bldg Fax: (727) 525-7331 A Ste 1 18 Yrs/99 Yrs Clearwater, FL 33761 Morton Plant Hospital (727) 581-8706 M-F 8:00 AM - 5:00 PM Fax: (727) 588-2447 PCMH: No 18 Yrs/99 Yrs Morton Plant Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

Ho, Janie MD Kasper, Jeffrey MD Provider ID: TPV1710961487-0 Provider ID: TPV1912907122-0 Gender: Female Gender: Male The Eye Physicians of Pinellas Orlick Berger Kasper MD PA PA 5800 49th St N S-109 3165 McMullen Booth Rd Bldg Saint Petersburg, FL 33709 A Ste 1 (727) 522-1115 Clearwater, FL 33761 Fax: (727) 522-0018 (727) 581-8706 18 Yrs/99 Yrs Fax: (727) 588-2447 Northside Hospital 18 Yrs/99 Yrs Languages: Spanish, Hindi, No Hospital PrivilegesPunjabi Covering Arrangem M-F 7:30 AM - 5:30 PM Languages: French, Romanian PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Kirsch, Leonard MD Provider ID: TPV1669479325-0 Ho, Janie MD Gender: Male Provider ID: TPV1710961487-0 The Eye Physicians of Pinellas Gender: Female PA The Eye Physicians of Pinellas 3165 McMullen Booth Rd Bldg PA A Ste 1 6133 Central Ave Clearwater, FL 33761 Saint Petersburg, FL 33710 (727) 581-8706 (727) 581-8706 Fax: (727) 588-2447 Fax: (727) 588-2447 18 Yrs/99 Yrs 18 Yrs/99 Yrs Largo Medical Center No Hospital PrivilegesMorton Plant Hospital Covering Arrangem Languages: French, Romanian Languages: French, Romanian M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Kirsch, Leonard MD Ho, Janie MD Provider ID: TPV1669479325-0 Provider ID: TPV1710961487-0 Gender: Male Gender: Female The Eye Physicians of Pinellas The Eye Physicians of Pinellas PA PA 6133 Central Ave 148 13th St SW Ste 200 Saint Petersburg, FL 33710 Largo, FL 33770 (727) 581-8706 (727) 581-8706 Fax: (727) 588-2447 Fax: (727) 588-2447 18 Yrs/99 Yrs 18 Yrs/99 Yrs Largo Medical Center No Hospital PrivilegesMorton Plant Hospital Covering Arrangem Languages: French, Romanian Languages: French, Romanian M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 410

Last update 08/14/2017

Specialty Physicians Pinellas Ophthalmology - cont. Kirsch, Leonard MD Provider ID: TPV1669479325-0 Gender: Male The Eye Physicians of Pinellas PA 148 13th St SW Ste 200 Largo, FL 33770 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs Largo Medical Center Morton Plant Hospital Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Kirsch, Leonard MD Provider ID: TPV1669479325-0 Gender: Male The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 18 Yrs/99 Yrs Largo Medical Center Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Knapp, Don MD Provider ID: TPV1205828571-0 Gender: Male Don B Knapp II MD 6499 38th Ave N B1 Saint Petersburg, FL 33710 (727) 344-1407 Fax: (727) 344-1408 18 Yrs/99 Yrs Northside Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Landy, Jennifer MD Mohadjer, Yasaman MD Provider ID: TPV1386609329-0 Gender: Female Provider ID: TPV1841231297-0 Southeast Eye Institute PA Gender: Female 9375 66th St N The Eye Physicians of Pinellas Pinellas Park, FL 33782 PA (727) 541-4469 3165 McMullen Booth Rd Bldg A Ste 1 Fax: (727) 546-9661 Clearwater, FL 33761 12 Yrs/99 Yrs (727) 581-8706 Languages: Spanish Fax: (727) 588-2447 M-F 7:30 AM - 5:00 PM 05 Yrs/99 Yrs PCMH: No Languages: French, Romanian Levy-Clarke, Grace MD M-F 8:00 AM - 5:00 PM Provider ID: TPV1437342847-0 PCMH: No Gender: Female Mohadjer, Yasaman MD Orlick Berger Kasper MD PA 5800 49th St N S-109 Saint Petersburg, FL 33709 Provider ID: TPV1841231297-0 (727) 522-1115 Gender: Female Fax: (727) 522-0018 The Eye Physicians of Pinellas PA 06 Yrs/99 Yrs 6133 Central Ave Languages: Spanish, Hindi, Punjabi Saint Petersburg, FL 33710 M-F 7:30 AM - 5:30 PM (727) 581-8706 PCMH: No Fax: (727) 588-2447 05 Yrs/99 Yrs Levy-Clarke, Grace MD Languages: French, Romanian Provider ID: TPV1437342847-0 M-F 8:00 AM - 5:00 PM Gender: Female PCMH: No Tampa Bay Uveitis Center LLC Mohadjer, Yasaman MD 5800 49th St N Ste S 108 Saint Petersburg, FL 33709 (855) 798-8393 Provider ID: TPV1841231297-0 Fax: (888) 539-6488 Gender: Female 06 Yrs/99 Yrs The Eye Physicians of Pinellas M-F 8:00 AM - 5:00 PM PA PCMH: No 148 13th St SW Ste 200 Largo, FL 33770 Mohadjer, Yasaman MD (727) 581-8706 Fax: (727) 588-2447 Provider ID: TPV1841231297-0 05 Yrs/99 Yrs Gender: Female Languages: French, Romanian The Eye Physicians of Pinellas M-F 8:00 AM - 5:00 PM PA PCMH: No 1225 W Bay Dr Largo, FL 33770 (727) 581-8706 Fax: (727) 586-3743 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Mohadjer, Yasaman MD Provider ID: TPV1841231297-0 Gender: Female The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Montzka, Dan MD Provider ID: TPV1841290293-0 Gender: Male Gulf Coast Retina Center 3001 Eastland Blvd Ste 1 Clearwater, FL 33761 (727) 726-1492 Fax: (727) 726-3560 06 Yrs/99 Yrs Mease Countryside Hospital Mease Dunedin Hospital M 8:00 AM - 5:00 PM T 8:00 AM - 12:30 PM PCMH: No Oberlander, Mark MD Provider ID: TPV1245292176-0 Gender: Male Southeast Eye Institute PA 9375 66th St N Pinellas Park, FL 33782 (727) 541-4469 Fax: (727) 546-9661 18 Yrs/99 Yrs Bayfront Medical Center Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Orlick, Martin MD Provider ID: TPV1003816018-0 Gender: Male Orlick Berger Kasper MD PA 5800 49th St N S-109 Saint Petersburg, FL 33709 (727) 522-1115 Fax: (727) 522-0018 00 Yrs/99 Yrs Languages: Spanish, Hindi, Punjabi M-F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Ophthalmology - cont. Patel, Nandesh MD Provider ID: TPV1821292228-0 Gender: Male Orlick Berger Kasper MD PA 5800 49th St N S-109 Saint Petersburg, FL 33709 (727) 522-1115 Fax: (727) 522-0018 00 Yrs/99 Yrs Languages: Spanish, Hindi, Punjabi M-F 7:30 AM - 5:30 PM PCMH: No Plous, Oren MD Provider ID: TPV1467422659-0 Gender: Male Tampa Bay Retina PA 3001 Eastland Blvd Ste 1 Clearwater, FL 33761 (941) 312-2769 Fax: (866) 426-2169 12 Yrs/99 Yrs Mease Countryside Hospital Morton Plant Hospital Winter Haven Hospital Languages: Spanish M-TH 9:00 AM - 5:00 PM F 1:00 AM - 5:00 PM PCMH: No Plous, Oren MD Provider ID: TPV1467422659-1 Gender: Male Southeast Eye Institute PA 9375 66th St N Pinellas Park, FL 33782 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Mease Countryside Hospital Morton Plant Hospital Winter Haven Hospital Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

Ross, Joseph MD Schwartz, Jeffrey MD Swann, Forrest MD Provider ID: TPV1780602482-0 Provider ID: TPV1700884350-0 Provider ID: TPV1407291420-0 Gender: Male Gender: Male Gender: Male Crystal River Eye Center LLC The Eye Physicians of Pinellas The Eye Physicians of Pinellas PA PA 1250 Belcher Rd 148 13th St SW Ste 200 6133 Central Ave Largo, FL 33771 Largo, FL 33770 Saint Petersburg, FL 33710 (727) 535-2300 (727) 581-8706 (727) 581-8706 Fax: (727) 535-2330 Fax: (727) 588-2447 Fax: (727) 588-2447 12 Yrs/99 Yrs 18 Yrs/99 Yrs 18 Yrs/99 Yrs Citrus Memorial Hospital Languages: French, Romanian No Hospital PrivilegesM-F 8:00 AM - 5:00 PM Covering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No Languages: French, Romanian PCMH: No Scherer, Warren MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: TPV1265519995-0 Schwartz, Jeffrey MD Provider ID: TPV1700884350-0 Gender: Male Swann, Forrest MD Gender: Male Crystal River Eye Center LLC Provider ID: TPV1407291420-0 The Eye Physicians of Pinellas 1250 Belcher Rd PA Gender: Male Largo, FL 33771 955 54th Ave North The Eye Physicians of Pinellas (727) 535-2300 PA Saint Petersburg, FL 33703 Fax: (727) 535-2330 148 13th St SW Ste 200 (727) 525-4700 18 Yrs/99 Yrs Largo, FL 33770 Fax: (727) 525-7331 Belleair Surgery Center (727) 581-8706 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Fax: (727) 588-2447 M-F 8:00 AM - 5:00 PM PCMH: No 18 Yrs/99 Yrs PCMH: No No Hospital PrivilegesSchwartz, Jeffrey MD Covering Arrangem Provider ID: TPV1700884350-0 Swann, Forrest MD Languages: French, Romanian Provider ID: TPV1407291420-0 Gender: Male M-F 8:00 AM - 5:00 PM Gender: Male The Eye Physicians of Pinellas PCMH: No The Eye Physicians of Pinellas PA 3165 McMullen Booth Rd Bldg PA 3165 McMullen Booth Rd Bldg Weinstock, Stephen MD A Ste 1 A Ste 1 Clearwater, FL 33761 Clearwater, FL 33761 Provider ID: TPV1841297686-0 (727) 581-8706 (727) 581-8706 Gender: Male Fax: (727) 588-2447 Fax: (727) 588-2447 The Eye Physicians of Pinellas 18 Yrs/99 Yrs 18 Yrs/99 Yrs PA Languages: French, Romanian No Hospital Privileges3165 McMullen Booth Rd Bldg M-F 8:00 AM - 5:00 PM Covering Arrangem A Ste 1 PCMH: No Languages: French, Romanian Clearwater, FL 33761 M-F 8:00 AM - 5:00 PM (727) 581-8706 Schwartz, Jeffrey MD Fax: (727) 588-2447 Provider ID: TPV1700884350-0 PCMH: No 18 Yrs/99 Yrs Gender: Male Largo Medical Center The Eye Physicians of Pinellas Languages: French, Romanian PA M-F 8:00 AM - 5:00 PM 6133 Central Ave PCMH: No Saint Petersburg, FL 33710 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 412

Last update 08/14/2017

Specialty Physicians Pinellas Ophthalmology - cont. Weinstock, Stephen MD Provider ID: TPV1841297686-0 Gender: Male The Eye Physicians of Pinellas PA 6133 Central Ave Saint Petersburg, FL 33710 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs Largo Medical Center Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Weinstock, Stephen MD Provider ID: TPV1841297686-0 Gender: Male The Eye Physicians of Pinellas PA 148 13th St SW Ste 200 Largo, FL 33770 (727) 581-8706 Fax: (727) 588-2447 18 Yrs/99 Yrs Largo Medical Center Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Weinstock, Stephen MD Provider ID: TPV1841297686-0 Gender: Male The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 18 Yrs/99 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Williams-Wallace, Nancy MD Provider ID: TPV1184650970-0 Gender: Female Florida Pediatric Associates LLC 36422 US 19 N Palm Harbor, FL 34684 (727) 772-7712 Fax: (727) 772-6891 00 Yrs/99 Yrs St Josephs Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Optician Eye Doctors Optical Outlets PA Provider ID: TPV1184174278-0 11290 Park Blvd Ste B Seminole, FL 33772 (727) 547-4856 Fax: (727) 201-0861 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1184815086-0 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 369-8827 00 Yrs/99 Yrs MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1215358833-0 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Eye Doctors Optical Outlets PA Provider ID: TPV1497047344-0 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1700077781-0 3740 Park Blvd Pinellas Park, FL 33781 (727) 547-4856 Fax: (727) 474-9835 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1720278104-0 3665 E Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 00 Yrs/99 Yrs MT 10:00 AM - 6:00 PM WTHF 9:00 AM - 5:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Eye Institute Optical LLC Provider ID: TPV1346695913-0 148 13th St SW Largo, FL 33770 (727) 584-5748 Fax: (727) 586-3743 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Optimart Inc Provider ID: TPV1174730352-0 35170 US Hwy 19 N Palm Harbor, FL 34684 (727) 789-5333 Fax: (727) 789-5428 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 413

Optimart Inc Provider ID: TPV1922215136-0 7165 Seminole Blvd Seminole, FL 33772 (727) 392-0907 Fax: (727) 529-2569 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Optimart St Petersburg Provider ID: TPV1598986598-0 4359 35th St N Saint Petersburg, FL 33714 (727) 525-3959 Fax: (727) 527-9695 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Visionworks Inc Provider ID: TPV1184900235-0 912 S Missouri Ave Clearwater, FL 33756 (727) 443-6493 Fax: (727) 447-0051 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Visionworks Inc Provider ID: TPV1730466707-0 11212 Park Blvd Seminole, FL 33772 (727) 397-8994 Fax: (727) 393-2882 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Visionworks Inc Provider ID: TPV1821375148-0 3301 4th St N Saint Petersburg, FL 33704 (727) 821-9540 Fax: (727) 823-1487 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Optician - cont. Visionworks Inc Provider ID: TPV1881971109-0 30715 US Hwy 19 Palm Harbor, FL 34684 (727) 786-7288 Fax: (727) 786-8258 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Visionworks Inc Provider ID: TPV1972880292-0 2143 Tyrone Blvd Saint Petersburg, FL 33710 (727) 345-4446 Fax: (727) 345-8945 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Anderson, Nicholas OD Barreiro, Francis OD Provider ID: TPV1689909442-0 Provider ID: TPV1184611410-0 Gender: Male Gender: Male The Eye Physicians of Pinellas The Eye Physicians of Pinellas PA PA 148 13th St SW Ste 200 6133 Central Ave Largo, FL 33770 Saint Petersburg, FL 33710 (727) 581-8706 (727) 581-8706 Fax: (727) 588-2447 Fax: (727) 588-2447 06 Yrs/99 Yrs 07 Yrs/99 Yrs Languages: French, Romanian Languages: French, Romanian M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Anderson, Nicholas OD Barreiro, Francis OD Provider ID: TPV1689909442-0 Provider ID: TPV1184611410-0 Gender: Male Gender: Male The Eye Physicians of Pinellas The Eye Physicians of Pinellas PA PA 955 54th Ave North 148 13th St SW Ste 200 Saint Petersburg, FL 33703 Largo, FL 33770 (727) 525-4700 (727) 581-8706 Optometry Fax: (727) 525-7331 Fax: (727) 588-2447 06 Yrs/99 Yrs 07 Yrs/99 Yrs Adler, Shepard OD M-F 8:00 AM - 5:00 PM Languages: French, Romanian Provider ID: TPV1366403974-0 PCMH: No M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Dr Barry Case LLC Aronson, Barry OD 11212 Park Blvd Provider ID: TPV1003819830-1 Barreiro, Francis OD Seminole, FL 33772 Gender: Male Provider ID: TPV1184611410-0 (727) 393-1501 Eye Doctors Optical Outlets Gender: Male Fax: (727) 393-2882 PA The Eye Physicians of Pinellas 05 Yrs/99 Yrs 3665 East Bay Dr Ste 200 PA M-F 9:00 AM - 6:00 PM Largo, FL 33771 955 54th Ave North Sat 11:00 AM - 4:00 PM (727) 538-2775 Saint Petersburg, FL 33703 PCMH: No Fax: (727) 213-6703 (727) 525-4700 05 Yrs/99 Yrs Fax: (727) 525-7331 Anderson, Nicholas OD Languages: Spanish, 07 Yrs/99 Yrs Provider ID: TPV1689909442-0 Vietnamese M-F 8:00 AM - 5:00 PM Gender: Male MT 10:00 AM - 6:00 PM PCMH: No The Eye Physicians of Pinellas WTH 9:00 AM - 5:00 PM PA Beckwitt, Julie-Ann OD F 9:00 AM - 3:00 PM 6133 Central Ave PCMH: No Provider ID: TPV1437262953-0 Saint Petersburg, FL 33710 Gender: Female (727) 581-8706 Aronson, Barry OD Myeyedr Optometry of Fax: (727) 588-2447 Provider ID: TPV1003819830-1 Florida LLC 06 Yrs/99 Yrs Gender: Male 2551 Drew St Ste 302 Languages: French, Romanian Eye Doctors Optical Outlets Clearwater, FL 33765 M-F 8:00 AM - 5:00 PM PA (727) 791-1214 PCMH: No 11290 Park Blvd Ste B Fax: (844) 766-9698 Seminole, FL 33772 05 Yrs/99 Yrs (727) 547-4856 M-F 9:00 AM - 5:00 PM Fax: (727) 201-0861 PCMH: No 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 414

Birnbaum, Suzanne OD Provider ID: TPV1417140054-0 Gender: Female Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Branin, Leslie OD Provider ID: TPV1457416380-0 Gender: Male Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Branin, Leslie OD Provider ID: TPV1457416380-0 Gender: Male Eye Doctors Optical Outlets PA 3740 Park Blvd Pinellas Park, FL 33781 (727) 547-4856 Fax: (727) 474-9835 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Camargo, Tara OD Provider ID: TPV1467701086-0 Gender: Female St Petersburg Eye Care Specialists PA 929 1st Ave N Saint Petersburg, FL 33705 (727) 898-3155 Fax: (727) 821-1912 05 Yrs/99 Yrs M-W 8:00 AM - 5:30 PM TH 8:00 AM - 7:00 PM F 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont. Campbell, Christopher OD Provider ID: TPV1144311366-0 Gender: Male Professional Eyecare Consultants PA 2000 66th St N Saint Petersburg, FL 33710 (727) 347-3937 Fax: (727) 347-3937 05 Yrs/99 Yrs Languages: Spanish M-TH 9:00 AM - 7:00 PM F 9:00 AM - 5:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Caputi, Lori OD Provider ID: TPV1336251511-0 Gender: Female Myeyedr Optometry of Florida LLC 2551 Drew St Ste 302 Clearwater, FL 33765 (727) 791-1214 Fax: (844) 766-9698 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Case, Barry OD Provider ID: TPV1730521055-0 Gender: Male Dr Barry Case LLC 11212 Park Blvd Seminole, FL 33772 (727) 393-1501 Fax: (727) 393-2882 09 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 11:00 AM - 4:00 PM PCMH: No

Chavez, Claudia OD Provider ID: TPV1881655645-0 Gender: Female Professional Eyecare Consultants PA 33330 US Hwy 19 N Palm Harbor, FL 34684 (727) 789-0443 Fax: (727) 786-3524 06 Yrs/99 Yrs Languages: Spanish M-TH 9:00 AM - 7:00 PM F 9:00 AM - 5:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ciccarello, Jim OD Provider ID: TPV1144264110-0 Gender: Male Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Ciccarello, Jim OD Provider ID: TPV1144264110-0 Gender: Male Eye Doctors Optical Outlets PA 27001 US Hwy 19 N Ste 2037 Clearwater, FL 33761 (727) 669-8486 Fax: (727) 213-6341 05 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Ciccarello, Jim OD Provider ID: TPV1144264110-0 Gender: Male Eye Doctors Optical Outlets PA 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 474-9835 05 Yrs/99 Yrs Languages: Spanish MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Ciccarello, Jim OD Provider ID: TPV1144264110-0 Gender: Male Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Ciccarello, Jim OD Provider ID: TPV1144264110-0 Gender: Male Eye Doctors Optical Outlets PA 3740 Park Blvd Pinellas Park, FL 33781 (727) 547-4856 Fax: (727) 474-9835 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 415

Clough, Scott OD Provider ID: TPV1326042375-0 Gender: Male Vision Specialty Associates PA 35170 US Hwy 19 N Palm Harbor, FL 34684 (727) 789-5333 Fax: (727) 789-5428 06 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Clough, Scott OD Provider ID: TPV1326042375-0 Gender: Male Vision Specialty Associates PA 7165 Seminole Blvd Seminole, FL 33772 (727) 392-0907 Fax: (727) 592-2569 06 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Clough, Scott OD Provider ID: TPV1326042375-1 Gender: Male Vision Specialty Associates PA 4359 35th St N Saint Petersburg, FL 33714 (727) 525-3959 Fax: (727) 527-9695 06 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Cochran, John OD Provider ID: TPV1538168836-0 Gender: Male Dr Barry Case LLC 11212 Park Blvd Seminole, FL 33772 (727) 393-1501 Fax: (727) 393-2882 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 11:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont.

Cothran, Nora OD Day, Paul OD De LA Torre, Miguel OD Provider ID: TPV1467882050-0 Provider ID: TPV1265634224-1 Provider ID: TPV1407956048-0 Cochran, John OD Gender: Female Gender: Male Gender: Male Provider ID: TPV1538168836-1 The Eye Physicians of Pinellas Vision Specialty Associates PA Eye Doctors Optical Outlets PA PA Gender: Male 4359 35th St N 148 13th St SW Ste 200 39310 US Hwy 19 N Sj Vision PA Saint Petersburg, FL 33714 Largo, FL 33770 Tarpon Springs, FL 34689 30715 US Hwy 19 N Ste 116 (727) 525-3959 (727) 581-8706 (727) 756-1220 Palm Harbor, FL 34684 Fax: (727) 527-9695 Fax: (727) 588-2447 Fax: (727) 608-4456 (727) 785-8645 05 Yrs/99 Yrs 05 Yrs/99 Yrs 05 Yrs/99 Yrs Fax: (727) 223-5808 M-F 9:00 AM - 5:00 PM Languages: French, Romanian Languages: Spanish, 05 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM Vietnamese M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 6:00 PM PCMH: No M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 5:00 PM De LA Torre, Miguel OD Sat 9:00 AM - 3:00 PM Sun 12:00 AM - 4:00 PM Cothran, Nora OD Provider ID: TPV1407956048-0 PCMH: No PCMH: No Provider ID: TPV1467882050-0 Gender: Male Cothran, Nora OD Gender: Female Eye Doctors Optical Outlets De LA Torre, Miguel OD Provider ID: TPV1407956048-0 PA Provider ID: TPV1467882050-0 The Eye Physicians of Pinellas PA Gender: Male 27001 US Hwy 19 N Ste 2037 Gender: Female 955 54th Ave North Eye Doctors Optical Outlets Clearwater, FL 33761 The Eye Physicians of Pinellas PA Saint Petersburg, FL 33703 PA (727) 669-8486 6901 22nd Ave N Ste 760 3165 McMullen Booth Rd Bldg (727) 525-4700 Fax: (727) 213-6341 Saint Petersburg, FL 33710 A Ste 1 Fax: (727) 525-7331 05 Yrs/99 Yrs (727) 343-3006 Clearwater, FL 33761 05 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Fax: (727) 474-9835 (727) 581-8706 M-F 8:00 AM - 5:00 PM Sat 10:00 AM - 9:00 PM 05 Yrs/99 Yrs Fax: (727) 588-2447 PCMH: No Sun 12:00 AM - 6:00 PM Languages: Spanish 05 Yrs/99 Yrs PCMH: No MTWTHFSat 10:00 AM - 9:00 Languages: French, Romanian D'Alesio, Michael OD PM Provider ID: TPV1902007016-0 De LA Torre, Miguel OD M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Provider ID: TPV1407956048-0 Sun 12:00 AM - 6:00 PM PCMH: No Michael Dalesio OD PA Gender: Male Cothran, Nora OD 8001 US Hwy 19 N Eye Doctors Optical Outlets De LA Torre, Miguel OD Provider ID: TPV1467882050-0 Pinellas Park, FL 33781 PA Provider ID: TPV1407956048-0 Gender: Female (727) 568-0385 3665 East Bay Dr Ste 200 Gender: Male The Eye Physicians of Pinellas Fax: (727) 851-9508 Largo, FL 33771 Eye Doctors Optical Outlets PA 04 Yrs/99 Yrs (727) 538-2775 PA 6133 Central Ave MTWFSat 9:30 AM - 6:00 PM Fax: (727) 213-6703 6927 4th St N Saint Petersburg, FL 33710 TH 10:00 AM - 6:00 PM 05 Yrs/99 Yrs Saint Petersburg, FL 33702 (727) 581-8706 PCMH: No Languages: Spanish, (727) 210-8672 Fax: (727) 588-2447 Vietnamese Fax: (727) 214-2594 Day, Paul OD 05 Yrs/99 Yrs MT 10:00 AM - 6:00 PM 05 Yrs/99 Yrs Languages: French, Romanian Provider ID: TPV1265634224-0 WTH 9:00 AM - 5:00 PM M-F 9:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM Gender: Male F 9:00 AM - 3:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Vision Specialty Associates PA PCMH: No PCMH: No 7165 Seminole Blvd Seminole, FL 33772 (727) 392-0907 Fax: (727) 592-2569 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont.

Ferris, Anthony OD Provider ID: TPV1457547366-1 De LA Torre, Miguel OD Gender: Male Provider ID: TPV1407956048-0 Eye Doctors Optical Outlets PA Gender: Male 11290 Park Blvd Ste B Eye Doctors Optical Outlets PA Seminole, FL 33772 3740 Park Blvd (727) 547-4856 Pinellas Park, FL 33781 Fax: (727) 201-0861 (727) 547-4856 04 Yrs/99 Yrs Fax: (727) 474-9835 M-F 9:00 AM - 6:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 4:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 3:00 PM Flanagan, Deborah OD PCMH: No Provider ID: TPV1982669453-0 De LA Torre, Miguel OD Gender: Female Provider ID: TPV1407956048-0 Deborah C Flanagan OD PA Gender: Male 4940 Central Ave Eye Doctors Optical Outlets Saint Petersburg, FL 33707 PA (727) 321-6600 11290 Park Blvd Ste B Fax: (727) 321-8300 Seminole, FL 33772 03 Yrs/99 Yrs (727) 547-4856 MWTHF 8:00 AM - 5:30 PM Fax: (727) 201-0861 T 8:00 AM - 6:30 PM 05 Yrs/99 Yrs Sat 9:00 AM - 1:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM Flanagan, Thomas OD PCMH: No Provider ID: TPV1265495212-0 Demarco, Leo OD Gender: Male Provider ID: TPV1477608156-0 Eye Doctors Optical Outlets Gender: Male PA Eye Doctors Optical Outlets 6901 22nd Ave N Ste 760 PA Saint Petersburg, FL 33710 39310 US Hwy 19 N (727) 343-3006 Tarpon Springs, FL 34689 Fax: (727) 474-9835 (727) 756-1220 05 Yrs/99 Yrs Fax: (727) 608-4456 Languages: Spanish 05 Yrs/99 Yrs MTWTHFSat 10:00 AM - 9:00 Languages: Spanish, PM Vietnamese Sun 12:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 3:00 PM Flanagan, Thomas OD PCMH: No Provider ID: TPV1265495212-0 Diaczyk, Andrew OD Gender: Male Provider ID: TPV1902953433-0 Eye Doctors Optical Outlets Gender: Male PA Andrew Diaczyk 6927 4th St N 4887 34th St S Saint Petersburg, FL 33702 Saint Petersburg, FL 33711 (727) 210-8672 (727) 864-4047 Fax: (727) 214-2594 Fax: (727) 864-0060 05 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 3:00 PM PCMH: No PCMH: No

Furman, Adam OD Graham, Ben OD Provider ID: TPV1336541465-0 Provider ID: TPV1558497669-0 Gender: Male Gender: Male Vision Specialty Associates PA Ben V Graham OD PHD PA 35170 US Hwy 19 N 2143 Tyrone Blvd Palm Harbor, FL 34684 Saint Petersburg, FL 33710 (727) 789-5333 (727) 345-3360 Fax: (727) 789-5428 Fax: (727) 347-3624 06 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM M-F 9:00 AM - 5:00 PM Sat 12:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No Gruszka, Melinda OD Furman, Adam OD Provider ID: TPV1194050203-0 Provider ID: TPV1336541465-0 Gender: Female Gender: Male The Eye Physicians of Pinellas Vision Specialty Associates PA PA 3165 McMullen Booth Rd Bldg 7165 Seminole Blvd A Ste 1 Seminole, FL 33772 Clearwater, FL 33761 (727) 392-0907 (727) 581-8706 Fax: (727) 592-2569 Fax: (727) 588-2447 06 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish Languages: French, Romanian M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No Gruszka, Melinda OD Furman, Adam OD Provider ID: TPV1194050203-0 Provider ID: TPV1336541465-1 Gender: Female Gender: Male Vision Specialty Associates PA The Eye Physicians of Pinellas PA 4359 35th St N 6133 Central Ave Saint Petersburg, FL 33714 Saint Petersburg, FL 33710 (727) 525-3959 (727) 581-8706 Fax: (727) 527-9695 Fax: (727) 588-2447 06 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: French, Romanian Sat 9:00 AM - 2:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Furman, Megan OD Provider ID: TPV1548707334-0 Gruszka, Melinda OD Provider ID: TPV1194050203-0 Gender: Female Vision Specialty Associates PA Gender: Female The Eye Physicians of Pinellas 4359 35th St N PA Saint Petersburg, FL 33714 148 13th St SW Ste 200 (727) 525-3959 Largo, FL 33770 Fax: (727) 527-9695 (727) 581-8706 06 Yrs/99 Yrs Fax: (727) 588-2447 M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM Languages: French, Romanian PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont.

Hernandez, Madeline OD Provider ID: TPV1710907944-2 Gender: Female Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 07 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Herriott, Michael OD Herriott, Michael OD Provider ID: TPV1942588926-0 Provider ID: TPV1942588926-0 Gruszka, Melinda OD Gender: Male Gender: Male Provider ID: TPV1194050203-0 Eye Doctors Optical Outlets Eye Doctors Optical Outlets PA PA Gender: Female 39310 US Hwy 19 N 3740 Park Blvd The Eye Physicians of Pinellas PA Tarpon Springs, FL 34689 Pinellas Park, FL 33781 955 54th Ave North (727) 756-1220 (727) 547-4856 Saint Petersburg, FL 33703 Fax: (727) 608-4456 Fax: (727) 474-9835 (727) 525-4700 05 Yrs/99 Yrs 05 Yrs/99 Yrs Fax: (727) 525-7331 Languages: Spanish, M-F 9:00 AM - 6:00 PM Vietnamese 05 Yrs/99 Yrs Sat 9:00 AM - 3:00 PM M-F 9:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM PCMH: No Sat 9:00 AM - 3:00 PM PCMH: No Hetherington, Mark OD PCMH: No Hernandez, Madeline OD Provider ID: TPV1437258944-0 Herriott, Michael OD Provider ID: TPV1710907944-0 Herriott, Michael OD Gender: Male Provider ID: TPV1942588926-0 Provider ID: TPV1942588926-0 Vision Specialty Associates PA Gender: Female Gender: Male Vision Specialty Associates PA Gender: Male 35170 US Hwy 19 N Eye Doctors Optical Outlets Eye Doctors Optical Outlets 35170 US Hwy 19 N Palm Harbor, FL 34684 PA PA Palm Harbor, FL 34684 (727) 789-5333 27001 US Hwy 19 N Ste 2037 6901 22nd Ave N Ste 760 (727) 789-5333 Fax: (727) 789-5428 Clearwater, FL 33761 Saint Petersburg, FL 33710 Fax: (727) 789-5428 07 Yrs/99 Yrs (727) 669-8486 (727) 343-3006 07 Yrs/99 Yrs Languages: Spanish Fax: (727) 213-6341 Fax: (727) 474-9835 Languages: Spanish M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM M-F 10:30 AM - 8:30 PM Languages: Spanish Sat 9:00 AM - 2:00 PM PCMH: No Sat 10:00 AM - 9:00 PM MTWTHFSat 10:00 AM - 9:00 PCMH: No PM Sun 12:00 AM - 6:00 PM Hetherington, Mark OD Sun 12:00 AM - 6:00 PM Hernandez, Madeline OD PCMH: No Provider ID: TPV1437258944-0 PCMH: No Provider ID: TPV1710907944-0 Gender: Male Herriott, Michael OD Gender: Female Vision Specialty Associates PA Vision Specialty Associates PA Provider ID: TPV1942588926-0 Herriott, Michael OD 7165 Seminole Blvd Provider ID: TPV1942588926-0 Seminole, FL 33772 Gender: Male 7165 Seminole Blvd Gender: Male Eye Doctors Optical Outlets Seminole, FL 33772 (727) 392-0907 PA Eye Doctors Optical Outlets (727) 392-0907 Fax: (727) 592-2569 PA 3665 East Bay Dr Ste 200 Fax: (727) 592-2569 07 Yrs/99 Yrs 6927 4th St N Largo, FL 33771 07 Yrs/99 Yrs Languages: Spanish Saint Petersburg, FL 33702 (727) 538-2775 Languages: Spanish M-F 9:00 AM - 5:00 PM (727) 210-8672 Fax: (727) 213-6703 M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM Fax: (727) 214-2594 05 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM PCMH: No 05 Yrs/99 Yrs Languages: Spanish, PCMH: No Vietnamese M-F 9:00 AM - 6:00 PM Hetherington, Mark OD MT 10:00 AM 6:00 PM Sat 9:00 AM - 3:00 PM Hernandez, Madeline OD Provider ID: TPV1437258944-0 WTH 9:00 AM - 5:00 PM PCMH: No Provider ID: TPV1710907944-1 Gender: Male F 9:00 AM - 3:00 PM Gender: Female Vision Specialty Associates PA Vision Specialty Associates PA PCMH: No 4359 35th St N 4359 35th St N Saint Petersburg, FL 33714 Saint Petersburg, FL 33714 (727) 525-3959 (727) 525-3959 Fax: (727) 527-9695 Fax: (727) 527-9695 07 Yrs/99 Yrs 07 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 418

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont.

Honeyblue, Shamika OD Provider ID: TPV1538317219-1 Hetherington, Mark OD Gender: Female Provider ID: TPV1437258944-1 Shamika L Honeyblue OD PA Gender: Male 7211 US Hwy 19 North Vision Specialty Associates PA Pinellas Park, FL 33781 4359 35th St N (727) 521-2020 Saint Petersburg, FL 33714 Fax: (727) 521-6762 (727) 525-3959 07 Yrs/99 Yrs Fax: (727) 527-9695 MT 9:00 AM - 7:00 PM 07 Yrs/99 Yrs W 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM TH 10:00 AM - 2:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No Honeyblue, Shamika OD Ho, Thanh OD Provider ID: TPV1538317219-1 Provider ID: TPV1336404342-0 Gender: Female Gender: Female Vision Specialty Associates PA Myeyedr Optometry of 4359 35th St N Florida LLC Saint Petersburg, FL 33714 2551 Drew St Ste 302 (727) 525-3959 Clearwater, FL 33765 Fax: (727) 527-9695 (727) 791-1214 07 Yrs/99 Yrs Fax: (844) 766-9698 M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No Huggett, Edward OD Honeyblue, Shamika OD Provider ID: 214090 Provider ID: TPV1538317219-0 Gender: Male Gender: Female 2436 Bayshore Blvd Vision Specialty Associates PA Dunedin, FL 34698 35170 US Hwy 19 N (727) 789-0199 Palm Harbor, FL 34684 Fax: (727) 789-1767 (727) 789-5333 00 Yrs/130 Yrs Fax: (727) 789-5428 PCMH: No 07 Yrs/99 Yrs Ingham, Richard OD Languages: Spanish M-F 9:00 AM - 5:00 PM Provider ID: TPV1952464786-0 Sat 9:00 AM - 2:00 PM Gender: Male PCMH: No Eye Doctors Optical Outlets PA Honeyblue, Shamika OD 6901 22nd Ave N Ste 760 Provider ID: TPV1538317219-0 Saint Petersburg, FL 33710 Gender: Female (727) 343-3006 Vision Specialty Associates PA Fax: (727) 474-9835 7165 Seminole Blvd 05 Yrs/99 Yrs Seminole, FL 33772 Languages: Spanish (727) 392-0907 MTWTHFSat 10:00 AM - 9:00 PM Fax: (727) 592-2569 Sun 12:00 AM - 6:00 PM 07 Yrs/99 Yrs PCMH: No Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No

Ingham, Richard OD Provider ID: TPV1952464786-0 Gender: Male Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Johnson, Douglas OD Provider ID: TPV1114925773-0 Gender: Male The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Jones, Douglas OD Johnson, Douglas OD Provider ID: TPV1063587327-0 Provider ID: TPV1114925773-0 Gender: Male Gender: Male Vision Specialty Associates PA The Eye Physicians of Pinellas 7165 Seminole Blvd PA Seminole, FL 33772 3165 McMullen Booth Rd Bldg (727) 392-0907 A Ste 1 Fax: (727) 592-2569 Clearwater, FL 33761 05 Yrs/99 Yrs (727) 581-8706 Languages: Spanish Fax: (727) 588-2447 M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM Languages: French, Romanian PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Jones, Douglas OD Provider ID: TPV1063587327-0 Johnson, Douglas OD Gender: Male Provider ID: TPV1114925773-0 Vision Specialty Associates PA Gender: Male 35170 US Hwy 19 N The Eye Physicians of Pinellas Palm Harbor, FL 34684 PA (727) 789-5333 6133 Central Ave Fax: (727) 789-5428 Saint Petersburg, FL 33710 05 Yrs/99 Yrs (727) 581-8706 Languages: Spanish Fax: (727) 588-2447 M-F 9:00 AM - 5:00 PM 05 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM Languages: French, Romanian PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Jones, Douglas OD Provider ID: TPV1063587327-1 Johnson, Douglas OD Gender: Male Provider ID: TPV1114925773-0 Vision Specialty Associates PA Gender: Male 4359 35th St N The Eye Physicians of Pinellas Saint Petersburg, FL 33714 PA (727) 525-3959 148 13th St SW Ste 200 Fax: (727) 527-9695 Largo, FL 33770 05 Yrs/99 Yrs (727) 581-8706 M-F 9:00 AM - 5:00 PM Fax: (727) 588-2447 Sat 9:00 AM - 2:00 PM 05 Yrs/99 Yrs PCMH: No Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 419

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont. Konynenbelt, Benjamin OD Provider ID: TPV1114300472-0 Gender: Male Myeyedr Optometry of Florida LLC 2551 Drew St Ste 302 Clearwater, FL 33765 (727) 791-1214 Fax: (844) 766-9698 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Konynenbelt, Jessie OD Provider ID: TPV1659749323-0 Gender: Female Myeyedr Optometry of Florida LLC 2551 Drew St Ste 302 Clearwater, FL 33765 (727) 791-1214 Fax: (844) 766-9698 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kreifels, Kacie OD Provider ID: TPV1508277948-0 Gender: Female Crystal River Eye Center LLC 1250 Belcher Rd Largo, FL 33771 (727) 535-2300 Fax: (727) 535-2330 03 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kuan, Sujey OD Provider ID: TPV1437487659-0 Gender: Female Sj Vision PA 30715 US Hwy 19 N Ste 116 Palm Harbor, FL 34684 (727) 785-8645 Fax: (727) 223-5808 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 5:00 PM Sun 12:00 AM - 4:00 PM PCMH: No

Laplume, Jeffery OD Provider ID: TPV1093745887-0 Gender: Male The Eye Physicians of Pinellas PA 148 13th St SW Ste 200 Largo, FL 33770 (727) 581-8706 Fax: (727) 588-2447 04 Yrs/99 Yrs Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

Lewenson, Robert OD Provider ID: TPV1235181769-0 Gender: Male Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

McKnight, Jaclyn OD Provider ID: TPV1285171272-0 Gender: Female Eye Doctors Optical Outlets PA 3740 Park Blvd Pinellas Park, FL 33781 (727) 547-4856 Fax: (727) 474-9835 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Lappano, Alfred OD Lewenson, Robert OD Provider ID: TPV1194727669-0 Provider ID: TPV1235181769-0 Gender: Male Gender: Male Vision Specialty Associates PA Eye Doctors Optical Outlets PA 35170 US Hwy 19 N 11290 Park Blvd Ste B Palm Harbor, FL 34684 Seminole, FL 33772 (727) 789-5333 (727) 547-4856 Fax: (727) 789-5428 Fax: (727) 201-0861 05 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 4:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No

McKnight, Jaclyn OD Provider ID: TPV1285171272-0 Gender: Female Eye Doctors Optical Outlets PA 11290 Park Blvd Ste B Seminole, FL 33772 (727) 547-4856 Fax: (727) 201-0861 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Mason, John OD Lappano, Alfred OD Provider ID: TPV1467481812-0 Provider ID: TPV1194727669-0 Gender: Male Gender: Male Vision Specialty Associates PA John H Mason PA 5712 5th Ave N 7165 Seminole Blvd Saint Petersburg, FL 33710 Seminole, FL 33772 (727) 344-0800 (727) 392-0907 Fax: (727) 381-9190 Fax: (727) 592-2569 05 Yrs/99 Yrs 05 Yrs/99 Yrs MW 10:00 AM - 6:00 PM Languages: Spanish TTHF 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Sat 8:30 AM - 11:00 PM Sat 9:00 AM - 2:00 PM PCMH: No PCMH: No

Meer, Henry OD Provider ID: TPV1255449732-0 Gender: Male Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

McKnight, Jaclyn OD Lappano, Alfred OD Provider ID: TPV1285171272-0 Provider ID: TPV1194727669-1 Gender: Female Gender: Male Vision Specialty Associates PA Eye Doctors Optical Outlets PA 4359 35th St N 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33714 Saint Petersburg, FL 33710 (727) 525-3959 (727) 343-3006 Fax: (727) 527-9695 Fax: (727) 474-9835 05 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish Sat 9:00 AM - 2:00 PM MTWTHFSat 10:00 AM - 9:00 PCMH: No PM Sun 12:00 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 420

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont. Meer, Henry OD Provider ID: TPV1255449732-0 Gender: Male Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Merlino, Brian OD Musumeci, Salvatore OD Provider ID: TPV1841418555-0 Gender: Male Provider ID: TPV1003814088-0 Vision Specialty Associates PA Gender: Male 7165 Seminole Blvd Southeast Eye Institute PA Seminole, FL 33772 6585 126th Ave N Ste D1 (727) 392-0907 Largo, FL 33773 Fax: (727) 592-2569 (727) 541-4469 05 Yrs/99 Yrs Fax: (727) 546-9661 Languages: Spanish 09 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish Sat 9:00 AM - 2:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Panchal, Priti OD Provider ID: TPV1912213240-0 Gender: Female The Eye Physicians of Pinellas PA 6133 Central Ave Saint Petersburg, FL 33710 (727) 581-8706 Fax: (727) 588-2447 05 Yrs/99 Yrs Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

Panchal, Priti OD Merlino, Brian OD Musumeci, Salvatore OD Provider ID: TPV1912213240-0 Provider ID: TPV1841418555-1 Gender: Female Gender: Male Provider ID: TPV1003814088-0 The Eye Physicians of Pinellas Vision Specialty Associates PA Gender: Male Meer, Henry OD PA 4359 35th St N Southeast Eye Institute PA Provider ID: TPV1255449732-0 148 13th St SW Ste 200 Saint Petersburg, FL 33714 9375 66th St N Gender: Male Largo, FL 33770 (727) 525-3959 Pinellas Park, FL 33782 Eye Doctors Optical Outlets (727) 581-8706 Fax: (727) 527-9695 (727) 541-4469 PA Fax: (727) 588-2447 05 Yrs/99 Yrs Fax: (727) 546-9661 6927 4th St N 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM 09 Yrs/99 Yrs Saint Petersburg, FL 33702 Languages: French, Romanian Sat 9:00 AM - 2:00 PM Languages: Spanish (727) 210-8672 M-F 8:00 AM - 5:00 PM PCMH: No M-F 7:30 AM - 5:00 PM Fax: (727) 214-2594 PCMH: No PCMH: No 05 Yrs/99 Yrs Miller, Joseph OD Panchal, Priti OD M-F 9:00 AM - 6:00 PM Provider ID: TPV1144301219-0 Musumeci, Salvatore OD Sat 9:00 AM - 3:00 PM Provider ID: TPV1912213240-0 Gender: Male PCMH: No Gender: Female Sj Vision PA Provider ID: TPV1003814088-0 The Eye Physicians of Pinellas 30715 US Hwy 19 N Ste 116 Gender: Male Merlino, Brian OD PA Palm Harbor, FL 34684 Southeast Eye Institute PA Provider ID: TPV1841418555-0 955 54th Ave North (727) 785-8645 1915 34th St N Gender: Male Saint Petersburg, FL 33703 Fax: (727) 223-5808 Saint Petersburg, FL 33713 Vision Specialty Associates PA 05 Yrs/99 Yrs (727) 525-4700 (727) 541-4469 35170 US Hwy 19 N Fax: (727) 525-7331 M-F 9:00 AM - 6:00 PM Fax: (727) 546-9661 Palm Harbor, FL 34684 05 Yrs/99 Yrs Sat 9:00 AM - 5:00 PM 09 Yrs/99 Yrs (727) 789-5333 M-F 8:00 AM - 5:00 PM Sun 12:00 AM - 4:00 PM Languages: Spanish Fax: (727) 789-5428 PCMH: No PCMH: No M-F 8:00 AM - 5:00 PM 05 Yrs/99 Yrs PCMH: No Parrish, Gregory OD Languages: Spanish Muse, James OD Provider ID: TPV1598759458-2 M-F 9:00 AM - 5:00 PM Provider ID: TPV1710964077-0 Panchal, Priti OD Gender: Male Sat 9:00 AM - 2:00 PM Gender: Male Provider ID: TPV1912213240-0 Myeyedr Optometry of PCMH: No Crystal River Eye Center LLC Gender: Female Florida LLC 1250 Belcher Rd The Eye Physicians of Pinellas 2551 Drew St Ste 302 Largo, FL 33771 PA Clearwater, FL 33765 (727) 535-2300 3165 McMullen Booth Rd Bldg (727) 791-1214 Fax: (727) 535-2330 A Ste 1 Fax: (844) 766-9698 05 Yrs/99 Yrs Clearwater, FL 33761 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM (727) 581-8706 M-F 9:00 AM - 5:00 PM PCMH: No Fax: (727) 588-2447 PCMH: No 05 Yrs/99 Yrs Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 421

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont. Patel, Deepa OD Provider ID: TPV1366825176-0 Gender: Female Eye Doctors Optical Outlets PA 27001 US Hwy 19 N Ste 2037 Clearwater, FL 33761 (727) 669-8486 Fax: (727) 213-6341 05 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Patel, Deepa OD Provider ID: TPV1366825176-0 Gender: Female Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Patel, Deepa OD Provider ID: TPV1366825176-0 Gender: Female Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Patel, Deepa OD Provider ID: TPV1366825176-0 Gender: Female Eye Doctors Optical Outlets PA 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 474-9835 05 Yrs/99 Yrs Languages: Spanish MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Patel, Deepa OD Provider ID: TPV1366825176-0 Gender: Female Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Phillips, Jeffrey OD Provider ID: TPV1811974900-0 Gender: Male Jeffrey D Phillips OD PA 1903 Tyrone Blvd N Saint Petersburg, FL 33710 (727) 345-4035 Fax: (727) 384-3112 05 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Phillips, Susan OD Provider ID: TPV1437177789-0 Gender: Female Jeffrey D Phillips OD PA 1903 Tyrone Blvd N Saint Petersburg, FL 33710 (727) 345-4035 Fax: (727) 384-3112 05 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Plante, Parker OD Provider ID: TPV1528055043-0 Gender: Male Eye Doctors Optical Outlets PA 27001 US Hwy 19 N Ste 2037 Clearwater, FL 33761 (727) 669-8486 Fax: (727) 213-6341 05 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Plante, Parker OD Provider ID: TPV1528055043-0 Gender: Male Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Plante, Parker OD Provider ID: TPV1528055043-0 Gender: Male Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 422

Plante, Parker OD Provider ID: TPV1528055043-0 Gender: Male Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Plante, Parker OD Provider ID: TPV1528055043-0 Gender: Male Eye Doctors Optical Outlets PA 11290 Park Blvd Ste B Seminole, FL 33772 (727) 547-4856 Fax: (727) 201-0861 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Pradilla, Sergio OD Provider ID: TPV1881027811-0 Gender: Male Eye Doctors Optical Outlets PA 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 474-9835 05 Yrs/99 Yrs Languages: Spanish MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Radeke, Amanda OD Provider ID: TPV1780069591-0 Gender: Female Southeast Eye Institute PA 6585 126th Ave N Ste D1 Largo, FL 33773 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont. Radeke, Amanda OD Provider ID: TPV1780069591-0 Gender: Female Southeast Eye Institute PA 9375 66th St N Pinellas Park, FL 33782 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Radeke, Amanda OD Provider ID: TPV1780069591-0 Gender: Female Southeast Eye Institute PA 1915 34th St N Saint Petersburg, FL 33713 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rosenfeld, Jay OD Provider ID: TPV1114924040-0 Gender: Male Jay Rosenfeld OD PA 2541-1 Countryside Blvd Clearwater, FL 33761 (727) 799-4500 Fax: (727) 724-1633 05 Yrs/99 Yrs MT 8:00 AM - 5:00 PM W 8:00 AM - 6:00 PM THF 8:00 AM - 4:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Ryczek, Dennis OD Provider ID: TPV1447243852-0 Gender: Male Ryczek Eye Associates 5412 Central Ave Saint Petersburg, FL 33707 (727) 327-8855 Fax: (727) 323-0720 05 Yrs/99 Yrs M 9:00 AM - 5:00 PM T 9:00 AM - 5:30 PM W 8:00 AM - 5:00 PM TH 9:00 AM - 6:00 PM F 8:00 AM - 12:00 PM PCMH: No

Sacksteder, Ryan OD Provider ID: TPV1265780555-0 Gender: Male The Eye Physicians of Pinellas PA 148 13th St SW Ste 200 Largo, FL 33770 (727) 581-8706 Fax: (727) 588-2447 05 Yrs/99 Yrs Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No

Saint Jean, Caleb OD Provider ID: TPV1942650924-0 Gender: Male Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 03 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Sacksteder, Ryan OD Provider ID: TPV1265780555-0 Sacksteder, Ryan OD Gender: Male The Eye Physicians of Pinellas Saint Jean, Caleb OD Provider ID: TPV1265780555-0 PA Provider ID: TPV1942650924-0 Gender: Male 955 54th Ave North Gender: Male The Eye Physicians of Pinellas Saint Petersburg, FL 33703 Eye Doctors Optical Outlets PA PA 3165 McMullen Booth Rd Bldg (727) 525-4700 39310 US Hwy 19 N A Ste 1 Fax: (727) 525-7331 Tarpon Springs, FL 34689 Clearwater, FL 33761 05 Yrs/99 Yrs (727) 756-1220 (727) 581-8706 M-F 8:00 AM - 5:00 PM Fax: (727) 608-4456 Fax: (727) 588-2447 PCMH: No 03 Yrs/99 Yrs 05 Yrs/99 Yrs Languages: Spanish, Languages: French, Romanian Saint Jean, Caleb OD Provider ID: TPV1942650924-0 Vietnamese M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 6:00 PM Gender: Male PCMH: No Sat 9:00 AM - 3:00 PM Dr Barry Case LLC Sacksteder, Ryan OD PCMH: No 11212 Park Blvd Provider ID: TPV1265780555-0 Seminole, FL 33772 Saint Jean, Caleb OD Gender: Male (727) 393-1501 Provider ID: TPV1942650924-0 The Eye Physicians of Pinellas Fax: (727) 393-2882 Gender: Male PA 03 Yrs/99 Yrs Eye Doctors Optical Outlets 6133 Central Ave M-F 9:00 AM - 6:00 PM PA Saint Petersburg, FL 33710 Sat 11:00 AM - 4:00 PM 6901 22nd Ave N Ste 760 (727) 581-8706 PCMH: No Saint Petersburg, FL 33710 Fax: (727) 588-2447 (727) 343-3006 Saint Jean, Caleb OD 05 Yrs/99 Yrs Languages: French, Romanian Provider ID: TPV1942650924-0 Fax: (727) 474-9835 03 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Gender: Male Languages: Spanish PCMH: No Eye Doctors Optical Outlets MTWTHFSat 10:00 AM - 9:00 PA PM 27001 US Hwy 19 N Ste 2037 Sun 12:00 AM - 6:00 PM Clearwater, FL 33761 PCMH: No (727) 669-8486 Fax: (727) 213-6341 03 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 423

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont.

Saint Jean, Caleb OD Schoneck, Katie OD Provider ID: TPV1942650924-1 Provider ID: TPV1720153992-0 Saint Jean, Caleb OD Gender: Male Gender: Female Provider ID: TPV1942650924-0 Vision Specialty Associates PA Eye Doctors Optical Outlets PA Gender: Male 4359 35th St N 3665 East Bay Dr Ste 200 Eye Doctors Optical Outlets Saint Petersburg, FL 33714 PA Largo, FL 33771 (727) 525-3959 6927 4th St N (727) 538-2775 Fax: (727) 527-9695 Saint Petersburg, FL 33702 Fax: (727) 213-6703 03 Yrs/99 Yrs (727) 210-8672 05 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Fax: (727) 214-2594 Languages: Spanish, Sat 9:00 AM - 2:00 PM Vietnamese 03 Yrs/99 Yrs PCMH: No MT 10:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Schatz, Scott OD WTH 9:00 AM - 5:00 PM Sat 9:00 AM - 3:00 PM F 9:00 AM - 3:00 PM PCMH: No Provider ID: TPV1154495141-1 PCMH: No Gender: Male Saint Jean, Caleb OD Eye Doctors Optical Outlets Schoneck, Katie OD Provider ID: TPV1942650924-0 PA Provider ID: TPV1720153992-0 Gender: Male 6901 22nd Ave N Ste 760 Gender: Female Eye Doctors Optical Outlets Saint Petersburg, FL 33710 PA Eye Doctors Optical Outlets (727) 343-3006 PA 3740 Park Blvd Fax: (727) 474-9835 6927 4th St N Pinellas Park, FL 33781 05 Yrs/99 Yrs Saint Petersburg, FL 33702 (727) 547-4856 Languages: Spanish (727) 210-8672 Fax: (727) 474-9835 MTWTHFSat 10:00 AM - 9:00 Fax: (727) 214-2594 03 Yrs/99 Yrs PM 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sun 12:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Sat 9:00 AM - 3:00 PM PCMH: No Schoneck, Katie OD PCMH: No Saint Jean, Caleb OD Provider ID: TPV1720153992-0 Scott, Christopher OD Provider ID: TPV1942650924-1 Gender: Female Provider ID: TPV1326004953-0 Gender: Male Eye Doctors Optical Outlets Gender: Male Vision Specialty Associates PA PA 27001 US Hwy 19 N Ste 2037 Eye Doctors Optical Outlets 35170 US Hwy 19 N PA Clearwater, FL 33761 Palm Harbor, FL 34684 3665 East Bay Dr Ste 200 (727) 669-8486 (727) 789-5333 Largo, FL 33771 Fax: (727) 213-6341 Fax: (727) 789-5428 (727) 538-2775 05 Yrs/99 Yrs 03 Yrs/99 Yrs Fax: (727) 213-6703 M-F 10:30 AM - 8:30 PM Languages: Spanish 05 Yrs/99 Yrs Sat 10:00 AM 9:00 PM M-F 9:00 AM - 5:00 PM Languages: Spanish, Sun 12:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Vietnamese PCMH: No PCMH: No MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM Saint Jean, Caleb OD F 9:00 AM - 3:00 PM Provider ID: TPV1942650924-1 PCMH: No Gender: Male Vision Specialty Associates PA 7165 Seminole Blvd Seminole, FL 33772 (727) 392-0907 Fax: (727) 592-2569 03 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 424

Scott, Christopher OD Provider ID: TPV1326004953-1 Gender: Male Eye Doctors Optical Outlets PA 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 474-9835 05 Yrs/99 Yrs Languages: Spanish MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Shea, Daniel OD Provider ID: TPV1952687816-0 Gender: Male Southeast Eye Institute PA 6585 126th Ave N Ste D1 Largo, FL 33773 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Shea, Daniel OD Provider ID: TPV1952687816-0 Gender: Male Southeast Eye Institute PA 9375 66th St N Pinellas Park, FL 33782 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Shea, Daniel OD Provider ID: TPV1952687816-0 Gender: Male Southeast Eye Institute PA 1915 34th St N Saint Petersburg, FL 33713 (727) 541-4469 Fax: (727) 546-9661 12 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont.

Stroud, Sandra OD Provider ID: TPV1922041458-0 Smith, Mary OD Gender: Female Provider ID: TPV1558369108-0 Dr Sandra Stroud OD PA Gender: Female 41272 US Hwy 19 N The Eye Physicians of Pinellas Tarpon Springs, FL 34689 PA (727) 937-6551 3165 McMullen Booth Rd Bldg Fax: (727) 942-7200 A Ste 1 05 Yrs/99 Yrs Clearwater, FL 33761 MTTH 9:00 AM - 5:00 PM (727) 581-8706 W 10:00 AM - 7:00 PM Fax: (727) 588-2447 F 9:00 AM - 4:00 PM 12 Yrs/99 Yrs PCMH: No Languages: French, Romanian M-F 8:00 AM - 5:00 PM Tran, Baotram OD PCMH: No Provider ID: TPV1295920643-0 Gender: Female Smith, Mary OD Professional Eyecare Provider ID: TPV1558369108-0 Consultants PA Gender: Female 2000 66th St N The Eye Physicians of Pinellas Saint Petersburg, FL 33710 PA (727) 347-3937 6133 Central Ave Fax: (727) 347-3937 Saint Petersburg, FL 33710 05 Yrs/99 Yrs (727) 581-8706 Languages: Spanish Fax: (727) 588-2447 M-TH 9:00 AM - 7:00 PM 12 Yrs/99 Yrs F 9:00 AM - 5:00 PM Languages: French, Romanian Sat 9:00 AM - 4:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Tran, Baotram OD Smith, Mary OD Provider ID: TPV1295920643-0 Provider ID: TPV1558369108-0 Gender: Female Gender: Female Eye Doctors Optical Outlets The Eye Physicians of Pinellas PA PA 27001 US Hwy 19 N Ste 2037 148 13th St SW Ste 200 Clearwater, FL 33761 Largo, FL 33770 (727) 669-8486 (727) 581-8706 Fax: (727) 213-6341 Fax: (727) 588-2447 05 Yrs/99 Yrs 12 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Languages: French, Romanian Sat 10:00 AM - 9:00 PM M-F 8:00 AM - 5:00 PM Sun 12:00 AM - 6:00 PM PCMH: No PCMH: No Smith, Mary OD Provider ID: TPV1558369108-0 Gender: Female The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 12 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Tran, Baotram OD Provider ID: TPV1295920643-0 Gender: Female Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Tran, Baotram OD Provider ID: TPV1295920643-0 Gender: Female Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Tran, Baotram OD Provider ID: TPV1295920643-0 Gender: Female Eye Doctors Optical Outlets PA 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 474-9835 05 Yrs/99 Yrs Languages: Spanish MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

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Tran, Baotram OD Provider ID: TPV1295920643-0 Gender: Female Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Tran, Baotram OD Provider ID: TPV1295920643-0 Gender: Female Eye Doctors Optical Outlets PA 3740 Park Blvd Pinellas Park, FL 33781 (727) 547-4856 Fax: (727) 474-9835 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Tran, Baotram OD Provider ID: TPV1295920643-1 Gender: Female Eye Doctors Optical Outlets PA 11290 Park Blvd Ste B Seminole, FL 33772 (727) 547-4856 Fax: (727) 201-0861 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Tran-Lockwood, Julie OD Provider ID: TPV1639377104-0 Gender: Female Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Optometry - cont. Tran-Lockwood, Julie OD Provider ID: TPV1639377104-0 Gender: Female Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 27001 US Hwy 19 N Ste 2037 Clearwater, FL 33761 (727) 669-8486 Fax: (727) 213-6341 05 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 3665 East Bay Dr Ste 200 Largo, FL 33771 (727) 538-2775 Fax: (727) 213-6703 05 Yrs/99 Yrs Languages: Spanish, Vietnamese MT 10:00 AM - 6:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No

Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 39310 US Hwy 19 N Tarpon Springs, FL 34689 (727) 756-1220 Fax: (727) 608-4456 05 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 6901 22nd Ave N Ste 760 Saint Petersburg, FL 33710 (727) 343-3006 Fax: (727) 474-9835 05 Yrs/99 Yrs Languages: Spanish MTWTHFSat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 6927 4th St N Saint Petersburg, FL 33702 (727) 210-8672 Fax: (727) 214-2594 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No

Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 3740 Park Blvd Pinellas Park, FL 33781 (727) 547-4856 Fax: (727) 474-9835 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Vu, Anthony OD Provider ID: TPV1972868818-0 Gender: Female Eye Doctors Optical Outlets PA 11290 Park Blvd Ste B Seminole, FL 33772 (727) 547-4856 Fax: (727) 201-0861 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Wachter, John OD Provider ID: TPV1770551129-0 Gender: Male Southeast Eye Institute PA 6585 126th Ave N Ste D1 Largo, FL 33773 (727) 541-4469 Fax: (727) 546-9661 04 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wachter, John OD Provider ID: TPV1770551129-0 Gender: Male Southeast Eye Institute PA 9375 66th St N Pinellas Park, FL 33782 (727) 541-4469 Fax: (727) 546-9661 04 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

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Wachter, John OD Provider ID: TPV1770551129-0 Gender: Male Southeast Eye Institute PA 1915 34th St N Saint Petersburg, FL 33713 (727) 541-4469 Fax: (727) 546-9661 04 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Wilcoxon, Dennis OD Provider ID: TPV1932105178-0 Gender: Male The Eye Physicians of Pinellas PA 6133 Central Ave Saint Petersburg, FL 33710 (727) 581-8706 Fax: (727) 588-2447 05 Yrs/99 Yrs Languages: French, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Wilcoxon, Dennis OD Provider ID: TPV1932105178-0 Gender: Male The Eye Physicians of Pinellas PA 955 54th Ave North Saint Petersburg, FL 33703 (727) 525-4700 Fax: (727) 525-7331 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Yee, Daniel OD Provider ID: TPV1457723355-0 Gender: Male Eye Doctors Optical Outlets PA 27001 US Hwy 19 N Ste 2037 Clearwater, FL 33761 (727) 669-8486 Fax: (727) 213-6341 05 Yrs/99 Yrs M-F 10:30 AM - 8:30 PM Sat 10:00 AM - 9:00 PM Sun 12:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Orthodontics Brockway, Chelsea DDS Provider ID: TPVP159206-01 Gender: Female Florida Orthodontic Associates LLC 4021 Central Ave Saint Petersburg, FL 33713 (727) 442-4070 Fax: (727) 442-0150 00 Yrs/99 Yrs Languages: Spanish MT 7:30 AM - 5:00 PM PCMH: No Brockway, Chelsea DDS Provider ID: TPVP159206-02 Gender: Female Florida Orthodontic Associates 8686 131st St N Seminole, FL 33776 (727) 442-4070 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Brockway, Chelsea DDS Provider ID: TPVP159206-04 Gender: Female Florida Orthodontic Associates LLC 1433 Ct St Clearwater, FL 33756 (727) 442-4070 Fax: (727) 442-0150 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM T 7:30 AM - 5:00 PM W 11:00 AM - 5:00 PM PCMH: No

McDowell, Ernest DMD Provider ID: TPVP104348-01 Gender: Male Florida Orthodontic Associates LLC 4021 Central Ave Saint Petersburg, FL 33713 (727) 442-4070 Fax: (727) 442-0150 00 Yrs/99 Yrs Languages: Spanish MT 7:30 AM - 5:00 PM PCMH: No McDowell, Ernest DMD Provider ID: TPVP104348-02 Gender: Male Florida Orthodontic Associates LLC 1433 Ct St Clearwater, FL 33756 (727) 442-4070 Fax: (727) 442-0150 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM T 7:30 AM - 5:00 PM W 11:00 AM - 5:00 PM PCMH: No McDowell, Ernest DMD Provider ID: TPVP104348-03 Gender: Male Florida Orthodontic Associates 8686 131st St N Seminole, FL 33776 (727) 442-4070 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Nelson, Stephen DMD Provider ID: TPVP44404-03 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Nelson, Stephen DMD Provider ID: TPVP44404-15 Gender: Male Coast Dental - Clearwater 23680 US Hwy 19 North Clearwater, FL 33765 (727) 799-1010 Fax: (727) 799-6909 00 Yrs/99 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 1:00 PM PCMH: No Nguyen, James DMD Provider ID: TPVP131337-31 Gender: Male Coast Dental - St Petersburg 7801 Dr Martin Luther King Jr St N Saint Petersburg, FL 33702 (727) 525-4499 Fax: (727) 525-9683 00 Yrs/99 Yrs Languages: Polish M-F 8:30 AM - 5:00 PM PCMH: No Nguyen, James DMD Provider ID: TPVP131337-34 Gender: Male Coast Dental - Largo 10427 Ulmerton Rd Ste B-3 Largo, FL 33771 (727) 535-9993 Fax: (727) 530-1958 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

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Parsa, Mitra DDS Provider ID: TPVP126985-05 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Pain Management Friedman, Charles DO Provider ID: 22964 Gender: Male Pain Relief Centers 6640 78th Ave N Ste A Pinellas Park, FL 33781 (727) 518-8660 Fax: (727) 518-8662 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM PCMH: No Le, Thanh MD Provider ID: 28238 Gender: Male Pain Relief Centers 6640 78th Ave N Ste A Pinellas Park, FL 33781 (727) 518-8660 Fax: (727) 518-8662 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital West Park Surgery Center, LLC Languages: Vietnamese M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Allergy & Immunology Leiding, Jennifer MD Provider ID: 691185 Gender: Female 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4150 Fax: (727) 767-8532 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Sher, Mandel MD Provider ID: 4947 Gender: Male Mr Sher MD Inc 11200 Seminole Blvd Ste 310 Largo, FL 33778 (727) 397-8557 Fax: (727) 397-4459 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Largo Medical Center Mease Hospital Dunedin MTH 8:30 AM - 4:30 PM T 1:00 AM - 5:30 PM W 1:30 AM - 4:30 PM PCMH: No Sher, Mandel MD Provider ID: 196325 Gender: Male USF Physicicans Group 800 6th St S Fl 1 Saint Petersburg, FL 33701 (727) 767-4150 Fax: (727) 767-8532 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Tang, Nathan MD Provider ID: 192127 Gender: Male USF Physicians Group 601 5th St S Saint Petersburg, FL 33701 (727) 892-4150 Fax: (727) 767-8532 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital Languages: Thai M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Cardiology Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 3253 N McMln Bth Rd Ste 200D Clearwater, FL 33761 (727) 322-4830 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 840 MLK St N Ste 100 Saint Petersburg, FL 33705 (727) 322-4830 Fax: (954) 858-0707 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Asante Korang, Alfred MD Provider ID: 1085232 Gender: Male Pediatric Physician Services Inc 601 5th St S Ste 711 Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatric Cardiology Associates 840 MLK St N Ste 400 Saint Petersburg, FL 33705 (727) 767-4200 Fax: (727) 767-8043 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Cardiology cont. Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (727) 322-4846 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 6500 38th Ave N Saint Petersburg, FL 33710 (727) 384-1414 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Crawford, Marguerite MD Provider ID: 314170 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Freire, Grace MD Provider ID: 298902 Gender: Female 601 5th St S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/130 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD

Crawford, Marguerite MD Provider ID: 314170 Gender: Female 601 5th St S Ste 206 Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Crawford, Marguerite MD Provider ID: 314170 Gender: Female 900 Carillon Pkwy Saint Petersburg, FL 33716 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Decker, Jamie MD Provider ID: 584686 Gender: Male Pediatric Cardiology 601 5th St S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-4970 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 840 MLK St N Ste 400 Saint Petersburg, FL 33705 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Hardin, Joel MD Provider ID: 1311775 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Ste 711 Saint Petersburg, FL 33701 (239) 390-0723 Fax: (855) 527-5510 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Cardiology cont. Hardin, Joel MD Provider ID: 1311775 Gender: Male Ppediatrix Medical Group of Florida 3253 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No Hardin, Joel MD Provider ID: 1311775 Gender: Male Ppediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (954) 858-0588 Fax: (855) 527-5510 00 Yrs/21 Yrs MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No Herbert, Carrie MD Provider ID: 1281244 Gender: Female Pediactric Physician Services Inc 601 5th St S 2nd Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male Pediatric Cardiology Associates 880 6th St S Ste 280 Saint Petersburg, FL 33701 (727) 892-4200 Fax: (727) 821-2461 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 840 MLK St N Ste 100 Saint Petersburg, FL 33705 (727) 767-4200 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Cardiology cont. Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 3253 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (727) 821-2461 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 840 Dr MLK Jr St N Ste 100 Saint Petersburg, FL 33705 (727) 767-4200 Fax: (727) 821-2461 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Marcuccio, Elisa MD Provider ID: 1031997 Gender: Female Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatric Cardiology Associates 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4831 Fax: (727) 322-4846 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Mauriello, Daniel MD Provider ID: 1027573 Gender: Male Pediatric Physician Services Inc 501 6th Ave S Dept 70-7130 Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group Inc 880 6th St S Saint Petersburg, FL 33701 (386) 329-9990 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Mauriello, Daniel MD Provider ID: 1027573 Gender: Male Pediatric Physician Services Inc 601 5th St S Outpatient Care Center 2nd Fl Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Martinez, Richard MD

McCormack, Jorge MD

Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 225657 Gender: Male Pediatric Cardiology Associates 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McCormack, Jorge MD

Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Provider ID: 225657 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Cardiology cont. McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatric Cardiology Associates 840 Dr ML King Jr St N Ste 400 Saint Petersburg, FL 33705 (727) 767-4200 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatric Cardiology Associates 880 6th St S Ste 280 Saint Petersburg, FL 33701 (727) 767-4200 Fax: (727) 767-8047 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Ng, Benton MD

McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Nguyen, Thieu MD Provider ID: 576135 Gender: Male Pediatric Physician Services, Inc 601 5th St S 5th Fl Saint Petersburg, FL 33701 (727) 767-3333 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Miller, Michelle MD Provider ID: 569568 Gender: Female Pediatric Physician Services Inc 601 5th St S 2nd Fl Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 1179732 Gender: Male Acsp Pediatric Cardiology 601 5th St S 2nd Fl Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc MT 8:30 AM - 5:00 PM PCMH: No

Ramey, Jeremy MD Provider ID: 840879 Gender: Male 601 5th St S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 3253 N McMln Bth Rd Ste 200D Clearwater, FL 33761 (727) 767-4200 Fax: (727) 821-2461 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 3253 N McMullen Booth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 601 5th St S Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Cardiology cont. Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 840 MLK St N Ste 310 Saint Petersburg, FL 33705 (727) 322-4830 Fax: (727) 727-7678 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Stapleton, Gary MD Provider ID: 462628 Gender: Male 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Stapleton, Gary MD Provider ID: 462628 Gender: Male 601 5th St S Ste 206 Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Stapleton, Gary MD Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 880 6th St S Ste 280 Saint Petersburg, FL 33701 (727) 767-8075 Fax: (727) 767-8047 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Jacobs, Jeffery MD Suh, Elsa MD Provider ID: 19272 Provider ID: 225664 Gender: Male Gender: Male Cardiac Surgical Associates Pediatrix Medical Group of LLP Florida 625 6th Ave S Ste 475 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 Saint Petersburg, FL 33701 (727) 822-6666 (727) 322-8430 Fax: (727) 821-5994 Fax: (855) 527-5510 00 Yrs/21 Yrs 00 Yrs/21 Yrs Johns Hopkins All Childrens Bayfront Health Spring Hill Hospital Inc Johns Hopkins All Childrens Mease Hospital Dunedin Hospital Inc South Florida Baptist Hospital St Anthonys Hospital M-F 9:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No

Suh, Elsa MD Pediatric Cardiovascular Provider ID: 225664 Surgery Gender: Male Pediatrix Medical Group of Florida Jacobs, Jeffery MD 3253 N McMullen Booth Rd Provider ID: 19272 Ste 100 Gender: Male Clearwater, FL 33761 Cardiac Surgical Associates (727) 767-4200 LLP Fax: (855) 527-5510 455 Pinellas St Ste 320 00 Yrs/21 Yrs Clearwater, FL 33756 Bayfront Health Spring Hill (727) 446-2273 Johns Hopkins All Childrens Fax: (727) 441-4966 Hospital Inc 00 Yrs/21 Yrs South Florida Baptist Hospital Johns Hopkins All Childrens Languages: Spanish Hospital Inc M-F 8:00 AM - 5:00 PM Mease Hospital Dunedin PCMH: No St Anthonys Hospital M-F 9:00 AM - 5:00 PM Suh, Elsa MD PCMH: No Provider ID: 225664 Jacobs, Jeffery MD Gender: Male Provider ID: 19272 Pediatrix Medical Group of Gender: Male Florida Cardiac Surgical Associates 601 5th St S LLP Saint Petersburg, FL 33701 6006 49th St N Ste 310 (727) 322-4830 Saint Petersburg, FL 33709 Fax: (855) 527-5510 (727) 527-9779 00 Yrs/21 Yrs Fax: (727) 522-0415 Bayfront Health Spring Hill 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Johns Hopkins All Childrens South Florida Baptist Hospital Hospital Inc Mease Hospital Dunedin Languages: Spanish St Anthonys Hospital M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Pediatric Dermatology

Maloney, Karen MD Provider ID: 1368399 Gender: Female Academic Alliance In Dermatology In 1201 S Myrtle Ave Clearwater, FL 33756 (727) 442-1917 Fax: (727) 446-3490 00 Yrs/130 Yrs MT 8:00 AM - 5:00 PM PCMH: No Maloney, Karen MD Provider ID: 1368399 Gender: Female Academic Alliance In Dermatology In 3165 N McMullen Booth Rd Ste D Clearwater, FL 33761 (727) 258-9143 Fax: (727) 823-7043 00 Yrs/130 Yrs MT 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Dermatology cont.

Cressman, Wade MD Trowbridge, Rose MD Provider ID: 8265 Provider ID: 912630 Gender: Male Gender: Female Maloney, Karen MD Pediatric Ear Nose and Throat Pediatric Otolaryngology Spec 601 5th St S Ste 701 601 5th St S Ste 701 Saint Petersburg, FL 33701 Provider ID: 1368399 Saint Petersburg, FL 33701 (727) 329-5400 Gender: Female (727) 329-5400 Fax: (727) 329-5401 Academic Alliance In Fax: (727) 329-5401 00 Yrs/18 Yrs Dermatology In 00 Yrs/21 Yrs Johns Hopkins All Childrens 646 Virginia St Ste 201 Citrus Surgical Center Hospital Inc Dunedin, FL 34698 Johns Hopkins All Childrens Pediatric Surgery Center LLC (727) 270-7291 Hospital Inc Odessa Fax: (727) 446-3490 Pediatric Surgery Centers LLC Pediatric Surgery Centers LLC 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM M 8:00 AM - 5:00 PM M-F 8:00 AM 5:30 PM PCMH: No PCMH: No PCMH: No Wasylik, Kathleen MD Pediatric Ear, Nose & Cressman, Wade MD Provider ID: 431688 Throat Provider ID: 8265 Gender: Female Gender: Male Pediatric Ear, Nose and Throat Andrews, Thomas MD Pediatric Otolaryngology Spec Provider ID: 1246 Associates 601 5th St S Ste 701 Gender: Male 1700 N McMln Bth Rd Ste B1 Saint Petersburg, FL 33701 Pediatric Ear Nose and Throat Clearwater, FL 33759 (727) 329-5400 Spec (727) 329-5400 Fax: (727) 329-5401 601 5th St S Ste 701 Fax: (727) 329-5401 00 Yrs/21 Yrs Saint Petersburg, FL 33701 00 Yrs/21 Yrs Johns Hopkins All Childrens (727) 329-5400 Citrus Surgical Center Hospital Inc Fax: (727) 329-5401 Johns Hopkins All Childrens Pediatric Surgery Center LLC 00 Yrs/21 Yrs Hospital Inc Odessa Johns Hopkins All Childrens Pediatric Surgery Centers LLC Pediatric Surgery Centers LLC Hospital Inc Languages: Spanish M-F 8:00 AM - 5:30 PM Pediatric Surgery Center LLC M-F 9:00 AM - 5:00 PM PCMH: No Odessa PCMH: No Pediatric Surgery Centers LLC Wasylik, Kathleen MD Languages: Spanish Trowbridge, Rose MD Provider ID: 431688 M-F 8:00 AM - 5:30 PM Provider ID: 912630 Gender: Female PCMH: No Gender: Female Pediatric Otolaryngology Pediatric Otolaryngology Head & Nec Andrews, Thomas MD 1700 N McMln Bth Rd Ste B1 1700 N McMln Bth Rd Ste B1 Provider ID: 1246 Clearwater, FL 33759 Clearwater, FL 33759 Gender: Male (727) 329-5400 (727) 329-5400 Pediatric Otolaryngology Fax: (727) 329-5401 Fax: (727) 329-5401 Associates 00 Yrs/18 Yrs 00 Yrs/21 Yrs 1700 N McMln Bth Rd Ste B1 Johns Hopkins All Childrens Johns Hopkins All Childrens Clearwater, FL 33759 Hospital Inc Hospital Inc (727) 329-5400 Pediatric Surgery Center LLC Pediatric Surgery Center LLC Fax: (727) 329-5401 Odessa Odessa 00 Yrs/21 Yrs Pediatric Surgery Centers LLC Pediatric Surgery Centers LLC Johns Hopkins All Childrens M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Hospital Inc PCMH: No PCMH: No Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Pediatric Endocrinology Begum Hasan, Jahanara MD Provider ID: 1368342 Gender: Female Pediatric Physician Services Inc 601 5th St S Ste 502 Saint Petersburg, FL 33701 (727) 767-3636 Fax: (727) 767-3638 00 Yrs/21 Yrs M-F 8:00 AM - 7:00 PM PCMH: No Gomez, Danielle MD Provider ID: 1172732 Gender: Female Pediatric Physician Services 601 5th St S Ste 502 Saint Petersburg, FL 33701 (727) 767-3636 Fax: (727) 767-3638 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Iyer, Pallavi MD Provider ID: 610585 Gender: Female Pediatric Physician Services 601 5th St S Saint Petersburg, FL 33701 (727) 767-3636 Fax: (727) 767-8482 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Jackman, Suzanne MD Provider ID: 713871 Gender: Female Pediatric Physician Services Inc 601 5th St S Dpt 7854 Saint Petersburg, FL 33701 (727) 767-3636 Fax: (727) 767-3638 12 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Endocrinology - Dhana, Leila MD cont. Provider ID: 207634 Root, Allen William MD Provider ID: 9410 Gender: Male Pediatric Physician Services 601 5th St S Ste 5 Saint Petersburg, FL 33701 (727) 767-3636 Fax: (727) 767-8482 00 Yrs/21 Yrs Tampa General Hospital Languages: Spanish, Creole M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Gastroenterology Condino, Adria DO Provider ID: 429785 Gender: Female 1840 Mease Dr Ste 204 Safety Harbor, FL 34695 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No Condino, Adria DO Provider ID: 429785 Gender: Female 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Female 1840 Mease Dr Ste 204 Safety Harbor, FL 34695 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Dhana, Leila MD Provider ID: 207634 Gender: Female 480 7th Ave S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Dhana, Leila MD Provider ID: 207634 Gender: Female 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Dhana, Leila MD Provider ID: 207634 Gender: Female 801 6th St S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 4:30 PM PCMH: No

Ignacio, Joseph MD Provider ID: 197151 Gender: Male 1840 Mease Dr Ste 204 Safety Harbor, FL 34695 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Plantation General Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Ignacio, Joseph MD Provider ID: 197151 Gender: Male 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Plantation General Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Irizarry, Karina MD Provider ID: 469781 Gender: Female 480 7th Ave S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Irizarry, Karina MD Provider ID: 469781 Gender: Female 601 5th St S Ste 605 Saint Petersburg, FL 33701 (813) 987-2911 Fax: (727) 822-1399 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Kaiser, Greg MD Provider ID: 19532 Gender: Male 1840 Mease Dr Ste 204 Safety Harbor, FL 34695 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Kaiser, Greg MD Provider ID: 19532 Gender: Male Ped Gastroen Hepatol Nutrition 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric McClenathan, Daniel MD Gastroenterology - cont. Kaiser, Greg MD Provider ID: 19532 Gender: Male Ped Gastroen Hepatol Nutrition 601 5th St South Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Karjoo, Sara MD Provider ID: 910740 Gender: Female 601 5th St S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital M-F 7:30 AM - 5:00 PM PCMH: No McClenathan, Daniel MD Provider ID: 1347 Gender: Male 1840 Mease Dr Ste 204 Safety Harbor, FL 34695 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1347 Gender: Male 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No McClenathan, Daniel MD Provider ID: 1347 Gender: Male Ped Gastroen Hepatol & Nutrition 801 6th St S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Narwal, Shivinder MD Provider ID: 923120 Gender: Male Thiru S Arasu MD 501 Martin Luther King St S Saint Petersburg, FL 33705 (727) 822-7344 Fax: (727) 497-0445 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No

Weerasooriya, Viraine MD Provider ID: 638801 Gender: Male Pediatric Gastroenterology, Hepatol 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Lee Memorial Hospital St Josephs Hospital M-F 8:00 AM - 3:00 PM PCMH: No Wilsey Jr, Michael MD Provider ID: 200955 Gender: Male 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Michele MD Provider ID: 8416 Gender: Female 1840 Mease Dr Ste 204 Safety Harbor, FL 34695 (727) 791-7504 Fax: (727) 791-6409 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

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Winesett, Michele MD Provider ID: 8416 Gender: Female 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 822-1399 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Genetics Crenshaw, Melissa MD Provider ID: 330746 Gender: Female Pediatric Physician Services Geneti 601 5th St S 5th Fl Saint Petersburg, FL 33701 (727) 767-4160 Fax: (727) 767-8270 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Hematology/ Oncology Ayala, Irmel MD Provider ID: 2522 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Hematology/ Oncology - cont. Ayala, Irmel MD Provider ID: 2522 Gender: Female 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Ayala, Irmel MD Provider ID: 2522 Gender: Female Florida Pediatric Hem/ Oncology PA 880 6th St S Ste 140 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Goldenberg, Neil MD Provider ID: 783540 Gender: Male 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: French M-F 8:30 AM - 5:00 PM PCMH: No

Grana, Nanette MD Provider ID: 451174 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Kerr, Jody MD Provider ID: 372911 Gender: Female 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Grana, Nanette MD Provider ID: 451174 Gender: Female 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Metts, Jonathan MD

Hale, Gregory MD Provider ID: 475478 Gender: Male All Children's Specialty Physicians 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Metts, Jonathan MD Provider ID: 1366780 Gender: Male Pediatric Physician Services Inc 777 4th St S 2nd Fl Saint Petersburg, FL 33701 (727) 767-3053 Fax: (727) 767-4970 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Kerr, Jody MD Provider ID: 372911 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1366780 Gender: Male Pediatric Physician Services Inc 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Moore, Colin MD Provider ID: 907719 Gender: Male Pediatric Physician Services 601 5th St S Fl 5 Box 6941 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

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Mueller, Brigitta MD Provider ID: 1037410 Gender: Female Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Oshrine, Benjamin MD Provider ID: 1000126 Gender: Male Pediatric Physician Services Inc 601 5th St S Ste 3 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Petrovic, Aleksandra MD Provider ID: 222321 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/19 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Serbo-Croation M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Hematology/ Oncology - cont. Petrovic, Aleksandra MD Provider ID: 222321 Gender: Female 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-6856 Fax: (727) 767-7472 00 Yrs/19 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Serbo-Croation M-F 9:00 AM - 5:00 PM PCMH: No

Sawczyn, Kelly MD Provider ID: 397206 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Sawczyn, Kelly MD Provider ID: 397206 Gender: Female 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 Petrovic, Aleksandra MD 00 Yrs/21 Yrs Johns Hopkins All Childrens Provider ID: 222321 Hospital Inc Gender: Female Ppsblood&Marrowtransplant- M-F 9:00 AM - 5:00 PM PCMH: No program 880 6th St S Ste 140 Stapleton, Stacie MD Saint Petersburg, FL 33701 Provider ID: 401213 (727) 767-8035 Gender: Female Fax: (727) 767-4803 501 6th Ave S 00 Yrs/19 Yrs Saint Petersburg, FL 33701 Johns Hopkins All Childrens (727) 767-4176 Hospital Inc 00 Yrs/21 Yrs Languages: Serbo-Croation Johns Hopkins All Childrens M-F 8:30 AM - 5:00 PM Hospital Inc PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Reed, Damon MD Provider ID: 451168 Stapleton, Stacie MD Gender: Male Provider ID: 401213 All Children's Specialty Gender: Female Physicians 601 5th St S Ste 302 601 5th St S 3rd Fl Saint Petersburg, FL 33701 Saint Petersburg, FL 33701 (727) 767-4176 (727) 767-4176 Fax: (727) 767-4379 Fax: (727) 767-4379 00 Yrs/21 Yrs 00 Yrs/21 Yrs Johns Hopkins All Childrens Johns Hopkins All Childrens Hospital Inc Hospital Inc M-F 9:00 AM - 5:00 PM Languages: Spanish PCMH: No M-F 8:30 AM - 5:00 PM PCMH: No

Wishnew, Jessica MD Provider ID: 1031486 Gender: Female Pediatric Physicians Services Inc 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Infectious Disease Berman, David DO Provider ID: 173540 Gender: Male 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Berman, David DO Provider ID: 173540 Gender: Male 601 5th St S Ste 504 Saint Petersburg, FL 33701 (727) 767-4160 Fax: (727) 767-8270 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Dumois III, Juan MD Provider ID: 17774 Gender: Male 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Dumois III, Juan MD Provider ID: 17774 Gender: Male 601 5th St S Ste 504 Saint Petersburg, FL 33701 (727) 767-4160 Fax: (727) 767-8270 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Dumois III, Juan MD Provider ID: 17774 Gender: Male 885 Parsons Ave Ste 407 Saint Petersburg, FL 33716 (727) 767-4160 Fax: (727) 767-4160 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Messina, Allison MD Provider ID: 346501 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-4160 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Messina, Allison MD Provider ID: 346501 Gender: Female Pediatric Physician Services 601 5th St S 5th Fl Saint Petersburg, FL 33701 (727) 767-4160 Fax: (727) 767-8270 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Infectious Disease - cont. Thomas, Matthew MD Provider ID: 1358710 Gender: Male Pediatric Physician Services Inc 601 5th St S Ste 504 Saint Petersburg, FL 33701 (727) 767-4160 Fax: (727) 767-8270 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Nephrology Ayestaran Cassani, Frank MD Provider ID: 1109909 Gender: Male 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4181 Fax: (727) 767-8379 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Neurosurgery Carey, Carolyn MD Provider ID: 173532 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Carey, Carolyn MD Provider ID: 173532 Gender: Female 601 5th St S Ste 511 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Carey, Carolyn MD Provider ID: 173532 Gender: Female Pediatric Physician Services Inc 880 6th St S Ste 310 Saint Petersburg, FL 33701 (727) 502-8181 Fax: (727) 502-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital MWTHF 8:30 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Rodriguez, Luis MD Provider ID: 309778 Gender: Male 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish, German M-F 9:00 AM - 5:00 PM PCMH: No

Rodriguez, Luis MD Provider ID: 309778 Gender: Male 601 5th St S Ste 511 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish, German M-F 9:00 AM - 5:00 PM PCMH: No Rodriguez, Luis MD Provider ID: 309778 Gender: Male Pediatric Physician Services Inc 880 6th St S Ste 310 Saint Petersburg, FL 33701 (727) 502-8181 Fax: (727) 502-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish, German M-F 8:30 AM - 5:00 PM PCMH: No Tuite, Gerald MD Provider ID: 17798 Gender: Male 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 Fax: (727) 767-8030 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Tuite, Gerald MD Provider ID: 17798 Gender: Male 601 5th St S Ste 511 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Tuite, Gerald MD Provider ID: 17798 Gender: Male Pediatric Physician Services Inc 880 6th St S Ste 310 Saint Petersburg, FL 33701 (727) 502-8181 Fax: (727) 502-8030 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Orthopaedics Beck, Scott MD Provider ID: 17806 Gender: Male Childrens Orthopaedic and Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Orthopaedics - Warnick, Drew MD cont. Provider ID: 557201 Benfanti, Paul MD Provider ID: 587667 Gender: Male Childrens Orthopaedic and Scoliosis 3850 Tampa Rd Palm Harbor, FL 34684 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish MT 9:00 AM - 12:00 PM PCMH: No Benfanti, Paul MD Provider ID: 587667 Gender: Male Childrens Orthopaedic and Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Hahn, Gregory MD Provider ID: 26988 Gender: Male Childrens Orthopaedic & Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Gender: Male Childrens Orthopaedic and Scoliosis 3850 Tampa Rd Palm Harbor, FL 34684 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Warnick, Drew MD Provider ID: 557201 Gender: Male Childrens Orthopaedic and Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Orthopedic Surgery Phillips, Lee MD Provider ID: 1100601 Gender: Male Children's Orthopaedic Scoliosis S 3850 Tampa Rd Palm Harbor, FL 34684 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc MT 8:30 AM - 5:00 PM PCMH: No

Phillips, Lee MD Provider ID: 1100601 Gender: Male Children's Orthopaedic Scoliosis S 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Pulmonology Demissie, Seifu MD Provider ID: 635842 Gender: Male Pediatric Pulmonary Associates PA 601 5th St S Ste 708 Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 4:30 PM PCMH: No Gondor, Magdalen MD

Green, Deanna MD Provider ID: 1172718 Gender: Female Pediatric Physician Services Inc 501 6th St S Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Green, Deanna MD Provider ID: 1172718 Gender: Female Pediatric Pulmonary Assoc 601 5th St S Ste 708 Dept 7598 Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kriseman, Anthony MD Provider ID: 17783 Gender: Male Outpatient Care Center 601 5th St S Ste 708 Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 4:30 PM PCMH: No

Provider ID: 19528 Gender: Female All Children's Outpatient Care Lake 601 5th St S Ste 708 Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 McKinley, Scott DO 00 Yrs/18 Yrs Johns Hopkins All Childrens Provider ID: 1241861 Hospital Inc Gender: Male M-F 8:30 AM - 4:30 PM Pediatric Physician Services PCMH: No 601 5th St S 708 Dept 3012 Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Pulmonology cont. Prpich, John MD Provider ID: 448916 Gender: Male Pediatric Pulmonary Specialists PA 3253 McMullen Booth Rd Safety Harbor, FL 34695 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/21 Yrs St Josephs Hospital M-TH 9:00 AM - 5:00 PM PCMH: No Robinson, Carolyn MD Provider ID: 1169969 Gender: Female Pediatric Physician Services, Inc 601 5th St S Ste 708 Saint Petersburg, FL 33701 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Rosenberg, David MD Provider ID: 1424 Gender: Male Pediatric Pulmonary Specialists PA 3253 McMullen Booth Rd Safety Harbor, FL 34695 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Lakeland Reg Medical Center St Josephs Hospital M-TH 9:00 AM - 5:00 PM PCMH: No

Pediatric Rheumatology Pediatric Sports Medicine Kays, David MD Nickeson Jr, Robert MD Provider ID: 219518 Gender: Male Pediatric Physician Services Inc 601 5th St S 5th Fl Saint Petersburg, FL 33701 (727) 767-7438 Fax: (727) 767-8270 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: French M-F 8:30 AM - 5:00 PM PCMH: No Santiago, Laisa MD Provider ID: 848123 Gender: Female 601 5th St S Saint Petersburg, FL 33701 (727) 767-7438 Fax: (727) 767-8270 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Sher, Mandel MD Provider ID: 196325 Gender: Male USF Physicicans Group 800 6th St S Fl 1 Saint Petersburg, FL 33701 (727) 767-4150 Fax: (727) 767-8532 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Irani, Sarah MD Provider ID: 1169967 Gender: Female Pediatric Physician Services, Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-7678 Fax: (727) 767-8420 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Carlos MD Provider ID: 694939 Gender: Male Ach Sport Medicine ClinicDr. Carl 601 5th St S Saint Petersburg, FL 33701 (727) 767-7678 Fax: (727) 767-4436 00 Yrs/130 Yrs St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Surgery Chandler, Nicole MD Provider ID: 461033 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Chandler, Nicole MD Provider ID: 461033 Gender: Female 601 5th St S Ste 306 Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

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Provider ID: 1182428 Gender: Male Pediatric Physician Services, Inc 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Rideout, Drew MD Provider ID: 916252 Gender: Male Outpatient Care Center 601 5th St S Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-4243 Fax: (727) 767-8612 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatric Urology Hoover, Dennis MD Provider ID: 2812 Gender: Male Palm Harbor At All Childrens Speci 3850 Tampa Rd Entrance A Palm Harbor, FL 34684 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Kolligian, Mark MD Provider ID: 164682 Gender: Male St Petersburg At All Childrens Hos 601 5th St S Ste 602 Saint Petersburg, FL 33701 (727) 456-1055 Fax: (727) 767-4214 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Hoover, Dennis MD Provider ID: 2812 Gender: Male St Petersburg At All Childrens Hos 601 5th St S Ste 602 Saint Petersburg, FL 33701 (727) 456-1055 Fax: (727) 767-4214 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Polsky, Ethan MD Provider ID: 341141 Gender: Male Palm Harbor At All Childrens Speci 3850 Tampa Rd Entrance A Palm Harbor, FL 34684 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Kolligian, Mark MD Provider ID: 164682 Gender: Male Palm Harbor At All Childrens Speci 3850 Tampa Rd Entrance A Palm Harbor, FL 34684 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Polsky, Ethan MD Provider ID: 341141 Gender: Male St Petersburg At All Childrens Ho 601 5th St S Ste 602 Saint Petersburg, FL 33701 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Aungst, Cary MD Provider ID: 1169549 Gender: Female East Lake Pediatrics 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Brinn, Melissa MD Provider ID: 1145926 Gender: Female Pediatric Physician Services Inc 601 5th St S Dept 7835 Saint Petersburg, FL 33701 (727) 767-8917 Fax: (727) 767-8482 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Butto, Fouad MD Provider ID: 1321322 Gender: Male Pediatrix Medial Group of Florida 3253 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Butto, Fouad MD Provider ID: 1321322 Gender: Male Pediatrix Medial Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No Cimino, David MD Provider ID: 959328 Gender: Male Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatrics - cont. Diego, Alejandro MD Provider ID: 1278584 Gender: Male Westcoast Neonatology 601 5th St S Occ 5th Fl Saint Petersburg, FL 33701 (727) 767-4313 Fax: (727) 767-4391 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Ellen, Jonathan MD Provider ID: 1090286 Gender: Male Pediatric Physician Services Inc. 601 5th St S Dept 9310 Saint Petersburg, FL 33701 (727) 767-6873 Fax: (727) 767-2821 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Hoang, Jessie MD Provider ID: 1232197 Gender: Female Pediatric Physician Services 501 6th Ave S Dept 6245 Saint Petersburg, FL 33701 (941) 917-7490 Fax: (727) 767-8420 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Pavan, Mary MD Provider ID: 1186178 Gender: Female USF Physicians Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Kelleher, Erin MD Provider ID: 916497 Gender: Female 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-4346 00 Yrs/18 Yrs Bayfront Medical Center M-F 8:00 AM - 7:00 PM PCMH: No

Reese, Jasmine MD

Kitterman, Christopher DO

Gupta, Monesha MD Provider ID: 1274232 Gender: Female Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Hill, Taryn MD Provider ID: 1251758 Gender: Female Pediatric Physician Services Inc 601 5th St S Ste 504 Saint Petersburg, FL 33701 (727) 767-8917 Fax: (727) 767-8482 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1310501 Gender: Female Pediatric Physician Services Inc. 601 5th St S Ste 504 Saint Petersburg, FL 33701 (727) 767-8917 Fax: (727) 767-8482 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sando, Jane MD Provider ID: 1242618 Provider ID: 1217397 Gender: Male Community Health Centers of Gender: Female Pinella Pediatric Physician Services Inc 1344 22nd St S 601 5th St S Dept 7835 Saint Petersburg, FL 33712 Saint Petersburg, FL 33701 (727) 824-8181 (727) 767-8917 Fax: (727) 823-7429 Fax: (727) 767-8482 00 Yrs/21 Yrs 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM M-F 8:00 AM - 5:00 PM Sat 8:00 AM - 4:30 PM PCMH: No PCMH: No Pavan, Mary MD Provider ID: 1186178 Gender: Female USF Physicians Group 480 7th Ave S Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Shah, Ashish MD Provider ID: 1270919 Gender: Male Pediatric Physician Services, Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

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Smith, Jessica MD Provider ID: 1169545 Gender: Female East Lake Pediatrics 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Sriaroon, Panida MD Provider ID: 523903 Gender: Female USF Physicians Group 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4150 Fax: (727) 767-8532 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Thai M-F 8:00 AM - 5:00 PM PCMH: No Sriaroon, Panida MD Provider ID: 523903 Gender: Female USF Physicicans Group 800 6th St S Saint Petersburg, FL 33701 (727) 892-4470 Fax: (727) 892-8532 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Thai M-F 8:00 AM - 5:00 PM PCMH: No Swan, Tricia MD Provider ID: 1274233 Gender: Female Pediactric Physician Services Inc 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-8480 Fax: (727) 767-8420 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pediatrics - cont. Tabassum, Rana MD Provider ID: 955785 Gender: Female Pinellas County Health Dept 12420 130th Ave Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 00 Yrs/18 Yrs Languages: Spanish, Hindi, Urdu, Punjabi M-F 9:00 AM - 5:00 PM PCMH: No

Pedodontics Blake, Richard DDS Provider ID: TPVP43663-01 Gender: Male Richard W Blake DDS PA 2701 Park Dr Ste 1 Clearwater, FL 33763 (727) 796-2187 Fax: (727) 791-7660 00 Yrs/99 Yrs Languages: Spanish MT 7:30 AM - 3:00 PM PCMH: No Blankenship, Susan DMD Provider ID: TPVP44348-01 Gender: Female Susan D Blankenship DMD 35036 US Hwy 19 N Palm Harbor, FL 34684 (727) 446-4699 Fax: (727) 771-6804 00 Yrs/99 Yrs Languages: Spanish MW 9:00 AM - 6:00 PM TTH 8:00 AM - 5:00 PM PCMH: No

Bui, Loananh DDS Provider ID: TPVP120562-24 Gender: Female Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Larkin, Brandon DDS Provider ID: TPVP158713-01 Gender: Male Kids Smiles Dental PLLC 1433 Ct St Clearwater, FL 33756 (727) 350-3336 Fax: (727) 442-0510 00 Yrs/99 Yrs Languages: Russian M-TH 8:00 AM - 5:00 PM PCMH: No

Larkin, Brandon DDS Provider ID: TPVP158713-02 Gender: Male Provider ID: TPVP119979-04 Kids Smiles Dental PLLC Gender: Male 8686 131st St N No Sugar Bugs Club Childrens Seminole, FL 33776 Dentistry (727) 442-4070 4156 Woodlands Pkwy Ste A Fax: (727) 442-0510 Palm Harbor, FL 34685 00 Yrs/99 Yrs (727) 478-3210 Languages: Russian Fax: (727) 255-5402 M-TH 8:00 AM - 5:00 PM 00 Yrs/99 Yrs PCMH: No M-W 8:00 AM - 4:00 PM Lee, Sara DMD PCMH: No Provider ID: TPVP156988-14 Cobbe, Michael DDS Gender: Male Provider ID: TPVP43801-01 Greenberg Dental Gender: Male Orthodontics Cobbe Dental 3711 49th St North 2707 Tampa Rd Saint Petersburg, FL 33710 Palm Harbor, FL 34684 (727) 547-3603 (727) 785-6521 Fax: (727) 551-4906 Fax: (727) 785-6237 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish PCMH: No M-TH 8:00 AM - 5:30 PM Lewis, Andre DDS F 8:00 AM - 5:00 PM Provider ID: TPVP115544-01 PCMH: No Gender: Male Edwards, Jenny DMD Great Expressions Dental Centers Provider ID: TPVP149782-04 400 Carillon Pkwy Ste 120 Gender: Female Saint Petersburg, FL 33716 Tyrone Square Mall Dental PA (727) 299-0728 6747 Tyrone Square Fax: (727) 209-1365 Saint Petersburg, FL 33710 00 Yrs/99 Yrs (727) 345-6100 Languages: Spanish Fax: (727) 345-0793 M-TH 8:00 AM - 5:00 PM 00 Yrs/99 Yrs PCMH: No Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Chuong, Christopher DDS

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Makram, Christina DDS Provider ID: TPVP165156-03 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No Naoom, Jennifer DDS Provider ID: TPVP102299-15 Gender: Female Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Pinero Correa, Rosario DDS Provider ID: TPV27901-08 Gender: Female Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pedodontics - cont. Poustchi-Amin, Farah DDS Provider ID: TPVP43789-01 Gender: Female Cobbe Dental 2707 Tampa Rd Palm Harbor, FL 34684 (727) 785-6521 Fax: (727) 785-6237 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:30 PM F 8:00 AM - 5:00 PM PCMH: No Rosen, David DMD Provider ID: TPVP102277-05 Gender: Male Great Expressions Dental Centers 400 Carillon Pkwy Ste 120 Saint Petersburg, FL 33716 (727) 299-0728 Fax: (727) 209-1365 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Sirage, Mohamed DMD Provider ID: TPVP125300-12 Gender: Male Tyrone Square Mall Dental PA 6747 Tyrone Square Saint Petersburg, FL 33710 (727) 345-6100 Fax: (727) 345-0793 00 Yrs/99 Yrs Languages: Russian MTWTHFSat 10:00 AM - 5:00 PM PCMH: No

Periodontics Bardsley, Norman DDS Provider ID: TPVP66204-15 Gender: Male Greenberg Dental Orthodontics 3711 49th St North Saint Petersburg, FL 33710 (727) 547-3603 Fax: (727) 551-4906 00 Yrs/99 Yrs Languages: Spanish PCMH: No

Physical Medicine & Rehabilitation Creed, Kevin MD Provider ID: 535869 Gender: Male Pinellas Physiatry Associates PA 4400 140th Ave N Ste 110 Clearwater, FL 33762 (727) 327-2600 Fax: (727) 327-2644 00 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Eichenbaum, Annette DO Provider ID: 748722 Gender: Female Pinellas Physiatry Associates PA 4400 140th Ave N Ste 110 Clearwater, FL 33762 (727) 327-2600 Fax: (727) 327-2644 00 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Gupta, Amitabh MD Provider ID: 304583 Gender: Male 5800 49th St N Ste S-205 Saint Petersburg, FL 33709 (727) 526-8000 Fax: (727) 521-2600 12 Yrs/130 Yrs Largo Medical Center Northside Hospital Languages: Hindi, Gujarati MT 9:00 AM - 5:00 PM PCMH: No Gupta, Amitabh MD Provider ID: 304583 Gender: Male 7895 Seminole Blvd Ste 101 Seminole, FL 33772 (727) 393-2732 Fax: (727) 391-0792 12 Yrs/130 Yrs Largo Medical Center Northside Hospital Languages: Hindi, Gujarati M-W 9:00 AM - 5:00 PM PCMH: No Hart, Dennis MD Provider ID: 926260 Gender: Male Pediatric Physician Services Inc 880 6th St S Saint Petersburg, FL 33701 (727) 767-4356 Fax: (727) 767-4319 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

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Le, Thanh MD Provider ID: 28238 Gender: Male Pain Relief Centers 6640 78th Ave N Ste A Pinellas Park, FL 33781 (727) 518-8660 Fax: (727) 518-8662 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital West Park Surgery Center, LLC Languages: Vietnamese M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM PCMH: No Lockett, Ricky DO Provider ID: 10310 Gender: Male 1501 5th Ave N Saint Petersburg, FL 33705 (727) 896-8686 Fax: (727) 898-9596 00 Yrs/130 Yrs MWTH 8:00 AM - 5:00 PM T 8:00 AM - 6:00 PM F 8:00 AM - 4:00 PM PCMH: No Reiskind, Marc MD Provider ID: 711 Gender: Male Pinellas Physiatry Associates PA 4400 140th Ave N Ste 100 Clearwater, FL 33762 (727) 327-2600 Fax: (727) 327-2644 00 Yrs/130 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Plastic & Reconstructive Rottgers, Stephen MD Surgery Provider ID: 1120191 Gallant, Michael MD Provider ID: 3823 Gender: Male Pediatric Physician Services Inc 601 5th St S Ste 306 Saint Petersburg, FL 33701 (727) 767-4920 Fax: (727) 767-4923 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc St Anthonys Hospital M-F 8:30 AM - 5:00 PM PCMH: No Lo, Percy MD Provider ID: 946384 Gender: Male Professional Healthcare Of Pinellas 1839 Central Ave Saint Petersburg, FL 33713 (727) 820-1040 Fax: (727) 822-8081 00 Yrs/130 Yrs St Petersburg General Hospital Languages: Spanish, French, Russian, Hindi M-F 8:00 AM - 5:00 PM PCMH: No Mentis, Marni DO Provider ID: 555723 Gender: Female Iconique Plastic Surgery 401 Corbett St Ste 310 Belleair, FL 33756 (727) 474-0205 Fax: (727) 474-9179 05 Yrs/130 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Male Pediatric Physician Services Inc 601 5th St S Dept 70 7895 Saint Petersburg, FL 33701 (727) 767-4920 Fax: (727) 767-7476 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Podiatry Abady, Robert DPM Provider ID: 266991 Gender: Male Florida Coast Foot and Ankle Center 1001 37th St N Ste F Saint Petersburg, FL 33713 (727) 384-3338 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish MT 8:30 AM - 5:00 PM WTH 9:00 AM - 12:00 PM PCMH: No

Bohnert, Shannon DPM Provider ID: 1426157 Gender: Male Kg Health Partners, Inc 13600 Icot Blvd Bldg B Clearwater, FL 33760 (727) 796-6900 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Colaluce, Marc DPM Provider ID: 163508 Gender: Male All Florida Podiatry 5101 Brittany Dr S Saint Petersburg, FL 33715 (727) 384-1111 Fax: (727) 384-1112 00 Yrs/130 Yrs Northside Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Edwards, Elizabeth DPM Provider ID: 1431220 Gender: Female Foot and Ankle Physicians PA 2350 Sunset Point Rd Ste A Clearwater, FL 33765 (727) 796-0565 Fax: (727) 796-7464 00 Yrs/18 Yrs M-F 8:30 AM - 4:30 PM PCMH: No Ezeude, Ngozi DPM Provider ID: 1160733 Gender: Female Kg Health Partners 701 Enterprise Rd E Ste 910 Safety Harbor, FL 34695 (727) 726-6900 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fullem, Brian DPM Provider ID: 359328 Gender: Male Elite Sports Podiatry 1700 N McMln Bth Rd Ste C2 Clearwater, FL 33759 (727) 330-7646 Fax: (727) 330-7645 00 Yrs/130 Yrs St Josephs Hospital MWF 9:00 AM - 5:00 PM TTH 7:00 AM - 5:00 PM PCMH: No

Colaluce, Marc DPM Provider ID: 163508 Gender: Male All Florida Podiatry 5760 10th Ave N Beaton, William DPM Saint Petersburg, FL 33710 (727) 384-1111 Provider ID: 152677 Fax: (727) 384-1112 Gender: Male 00 Yrs/130 Yrs Beaton Podiatry and Orthotic Northside Hospital Center Languages: Spanish Isenberg, Mark DPM 6600 34th Ave N M-F 8:00 AM - 5:00 PM Saint Petersburg, FL 33710 PCMH: No (727) 896-4615 Provider ID: 941260 Fax: (727) 347-0777 Delellis, Salvatore DPM Gender: Male 00 Yrs/130 Yrs 450 Hickorynut Ave Bayfront Medical Center Oldsmar, FL 34677 Provider ID: 920852 Northside Hospital (727) 573-2048 Gender: Male St Anthonys Hospital Fax: (727) 540-9049 Sal L Delellis DPM PA M-F 8:30 AM - 5:30 PM 00 Yrs/130 Yrs 1264 S Pinellas Ave PCMH: No M-F 9:00 AM - 5:00 PM Tarpon Springs, FL 34689 PCMH: No (727) 937-6398 Fax: (727) 937-6568 00 Yrs/130 Yrs Florida Hospital North Pinellas MT 8:00 AM - 5:00 PM WF 8:00 AM - 12:00 PM TH 8:00 AM - 6:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Pinellas Podiatry - cont. Johnson, Megan DPM Provider ID: 1431445 Gender: Female Community Health Solutions of Ameri 13600 Icot Blvd Bldg A Clearwater, FL 33760 (727) 498-3942 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Klein, Ian DPM Provider ID: 4933 Gender: Male Total Foot Care PA 7331 Dr MLK Jr St N Saint Petersburg, FL 33702 (727) 527-1249 Fax: (727) 521-1240 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Anthonys Physicians Surgery M-F 8:00 AM - 5:00 PM PCMH: No Kussel, Ferdinand DPM Provider ID: 759404 Gender: Male 2378 Sunset Point Rd Clearwater, FL 33765 (727) 797-5007 Fax: (727) 725-9737 00 Yrs/130 Yrs Largo Medical Center St Petersburg General Hospital Languages: Spanish MW 8:00 AM - 4:00 PM T 8:00 AM - 12:00 PM THF 8:30 AM - 5:00 PM PCMH: No

Liaros, Demetrios DPM Provider ID: 232626 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8227 Fax: (727) 824-8233 00 Yrs/130 Yrs St Anthonys Physicians Surgery M-F 9:00 AM - 5:00 PM PCMH: No May, Jonathan DPM Provider ID: 724357 Gender: Male Jonathan B May DPM PA 502 Pasadena Ave S Saint Petersburg, FL 33707 (727) 343-9400 Fax: (727) 209-0399 00 Yrs/130 Yrs Northside Hospital MT 9:00 AM - 5:00 PM PCMH: No May, Jonathan DPM Provider ID: 724357 Gender: Male Jonathan B May DPM PA 5748 54th Ave N Saint Petersburg, FL 33709 (727) 343-9400 Fax: (727) 209-0399 00 Yrs/130 Yrs Northside Hospital M-W 9:00 AM - 5:00 PM PCMH: No Parsons, Lisa DPM Provider ID: 986646 Gender: Female Kussel and Associates Inc 2378 Sunset Point Rd Clearwater, FL 33765 (727) 797-5007 Fax: (727) 725-9737 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Roever, Christopher DPM Provider ID: 1054397 Gender: Male Sal L Delellis DPM PA 1264 S Pinellas Ave Tarpon Springs, FL 34689 (727) 937-6398 Fax: (727) 937-6568 00 Yrs/130 Yrs Florida Hospital North Pinellas MT 8:00 AM - 4:00 PM WF 8:00 AM - 12:00 PM TH 8:00 AM - 5:00 PM PCMH: No Sica, Carissa DPM Provider ID: 555742 Gender: Female Kg Health Partners Inc 13600 Icot Blvd Bldg A Clearwater, FL 33760 (727) 796-6900 Fax: (727) 669-8417 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sica, Carissa DPM Provider ID: 555742 Gender: Female Kg Health Partners Inc 701 Enterprise Rd E Ste 910 Safety Harbor, FL 34695 (727) 796-6900 Fax: (727) 669-8417 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Villalba, Marcelo DPM Provider ID: 1043867 Gender: Female Kg Health Partners Inc 701 Enterprise Rd E Ste 910 Safety Harbor, FL 34695 (727) 796-6900 05 Yrs/130 Yrs Lake Wales Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

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Westerfield, Matthew DPM Provider ID: 1160734 Gender: Male Kg Health Partners Inc 701 Enterprise Rd E Ste 910 Safety Harbor, FL 34695 (727) 796-6900 Fax: (727) 669-8417 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Prosthetics Barr Prosthetics & Orthotics Provider ID: 245980 1000 Lakeview Rd Ste 6 Clearwater, FL 33756 (727) 447-2650 Fax: (727) 447-2353 00 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM PCMH: No

Pulmonary Disease Agrawal, Rajesh MD Provider ID: 12552 Gender: Male American Lung & Sleep Disorder 6223 66th St N Pinellas Park, FL 33781 (727) 528-4900 Fax: (727) 528-8628 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Anthonys Hospital Languages: Hindi M 1:00 AM - 4:00 PM TWTH 1:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pulmonary Disease - cont. Castro, Alfonso MD Ali, Mohamed MD Provider ID: 471647 Gender: Male Pasadena Center For Asthma Lung Di 1615 Pasadena Ave S Ste 200 Saint Petersburg, FL 33707 (727) 347-5452 Fax: (727) 347-2402 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Amin, Devendra MD

Provider ID: 801412 Gender: Male Bay Area Chest Physicians PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 18 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital Languages: Spanish M-F 8:30 AM - 4:30 PM PCMH: No Chandarana, Himanshu MD

Provider ID: 932292 Gender: Male Bay Area Chest Physicians PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 18 Yrs/130 Yrs Largo Medical Center Mease Countryside Hospital Morton Plant Hospital Languages: Spanish M-F 8:30 AM - 4:00 PM PCMH: No Bhaskar, Varun MD Provider ID: 9904 Gender: Male Varun Bhaskar MD 2855 Alt 19 Palm Harbor, FL 34683 (727) 771-7200 Fax: (727) 216-1396 18 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin Morton Plant Hospital MW 2:00 AM - 4:00 PM TF 9:00 AM - 5:00 PM TH 11:00 AM - 5:00 PM PCMH: No

Provider ID: 103 Gender: Male 6450 38th Ave N Ste 330 Saint Petersburg, FL 33710 (727) 345-8179 Fax: (727) 345-7484 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital Languages: Hindi MTWF 9:00 AM - 5:30 PM TH 9:30 AM - 6:00 PM PCMH: No Eckardt, Shea MD Provider ID: 567621 Gender: Male Bay Area Chest Physicians 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 18 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Gavi, Eli MD Provider ID: 462615 Gender: Male Bay Area Chest Physicians PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 443-0611 Fax: (727) 461-5493 18 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Mosburg, Jeramy DO

Kundra, Navnit MD

Mosburg, Jeramy DO

Provider ID: 949768 Gender: Male 2595 Tampa Rd Ste S and T Palm Harbor, FL 34684 (727) 781-4299 Fax: (727) 781-5387 12 Yrs/130 Yrs Mease Countryside Hospital Mease Hospital Dunedin M-TH 9:00 AM - 5:00 PM PCMH: No Masson Jr, John MD Provider ID: 201655 Gender: Male Bay Area Chest Physicians PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 00 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Mikulic, Lucas MD Provider ID: 1326733 Gender: Male Baycare Medical Group Inc 430 Morton Plant St 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 442-9332 18 Yrs/130 Yrs Languages: Spanish, Portuguese M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 448

Provider ID: 1202837 Gender: Male Bay Area Chest Physicians, PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 18 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Provider ID: 1317862 Gender: Female Baycare Medical Group Inc 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 442-9332 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Newan, Michael MD Provider ID: 188582 Gender: Male 1075 9th Ave N Saint Petersburg, FL 33705 (727) 895-5864 Fax: (727) 896-9598 18 Yrs/130 Yrs Bayfront Medical Center Northside Hospital St Anthonys Hospital Languages: Vietnamese M-TH 9:00 AM - 5:00 PM F 9:00 AM - 4:00 PM PCMH: No Orlando, Daniel MD Provider ID: 245315 Gender: Male Bay Area Chest Physicians PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 00 Yrs/130 Yrs Largo Medical Center Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Pulmonary Disease - cont. Bloom, David MD Pansuriya, Vinubhai MD Provider ID: 413361 Gender: Male Lung & Sleep Care Inc 2180 9th Ave N Saint Petersburg, FL 33713 (727) 522-3600 Fax: (727) 522-4499 18 Yrs/130 Yrs Bayfront Medical Center Northside Hospital St Petersburg General Hospital Languages: Gujarati M-F 8:00 AM - 5:00 PM PCMH: No Sarafian, Berc MD Provider ID: 508950 Gender: Male Berc Sarafian MD PA 1518 S Missouri Ave Clearwater, FL 33756 (727) 584-1344 Fax: (727) 584-7855 00 Yrs/130 Yrs Largo Medical Center Northside Hospital M-TH 9:00 AM - 2:00 PM PCMH: No

Radiation Oncology Altoos, Taghrid MD Provider ID: 1016655 Gender: Male Pinellas Radiation Oncology Assoc 3155 N McMullen Booth Rd Clearwater, FL 33761 (727) 669-9018 Fax: (727) 797-6047 18 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1150424 Gender: Male St. Anthony's Cancer Center 1201 5th Ave N Saint Petersburg, FL 33705 (727) 825-1253 Fax: (727) 825-1332 00 Yrs/130 Yrs St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Bloom, David MD Provider ID: 1150424 Gender: Male Wellspring Cancer Center 6600 66th St N Pinellas Park, FL 33781 (727) 343-0600 Fax: (727) 344-6163 00 Yrs/130 Yrs St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Cotman, Henry MD Provider ID: 19381 Gender: Male Henry Earl Cotman MD PA 6449 38th Ave N Saint Petersburg, FL 33710 (727) 893-6103 Fax: (727) 893-6964 02 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Northside Hospital St Anthonys Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Franzese, Frank MD Provider ID: 451606 Gender: Male Well Spring Cancer Center LLC 1201 5th Ave N Saint Petersburg, FL 33705 (727) 343-0600 Fax: (727) 343-6163 12 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No Franzese, Frank MD Provider ID: 451606 Gender: Male Well Spring Cancer Center LLC 6600 66th St N Pinellas Park, FL 33781 (727) 343-0600 Fax: (727) 343-6163 12 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Franzese, Frank MD Provider ID: 451606 Gender: Male Well Spring Cancer Center LLC 701 6th St S Saint Petersburg, FL 33701 (727) 343-0600 Fax: (727) 343-6163 12 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No

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Miercort, Craig MD Provider ID: 274984 Gender: Male 1201 5th Ave N Saint Petersburg, FL 33705 (727) 343-0600 Fax: (727) 344-6163 18 Yrs/130 Yrs Brandon Regional Hospital Largo Medical Center St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Miercort, Craig MD Provider ID: 274984 Gender: Male Wellspring Cancer Center 6600 66th St N Pinellas Park, FL 33781 (727) 343-0600 Fax: (727) 344-6163 18 Yrs/130 Yrs Brandon Regional Hospital Largo Medical Center St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Miller, Robert MD Provider ID: 451602 Gender: Male Well Spring Cancer Center LLC 1201 5th Ave N Saint Petersburg, FL 33705 (727) 343-0600 Fax: (727) 343-6163 16 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Radiation Oncology cont. Miller, Robert MD Provider ID: 451602 Gender: Male Well Spring Cancer Center LLC 6600 66th St N Pinellas Park, FL 33781 (727) 343-0600 Fax: (727) 343-6163 16 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Miller, Robert MD Provider ID: 451602 Gender: Male Well Spring Cancer Center LLC 701 6th St S Saint Petersburg, FL 33701 (727) 343-0600 Fax: (727) 343-6163 16 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No Shah, Hiral MD Provider ID: 387433 Gender: Male Pinellas Rad Oncology Associates 300 Pinellas St Clearwater, FL 33756 (727) 462-7220 Fax: (727) 669-4308 18 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Shah, Hiral MD Provider ID: 387433 Gender: Male Pinellas Rad Oncology Associates 3155 N McMullen Booth Rd Clearwater, FL 33761 (727) 669-9018 Fax: (727) 669-4308 18 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital M-F 8:00 AM - 5:00 PM PCMH: No Tralins, Kevin MD Provider ID: 186700 Gender: Male Bardmoor Cancer Center 8787 Bryan Dairy Rd Ste 120 Seminole, FL 33777 (727) 320-0200 Fax: (727) 394-8934 18 Yrs/130 Yrs Largo Medical Center Mease Countryside Hospital Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Radiation Therapy Solc, Zucel MD Provider ID: 9343 Gender: Male Well Cpring Cancer Center LLC 1201 5th Ave N Saint Petersburg, FL 33705 (727) 343-0600 Fax: (727) 343-6163 18 Yrs/130 Yrs Largo Medical Center Morton Plant North Bay Hospital St Anthonys Hospital Languages: Spanish MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No

Solc, Zucel MD Provider ID: 9343 Gender: Male Well Cpring Cancer Center LLC 701 6th St S Saint Petersburg, FL 33701 (727) 343-0600 Fax: (727) 343-6163 18 Yrs/130 Yrs Largo Medical Center Morton Plant North Bay Hospital St Anthonys Hospital Languages: Spanish MTWTHFSatSun 9:00 AM 5:00 PM PCMH: No Solc, Zucel MD Provider ID: 9343 Gender: Male Well Spring Cancer Center LLC 6600 66th St N Pinellas Park, FL 33781 (727) 343-0600 Fax: (727) 343-6163 18 Yrs/130 Yrs Largo Medical Center Morton Plant North Bay Hospital St Anthonys Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No St Pete Cancer Treatment Center Provider ID: 569813 St Peter Cancer Treatment Center 6449 38th Ave N Ste C3 D3 Saint Petersburg, FL 33710 (727) 344-5000 Fax: (321) 747-0362 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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West, John MD Provider ID: 212947 Gender: Male Tampa Bay Oncology Center Inc 1835 Indian Rocks Rd S Largo, FL 33774 (727) 586-2273 Fax: (727) 584-5966 18 Yrs/130 Yrs Largo Medical Center Largo Medical Center Indian Rocks M-F 8:00 AM - 4:30 PM PCMH: No

Radiology - Interventional & Vascular Bittles, Mark MD Provider ID: 1245950 Gender: Male Pediatric Physician Services Inc 501 6th Ave S Saint Petersburg, FL 33701 (727) 787-3318 Fax: (727) 767-8002 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Krackov, Warren MD Provider ID: 947633 Gender: Male American Access Care of Orlando LL 12666 Telecom Dr Saint Petersburg, FL 33736 (813) 972-4700 Fax: (813) 972-4705 18 Yrs/130 Yrs Jackson South Community Hospit Kendall Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Reproductive Endocrinology Plosker, Shayne MD Provider ID: 334481 Gender: Male USF Physicians Group 6450 38th Ave N Saint Petersburg, FL 33710 (813) 259-0692 Fax: (813) 259-0882 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Rheumatology

Masson Jr, John MD Provider ID: 201655 Gender: Male Bay Area Chest Physicians PA 430 Morton Plant St Ste 405 Clearwater, FL 33756 (727) 447-0668 Fax: (727) 461-5493 00 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Sports Medicine Mularoni, Philip MD

Sankoorikal, Antony MD Provider ID: 1174545 Gender: Male Pediatric Physician Services Inc 5016th Ave S Saint Petersburg, FL 33701 (727) 767-8480 Fax: (727) 767-8420 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 27525 Gender: Male Countryside Arthritis Center 2655 State Rd 580 Ste 201 Clearwater, FL 33761 (727) 797-7410 Fax: (727) 797-7411 18 Yrs/130 Yrs Florida Hospital North Pinellas Mease Countryside Hospital Mease Hospital Dunedin Rankin Jr, George MD M-F 9:00 AM - 5:00 PM Provider ID: 656649 PCMH: No Gender: Male Sleep Medicine Turley Family Health Center 807 N Myrtle Ave Gavi, Eli MD Clearwater, FL 33755 Provider ID: 462615 (727) 467-2400 Gender: Male Fax: (727) 467-2477 Bay Area Chest Physicians PA 00 Yrs/130 Yrs 430 Morton Plant St Ste 405 Morton Plant Hospital Clearwater, FL 33756 M-F 8:00 AM - 5:00 PM (727) 443-0611 PCMH: No Fax: (727) 461-5493 Wojnowich, Katherine MD 18 Yrs/130 Yrs Morton Plant Hospital M-F 8:00 AM - 5:00 PM Provider ID: 1125728 PCMH: No Gender: Female Bayfront Health Medical Group 603 7th St S Ste 440 Saint Petersburg, FL 33701 (727) 893-6333 Fax: (727) 553-7787 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Thoracic & Cardiovascular Chapa, Liberato MD Surgery Angell, William MD Provider ID: 12950 Gender: Male Angell and Ordiway MDS PA 800 Tarpon Wds Blvd Ste D Palm Harbor, FL 34685 (813) 871-5151 Fax: (813) 877-2674 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bryan II, Foster MD Provider ID: 605545 Gender: Male West Florida Cardiology Network LLC 1345 W. Bay Dr Ste 304 Largo, FL 33770 (727) 587-7100 Fax: (727) 585-3290 18 Yrs/130 Yrs Bayfront Medical Center Largo Medical Center Northside Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bryan II, Foster MD Provider ID: 605545 Gender: Male West Florida Cardiology Network LLC 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs Bayfront Medical Center Largo Medical Center Northside Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Provider ID: 1334 Gender: Male 455 Pinellas St Ste 320 Clearwater, FL 33756 (727) 446-2273 Fax: (727) 287-1954 00 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Morton Plant Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Curiale, Steven MD Provider ID: 1092094 Gender: Male Bayfront Health Medical Group 601 7th St S Ste 530 Saint Petersburg, FL 33701 (727) 553-7450 Fax: (727) 553-7451 18 Yrs/110 Yrs Bayfront Medical Center M-F 8:00 AM - 4:00 PM PCMH: No De Frain, Michael MD Provider ID: 452488 Gender: Male West Florida Cardiology Network LLC 1345 W. Bay Dr Ste 304 Largo, FL 33770 (727) 587-7100 Fax: (727) 585-3290 00 Yrs/130 Yrs Northside Hospital St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Thoracic & Cardiovascular Karl, Tom MD Surgery - cont. Provider ID: 1047664 De Frain, Michael MD Provider ID: 452488 Gender: Male West Florida Cardiology Network, LL 6006 49th St N Ste 310 Saint Petersburg, FL 33709 (727) 527-9779 Fax: (727) 522-0415 00 Yrs/130 Yrs Northside Hospital St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Hakki, A MD Provider ID: 6236 Gender: Male 10333 Seminole Blvd Ste 8 Largo, FL 33778 (727) 394-8100 Fax: (727) 394-8906 18 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Arabic, Kurdish M-F 9:00 AM - 5:00 PM PCMH: No Heric, Blaine MD Provider ID: 19868 Gender: Male Cardiac Surgical Associates LLP 455 Pinellas St Ste 320 Clearwater, FL 33756 (727) 446-2273 Fax: (727) 441-4966 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Largo Medical Center Mease Hospital Dunedin M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-6666 Fax: (727) 767-8606 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No Ordiway, Lester MD

Thoracic Surgery Van Gelder, Hugh MD Provider ID: 962637 Gender: Male Bayfront Health Medical Group 601 7th St S Ste 530 Saint Petersburg, FL 33701 (727) 553-7450 Fax: (727) 553-7451 18 Yrs/130 Yrs Northside Hospital St Anthonys Hospital St Petersburg General Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 12525 Gender: Male Urology Angell and Ordiway MDS PA 800 Tarpon Woods Blvd Ste D Diner, Eric MD Palm Harbor, FL 34685 Provider ID: 360559 (813) 871-5151 Gender: Male Fax: (813) 877-2674 Suncoast Medical Clinic LLC 18 Yrs/130 Yrs Florida Hospital North Pinellas 620 10th St N Ste 3D Saint Petersburg, FL 33705 Tampa Community Hospital (727) 824-7146 Tampa General Hospital Fax: (727) 824-7119 M-F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No Bayfront Medical Center Rovin, Joshua MD St Anthonys Hospital M-TH 9:00 AM - 5:00 PM Provider ID: 293970 F 9:00 AM - 12:00 PM Gender: Male PCMH: No Healthpoint Medical Group 455 Pinellas St Ste 320 Shah, Jaimin MD Clearwater, FL 33756 Provider ID: 1209403 (727) 446-2273 Gender: Male 00 Yrs/130 Yrs 620 10th St N Morton Plant Hospital Saint Petersburg, FL 33705 St Anthonys Hospital St Petersburg General (727) 824-7146 Hospital Fax: (727) 824-7119 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No Bayfront Medical Center M-F 9:00 AM - 5:00 PM Teekell-Taylor, Leah MD PCMH: No Provider ID: 358811 Gender: Female 10033 MLK St N Ste 300 Saint Petersburg, FL 33716 (727) 498-8898 Fax: (727) 800-6959 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Thomer, Marguerite MD Provider ID: 1004953 Gender: Female Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-7146 Fax: (727) 824-7119 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No Thomer, Marguerite MD Provider ID: 1004953 Gender: Female Suncoast Medical Clinic LLC 960 7th Ave N Saint Petersburg, FL 33705 (727) 824-7146 Fax: (727) 824-7119 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Vascular Surgery Almond, Brett MD Provider ID: 607495 Gender: Male 1615 Pasadena Ave S Ste 480 Saint Petersburg, FL 33707 (727) 345-2929 Fax: (727) 345-0340 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Almond, Brett MD Provider ID: 607495 Gender: Male 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Pinellas Vascular Surgery - cont. De Jesus Gomez, Gustavo MD Provider ID: 1235218 Gender: Male Rapha Vascular Specialists Inc 5000 Park St N Ste 1020 Saint Petersburg, FL 33709 (727) 827-2993 Fax: (727) 317-4900 18 Yrs/130 Yrs Bartow Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Gabriel, Yves MD Provider ID: 364832 Gender: Male 455 Pinellas St Ste 320 Clearwater, FL 33756 (727) 443-6798 Fax: (727) 441-4966 00 Yrs/130 Yrs Mease Countryside Hospital Morton Plant Hospital St Josephs Hospital Languages: French, Creole M-F 8:00 AM - 5:00 PM PCMH: No Murphy, Eugene MD Provider ID: 507201 Gender: Male Suncoast Medical Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8209 Fax: (727) 824-7154 18 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital St Anthonys Physicians Surgery M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Nwobi, Obinna MD Provider ID: 660635 Gender: Male Vascular Interventional Pavilion L 3500 38th Ave N Saint Petersburg, FL 33713 (727) 527-5100 Fax: (727) 527-5119 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Zuzga, Mark MD Provider ID: 306655 Gender: Male 1840 Mease Dr Ste 301 Safety Harbor, FL 34695 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs MT 9:00 AM - 5:00 PM W 9:00 AM - 4:00 PM PCMH: No Zuzga, Mark MD Provider ID: 306655 Gender: Male 430 Morton Plant St Ste 301 Clearwater, FL 33756 (727) 712-3233 Fax: (727) 712-1853 00 Yrs/130 Yrs M 1:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 453

Last update 08/14/2017

Specialty Physicians Polk Cardiac Electrophysiology Belal, Farouk MD Ahmed, Safi MD Provider ID: 1313444 Gender: Male Heart of Florida Physician Group 40124 Hwy 27 Ste 204 Davenport, FL 33837 (863) 419-2156 Fax: (863) 419-2157 00 Yrs/130 Yrs Languages: Hindi, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Cardiology

Provider ID: 194520 Gender: Male Cypress Cardiology PA 1255 State Rd 60 E Lake Wales, FL 33853 (863) 293-8336 Fax: (863) 293-8532 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Winter Haven Hospital Languages: Arabic M 9:00 AM - 11:30 PM PCMH: No Bhashyam, Siva MD

Al-Suleiman, Osama MD Provider ID: 221324 Gender: Male Heart and Vascular Clinic of Clermo 410 Lionel Way Ste 200 Davenport, FL 33837 (352) 432-7200 Fax: (352) 432-7070 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Belal, Farouk MD Provider ID: 194520 Gender: Male 320 1st St N Winter Haven, FL 33881 (863) 293-8336 Fax: (863) 293-8532 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Winter Haven Hospital Languages: Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1095324 Gender: Male Mid Florida Cardiovascular Center L 400 Ave K SE Ste 5 Winter Haven, FL 33880 (863) 269-0210 Fax: (888) 235-9876 18 Yrs/130 Yrs Florida Hospital Waterman Languages: Hindi, Telugu, Kannada M-F 8:00 AM - 5:00 PM PCMH: No Bolanos, Rodrigo MD Provider ID: 1085239 Gender: Male Baycare Medical Group 199 Ave B NW Ste 310 Winter Haven, FL 33881 (863) 292-4004 Fax: (863) 292-4005 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Chauhan, Ketul MD Provider ID: 522583 Gender: Male Premier Heart and Vascular Center P 1417 Lakelnd Hls Blvd Ste 104 Lakeland, FL 33805 (863) 858-6666 Fax: (813) 788-7691 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Carrollwood Florida Hospital Zephyrhills Languages: Hindi M 9:00 AM - 4:00 PM PCMH: No Gupta, Sunil MD Provider ID: 152315 Gender: Male Premier Heart and Vascular Center P 1417 Lakelnd Hls Blvd Ste 104 Lakeland, FL 33805 (863) 858-6666 Fax: (813) 788-7691 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Carrollwood Florida Hospital Zephyrhills Languages: Hindi M 9:00 AM - 4:00 PM PCMH: No Joseph, Oji MD Provider ID: 196547 Gender: Male Heart & Vascular Plc 1136 Bryn Mawr Ave Lake Wales, FL 33853 (863) 676-6296 Fax: (863) 676-6431 18 Yrs/130 Yrs Bartow Regional Medical Center Lake Wales Medical Center Orlando Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

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Joseph, Oji MD Provider ID: 196547 Gender: Male Heart and Vascular,Plc 294 Patterson Rd Ste B Haines City, FL 33844 (863) 676-6296 18 Yrs/130 Yrs Bartow Regional Medical Center Lake Wales Medical Center Orlando Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Khadim, Ghazanfar MD Provider ID: 456632 Gender: Male Florida Heart Institute 1500 Lakeland Hills Blvd Lakeland, FL 33805 (813) 780-6687 Fax: (813) 788-6554 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills South Florida Baptist Hospital Languages: Spanish, Chinese, Burmese MT 12:00 AM - 5:00 PM PCMH: No Laddu, Prashanta MD Provider ID: 1180177 Gender: Male Comprehensive Cardiovascular Specia 2231 North Blvd W Ste A Davenport, FL 33837 (863) 353-1390 Fax: (863) 438-4880 00 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Hospital M-F 9:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Cardiology - cont. Laddu, Prashanta MD Provider ID: 1180177 Gender: Male Comprehensive Cardiovascular Specia 320 1st St N Winter Haven, FL 33881 (863) 353-1390 Fax: (863) 438-4880 00 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Hospital M-F 10:00 AM - 2:00 PM PCMH: No Lall, Rajesh MD Provider ID: 1191439 Gender: Male Premier Heart and Vascular Center 3647 Innovation Dr Lakeland, FL 33812 (863) 646-5000 Fax: (863) 646-5001 18 Yrs/130 Yrs Bartow Regional Medical Center M-F 8:00 AM - 4:30 PM PCMH: No Mohib, Saiyed MD Provider ID: 1078178 Gender: Male Heart and Vascular Clinic of Clermo 294 Patterson Rd Ste B Haines City, FL 33844 (352) 432-7200 Fax: (352) 432-7070 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Mohib, Saiyed MD Provider ID: 1078178 Gender: Male Heart and Vascular Clinic of Clermo 410 Lionel Way Ste 200 Davenport, FL 33837 (352) 432-7200 Fax: (352) 432-7070 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nunez, Boris MD Provider ID: 11676 Gender: Male Advanced Interventional Cardiology 320 SR 60 E Lake Wales, FL 33853 (863) 679-7985 Fax: (863) 679-1865 18 Yrs/130 Yrs Florida Hospital Orlando Orlando Regional Medical Center Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No Patel, Roshankumar MD Provider ID: 1314996 Gender: Male Heart Vascular Institute of Florid 1110 Druid Cir Ste A Lake Wales, FL 33853 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patel, Roshankumar MD Provider ID: 1314996 Gender: Male Heart Vascular Institute of Florid 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Patel, Roshankumar MD Provider ID: 1314996 Gender: Male Heart Vascular Institute of Florid 405 Lionel Way Davenport, FL 33837 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Siddiqui, Irfan DO Provider ID: 584117 Gender: Female Heart and Vascular Plc 1110 Druid Cir Ste A Lake Wales, FL 33853 (863) 424-3278 Fax: (863) 420-9701 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 9:00 AM - 5:00 PM PCMH: No Siddiqui, Irfan DO Provider ID: 584117 Gender: Female Heart and Vascular Plc 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:30 AM - 5:00 PM PCMH: No Siddiqui, Irfan DO Provider ID: 584117 Gender: Female Heart and Vascular Plc 405 Lionel Way Davenport, FL 33837 (863) 424-3278 Fax: (863) 420-9701 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:30 AM - 5:00 PM PCMH: No

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Tai, Zaheed DO Provider ID: 283430 Gender: Male Comprehensive Cardiovascular Specia 2231 North Blvd W Ste A Davenport, FL 33837 (863) 353-1390 00 Yrs/130 Yrs Winter Haven Hospital Languages: Urdu M-F 9:00 AM - 5:00 PM PCMH: No Tai, Zaheed DO Provider ID: 283430 Gender: Male Comprehensive Cardiovascular Specia 23607 US Hwy 27 Lake Wales, FL 33859 (863) 353-1390 Fax: (863) 438-4880 00 Yrs/130 Yrs Winter Haven Hospital Languages: Urdu M-F 9:00 AM - 5:00 PM PCMH: No Tai, Zaheed DO Provider ID: 283430 Gender: Male Comprehensive Cardiovascular Specia 320 1st St N Winter Haven, FL 33881 (863) 353-1390 Fax: (863) 508-6326 00 Yrs/130 Yrs Winter Haven Hospital Languages: Urdu M-F 8:00 AM - 6:00 PM PCMH: No

Cardiovascular Surgery Evans, David MD Provider ID: 1140037 Gender: Male Baycare Medical Group 200 Ave F NE Winter Haven, FL 33881 (863) 292-4043 Fax: (863) 229-7523 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Child Neurology Vernier, Eric MD Provider ID: 1032698 Gender: Male Capernaum Medical Center For Kids P 5129 S Lakeland Dr Ste 1 and 2 Lakeland, FL 33813 (863) 232-4323 00 Yrs/21 Yrs Lee Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Winesett, Steven MD Provider ID: 461042 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Chiropractic Ison, Alexander DC Provider ID: TPV11611-01 Gender: Male Cleveland Heights Chiropractic Clinic 3740 Cleveland Heights Blvd Lakeland, FL 33813 (863) 646-5707 Fax: (863) 647-5044 12 Yrs/99 Yrs M-TH 8:30 AM - 5:30 PM PCMH: No Ison, Scottie DC Provider ID: TPV10934-01 Gender: Male Cleveland Heights Chiropractic Clinic 3740 Cleveland Heights Blvd Lakeland, FL 33813 (863) 646-5707 Fax: (863) 647-5044 00 Yrs/99 Yrs M-TH 8:30 AM - 5:30 PM PCMH: No

Lucido, David DC Provider ID: TPV10853-01 Gender: Male Lucido Chiropractic 1965 E Edgewood Dr Lakeland, FL 33803 (863) 683-8006 Fax: (863) 683-8225 10 Yrs/99 Yrs MF 8:00 AM - 5:00 PM TTH 8:00 AM - 4:00 PM W 8:00 AM - 6:00 PM PCMH: No Parker, Dane DC Provider ID: TPV10398-01 Gender: Male Lakeland Spine Center Inc 3242 S Florida Ave Lakeland, FL 33803 (863) 644-0880 Fax: (863) 644-4992 00 Yrs/99 Yrs MWF 8:00 AM - 6:30 PM TTH 9:00 AM - 12:00 PM PCMH: No Parker, Dane DC Provider ID: TPV10398-02 Gender: Male Family Wellness Center 1064 N Broadway Ave Bartow, FL 33830 (863) 519-9797 Fax: (863) 533-8723 00 Yrs/99 Yrs MT 2:00 AM - 6:30 PM PCMH: No Puentes, David DC Provider ID: TPV10400-01 Gender: Male David Puentes DC 795 S Broadway Ave Bartow, FL 33830 (863) 533-2766 Fax: (863) 533-0998 00 Yrs/99 Yrs Languages: Spanish MWF 8:00 AM - 6:00 PM TTH 9:00 AM - 12:30 PM PCMH: No

Raemisch, Christopher DC Provider ID: TPV10925-01 Gender: Male Ridge Chiropractic 82 Maxcy Plaza Circle Haines City, FL 33844 (863) 421-9700 Fax: (863) 421-1953 00 Yrs/99 Yrs Languages: Spanish MTWF 8:00 AM - 6:30 PM TH 8:00 AM - 11:00 PM Sat 8:00 AM - 1:00 PM PCMH: No Reckord, Mabbett DC Provider ID: TPV11625-01 Gender: Male Family Chiropractic Health Center 2027 E Edgewood Dr Lakeland, FL 33803 (863) 665-9597 Fax: (863) 665-1588 00 Yrs/99 Yrs MWTH 8:00 AM - 6:00 PM T 8:00 AM - 11:00 PM PCMH: No

Colon & Rectal Surgery Peraglie, Cesare MD Provider ID: 589459 Gender: Male Anal Recal Clinic 40124 Hwy 27 Ste 203 Davenport, FL 33837 (863) 353-1532 Fax: (863) 421-7161 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Dermatology By, Charya MD Provider ID: 1174547 Gender: Female Leavitt Medical Associates of Flori 202 Lake Miriam Dr S-1 Lakeland, FL 33813 (863) 647-2333 Fax: (863) 644-6729 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Cottam, John MD Provider ID: 162223 Gender: Male Dr John Cottam Dermatology and Cuta 222 W Main St Ste B Bartow, FL 33830 (863) 533-7999 Fax: (813) 962-0566 00 Yrs/130 Yrs MT 8:00 AM - 5:00 PM PCMH: No Cottam, John MD Provider ID: 162223 Gender: Male Dr John Cottam Dermatology and Cuta 741 County Rd 466 Lady Lake, FL 32159 (352) 259-1042 Fax: (813) 962-0566 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Funieru, Iulia MD Provider ID: 226057 Gender: Female Lakeland Dermatology Inc 202 Lake Miriam Dr Ste 1 Lakeland, FL 33813 (863) 647-2333 Fax: (863) 644-6729 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish, Romanian M-F 8:00 AM - 5:00 PM PCMH: No Glenn, Candace MD Provider ID: 1336767 Gender: Female Mid Florida Dermatology Associates 2302 North Blvd W Ste A Davenport, FL 33837 (407) 299-7333 Fax: (407) 293-2049 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Dermatology - cont. Graham, Thomas MD Provider ID: 1331667 Gender: Male Mid Florida Dermatology Associates 2302 North Blvd W Ste A Davenport, FL 33837 (407) 299-7333 Fax: (407) 293-2049 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Gutierrez, Michael MD Provider ID: 6171 Gender: Male Mid Florida Dermatology Associates 2302 North Blvd W Davenport, FL 33837 (888) 318-3183 Fax: (407) 293-2049 00 Yrs/130 Yrs Orlando Regional Medical Center Languages: Spanish M-TH 8:00 AM - 4:00 PM F 8:00 AM - 12:00 PM PCMH: No Murray, David MD Provider ID: 12240 Gender: Male Lakeland Dermatology Inc 202 Lake Miriam Dr Ste S1 Lakeland, FL 33813 (863) 647-2333 Fax: (863) 393-1995 00 Yrs/130 Yrs Citrus Surgical Center Lakeland Reg Medical Center Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No

Sandhu, Neil MD Provider ID: 1253016 Gender: Male Helen Kraus MD PA 4545 Pleasant Hill Rd Kissimmee, FL 34759 (888) 578-3188 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Ear, Nose & Throat Bradfield, Joseph MD Provider ID: 214501 Gender: Male The Barranco Clinic 160 E Lake Howard Dr Winter Haven, FL 33881 (863) 299-1251 Fax: (863) 299-7666 00 Yrs/130 Yrs Heart of Florida Reg Med Center ORHS-South Lake Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:30 PM PCMH: No Bradfield, Joseph MD Provider ID: 214501 Gender: Male The Barranco Clinic 175 Patterson Rd Haines City, FL 33844 (863) 421-4558 Fax: (863) 421-4438 00 Yrs/130 Yrs Heart of Florida Reg Med Center ORHS-South Lake Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:30 PM PCMH: No

Lingamallu, Ratnamani MD Provider ID: 2827 Gender: Female Central Florida ENT Associates PA 515 E Garden St Lakeland, FL 33805 (863) 683-5454 Fax: (863) 683-4652 00 Yrs/130 Yrs Central Florida Surgicenter Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Mangal, Ajay MD Provider ID: 1169390 Gender: Male Ear, Nose, and Throat of Polk Count 423 Linden Ln Lake Wales, FL 33853 (863) 676-1960 Fax: (863) 676-8378 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Matallana, Herman DO Provider ID: 208891 Gender: Male Family Care ENT & Rec Surgery 5420 Strickland Ave Lakeland, FL 33812 (863) 701-9510 Fax: (863) 701-9518 00 Yrs/130 Yrs Bartow Regional Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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Merritt, Robert MD Provider ID: 176476 Gender: Male The Barranco Clinic 160 E Lake Howard Dr Winter Haven, FL 33881 (863) 299-1251 Fax: (863) 299-7666 00 Yrs/130 Yrs Heart of Florida Reg Med Center M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:30 PM PCMH: No Merritt, Robert MD Provider ID: 176476 Gender: Male The Barranco Clinic 175 Patterson Rd Haines City, FL 33844 (863) 421-4558 Fax: (863) 421-4438 00 Yrs/130 Yrs Heart of Florida Reg Med Center M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:30 PM PCMH: No Stuart, Menachem MD Provider ID: 1108126 Gender: Male The Barranco Clinic PA 175 Patterson Rd Haines City, FL 33844 (863) 299-1251 Fax: (863) 299-7666 00 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Ear, Nose & Throat - cont. Baker, James DDS Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head Nec 3310 Lakeland Hills Blvd Lakeland, FL 33805 (941) 927-8805 Fax: (941) 925-6339 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No Zarranz, Robert MD Provider ID: 1143586 Gender: Male Ear, Nose, and Throat of Polk Co. 423 Linden Ln Lake Wales, FL 33853 (863) 676-1960 Fax: (863) 676-8378 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Endodontics Baker, James DDS Provider ID: TPVP44025-18 Gender: Male Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP44025-31 Gender: Male Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Baker, James DDS Provider ID: TPVP44025-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Baker, James DDS Provider ID: TPVP44025-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Cherian, Shiju DDS Provider ID: TPVP93658-18 Gender: Male Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Cherian, Shiju DDS Provider ID: TPVP93658-31 Gender: Male Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Cherian, Shiju DDS Provider ID: TPVP93658-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 458

Cherian, Shiju DDS Provider ID: TPVP93658-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-04 Gender: Female Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-21 Gender: Female Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Endodontics - cont. Millstein, Ashley DMD Provider ID: TPVP139323-47 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Millstein, Ashley DMD Provider ID: TPVP139323-54 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Mir, Hamza DDS Provider ID: TPV19593-26 Gender: Male Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

Mir, Hamza DDS Provider ID: TPV19593-63 Gender: Male Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Mir, Hamza DDS Provider ID: TPV19593-65 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Mir, Hamza DDS Provider ID: TPV19593-70 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Schwartz II, William DDS Provider ID: TPVP153182-07 Gender: Male Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Schwartz II, William DDS Provider ID: TPVP153182-09 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Schwartz II, William DDS

Schwartz II, William DDS Provider ID: TPVP153182-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Sreekantaiah, Kiran DDS Provider ID: TPVP118093-18 Gender: Male Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Sreekantaiah, Kiran DDS

Provider ID: TPVP153182-23 Gender: Male Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 459

Provider ID: TPVP118093-31 Gender: Male Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Endodontics - cont. Sreekantaiah, Kiran DDS Provider ID: TPVP118093-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Sreekantaiah, Kiran DDS Provider ID: TPVP118093-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Family Practice Louisville, Tommy MD Provider ID: 304788 Gender: Male First Help Urgent Care Clinic 1801 Crystal Lake Dr Lakeland, FL 33801 (863) 937-8886 Fax: (863) 937-8892 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Louisville, Tommy MD Provider ID: 304788 Gender: Male First Help Urgent Care Clinic 235 N Commonwealth Ave Polk City, FL 33868 (863) 984-8000 Fax: (863) 984-8009 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Louisville, Tommy MD Provider ID: 304788 Gender: Male First Help Urgent Care Clinic 320 1st St S Winter Haven, FL 33880 (863) 299-8485 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 6:30 PM PCMH: No

Gastroenterology Izsak, Eliezer MD Provider ID: 443 Gender: Male Gastroenterology of Polk County 1120 Carlton Ave Ste 1600 Lake Wales, FL 33853 (863) 676-0852 Fax: (863) 679-7832 18 Yrs/130 Yrs Languages: Hebrew M-F 8:00 AM - 5:00 PM PCMH: No Kahlon, Devendra MD Provider ID: 17658 Gender: Male Gastroentrology Consultants 40124 Hwy 27 Ste 102 Davenport, FL 33837 (863) 419-1166 Fax: (863) 419-1188 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Languages: Hindi, Punjabi M-F 8:00 AM - 5:00 PM PCMH: No

Mohiuddin, Muhammad MD

Vargas, David MD Provider ID: 26565 Gender: Male Provider ID: 176701 145 Ave G SW Gender: Male Gastroenterology & Nutrition Winter Haven, FL 33880 (863) 687-8335 339 Cypress Pkwy Fax: (863) 687-8337 Kissimmee, FL 34759 18 Yrs/130 Yrs (407) 843-0443 Bartow Regional Medical Fax: (407) 847-0721 Center 00 Yrs/130 Yrs Lakeland Reg Medical Center Arnold Palmer Hospital For Winter Haven Hospital Children Languages: Spanish Citrus Surgical Center M-F 8:00 AM - 5:00 PM Orlando Regional Medical Center PCMH: No Languages: Spanish, Urdu General Dentistry M 2:00 AM - 5:00 PM PCMH: No Amaro, David DDS Nobo, Christopher MD Provider ID: TPV11922-63 Gender: Male Greenberg Dental Provider ID: 1323376 Orthodontics Gender: Male 4969 US Hwy 98 N Baycare Medical Group Inc Lakeland, FL 33809 7599 Cypress Gardens Blvd (863) 614-0044 Winter Haven, FL 33884 Fax: (863) 272-7566 (863) 519-1799 00 Yrs/99 Yrs Fax: (863) 229-7550 Languages: Spanish 18 Yrs/130 Yrs MT 11:00 AM - 7:00 PM M-F 9:00 AM - 5:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No PCMH: No Vargas, David MD Amaro, David DDS Provider ID: 26565 Provider ID: TPV11922-68 Gender: Male Gender: Male 1114 S Florida Ave Greenberg Dental Lakeland, FL 33803 Orthodontics (863) 687-8335 2926 S Florida Ave Fax: (863) 687-8337 Lakeland, FL 33803 18 Yrs/130 Yrs (863) 226-6229 Bartow Regional Medical Fax: (863) 333-5633 Center 00 Yrs/99 Yrs Lakeland Reg Medical Center Winter Haven Hospital Languages: Spanish Languages: Spanish MT 7:00 AM - 3:00 PM M-F 8:00 AM - 5:00 PM WTH 11:00 AM - 7:00 PM PCMH: No F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 460

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Avila, Daira DMD Antony, Archana DDS Provider ID: TPVP93467-02 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Antony, Archana DDS Provider ID: TPVP93467-03 Gender: Female Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No Antony, Archana DDS Provider ID: TPVP93467-05 Gender: Female Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Antony, Archana DDS Provider ID: TPVP93467-07 Gender: Female Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Provider ID: TPV19318-43 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Azadi, Anthony DDS Provider ID: TPVP156642-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Azadi, Anthony DDS Provider ID: TPVP156642-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Barcia, Antonio DDS Provider ID: TPVP148175-03 Gender: Male Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Barrett, Steven DDS Provider ID: TPV12124-70 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Barrett, Steven DDS Provider ID: TPV12124-77 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

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Barzyk, Jeffrey DMD Provider ID: TPVP42849-01 Gender: Male Doh - Polk County Health Department 1805 Hobbs Rd Auburndale, FL 33823 (863) 965-6333 Fax: (863) 968-5096 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Barzyk, Jeffrey DMD Provider ID: TPVP42849-02 Gender: Male Doh - Polk County Health Department 1700 Baker Ave East Haines City, FL 33844 (863) 421-3204 Fax: (863) 419-3497 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Barzyk, Jeffrey DMD Provider ID: TPVP42849-03 Gender: Male Doh - Polk County Health Department 2090 E Clower St Bartow, FL 33830 (863) 534-7258 Fax: (863) 534-7114 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Barzyk, Jeffrey DMD Provider ID: TPVP42849-04 Gender: Male Doh - Polk County Health Department 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2636 Fax: (863) 413-2747 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Brown, Troy DDS Beitscher, Stan DDS Provider ID: TPV6286-73 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Beitscher, Stan DDS Provider ID: TPV6286-78 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Boyett, Kimberly DDS Provider ID: TPVP93642-01 Gender: Female Walding Associates 444 W Pipkin Rd Lakeland, FL 33813 (863) 619-6600 Fax: (863) 619-6644 00 Yrs/99 Yrs Languages: Spanish MTTH 7:30 AM - 5:00 PM W 7:30 AM - 3:00 PM PCMH: No

Provider ID: TPVP133493-01 Gender: Male Doh - Polk County Health Department 1805 Hobbs Rd Auburndale, FL 33823 (863) 965-6333 Fax: (863) 968-5096 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brown, Troy DDS Provider ID: TPVP133493-02 Gender: Male Doh - Polk County Health Department 1700 Baker Ave East Haines City, FL 33844 (863) 421-3204 Fax: (863) 419-3497 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brown, Troy DDS Provider ID: TPVP133493-03 Gender: Male Doh - Polk County Health Department 2090 E Clower St Bartow, FL 33830 (863) 534-7258 Fax: (863) 534-7114 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Brown, Troy DDS Provider ID: TPVP133493-04 Gender: Male Doh - Polk County Health Department 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2636 Fax: (863) 413-2747 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Calderon, Nadia DDS Provider ID: TPVP159198-37 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-08 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Caputo, Michael DDS Provider ID: TPVP156605-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 462

Cardenas, Carlos DDS Provider ID: TPV12871-01 Gender: Male Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Cardenas, Carlos DDS Provider ID: TPV12871-05 Gender: Male Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Cardenas, Carlos DDS Provider ID: TPV12871-09 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Cardenas, Carlos DDS Provider ID: TPV12871-10 Gender: Male Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Chasko Jr., Joseph DDS Cardenas, Carlos DDS Provider ID: TPV12871-11 Gender: Male Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Chan, Stacey DMD Provider ID: TPVP128179-12 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Chan, Stacey DMD Provider ID: TPVP128179-40 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Provider ID: TPVP44028-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Chasko Jr., Joseph DDS Provider ID: TPVP44028-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Chou, Victor DMD Provider ID: TPVP149085-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Chou, Victor DMD Provider ID: TPVP149085-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Cocchieri, Richard DDS Provider ID: TPVP36034-02 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Cocchieri, Richard DDS Provider ID: TPVP36034-03 Gender: Male Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No Cocchieri, Richard DDS Provider ID: TPVP36034-05 Gender: Male Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 463

Cocchieri, Richard DDS Provider ID: TPVP36034-07 Gender: Male Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Colon, Agdha DDS Provider ID: TPV17219-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Colon, Agdha DDS Provider ID: TPV17219-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Contreras, Philip DDS Provider ID: TPV14550-01 Gender: Male Philip Contreras 1251 Ariana St Lakeland, FL 33803 (863) 688-9884 Fax: (863) 683-7667 00 Yrs/99 Yrs M-TH 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Cooper, Angela DDS Cooper, Angela DDS Provider ID: TPV13255-03 Gender: Female Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Cooper, Angela DDS Provider ID: TPV13255-07 Gender: Female Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Cooper, Angela DDS Provider ID: TPV13255-14 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Cooper, Angela DDS Provider ID: TPV13255-15 Gender: Female Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: Spanish, French M-W 7:30 AM - 5:30 PM PCMH: No

Provider ID: TPV13255-16 Gender: Female Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Correal, Juliana DMD Provider ID: TPV19357-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Correal, Juliana DMD Provider ID: TPV19357-68 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Coughlin, Lauren DMD Provider ID: TPVP155479-09 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Coughlin, Lauren DMD Provider ID: TPVP155479-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Daccache, Danny DDS Provider ID: TPV14554-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 464

Daccache, Danny DDS Provider ID: TPV14554-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Dacunha, Andrew DMD Provider ID: TPVP131668-09 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Dacunha, Andrew DMD Provider ID: TPVP131668-12 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. DO, Tutrinh DMD Davidson, Timothy DMD Provider ID: TPVP156861-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Davidson, Timothy DMD Provider ID: TPVP156861-37 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No DO, Tutrinh DMD Provider ID: TPVP145627-33 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP145627-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Doherty, Nicole DDS Provider ID: TPV15963-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Doherty, Nicole DDS Provider ID: TPV15963-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Earnhardt, Charles DDS Provider ID: TPV18116-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Ebner, Stephen DDS Provider ID: TPVP123775-04 Gender: Male Doh - Polk County Health Department 1805 Hobbs Rd Auburndale, FL 33823 (863) 965-6333 Fax: (863) 968-5096 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ebner, Stephen DDS Provider ID: TPVP123775-05 Gender: Male Doh - Polk County Health Department 1700 Baker Ave East Haines City, FL 33844 (863) 421-3204 Fax: (863) 419-3497 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ebner, Stephen DDS Provider ID: TPVP123775-06 Gender: Male Doh - Polk County Health Department 2090 E Clower St Bartow, FL 33830 (863) 534-7258 Fax: (863) 534-7114 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 465

Ebner, Stephen DDS Provider ID: TPVP123775-07 Gender: Male Doh - Polk County Health Department 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2636 Fax: (863) 413-2747 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Edwards, Jesse DMD Provider ID: TPVP137747-31 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Edwards, Jesse DMD Provider ID: TPVP137747-36 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Feng, Connie DMD Farzaneh, Masoud DDS Provider ID: TPV13817-01 Gender: Male Mulberry Dental Care Inc 105 N Church Ave Mulberry, FL 33860 (863) 869-8888 Fax: (863) 869-8880 00 Yrs/99 Yrs M-TH 8:00 AM - 4:30 PM F 8:00 AM - 3:00 PM PCMH: No Fawcett, Ian DDS Provider ID: TPVP129745-01 Gender: Male Dental Associates of Bartow 2090 Flamingo Dr East Bartow, FL 33830 (863) 533-4444 Fax: (863) 519-4453 00 Yrs/99 Yrs Languages: Spanish M 8:00 AM - 5:00 PM TTH 9:00 AM - 6:00 PM W 7:00 AM - 1:00 PM F 8:00 AM - 1:00 PM PCMH: No Feng, Connie DMD Provider ID: TPVP145594-33 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP145594-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Ferreira, Stephanie DDS Provider ID: TPVP137939-31 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Ferreira, Stephanie DDS Provider ID: TPVP137939-36 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Fidy, Ramez DDS Provider ID: TPV19348-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Fidy, Ramez DDS Provider ID: TPV19348-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Franceschi, Marisa DDS Provider ID: TPV13763-03 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 466

Franceschi, Marisa DDS Provider ID: TPV13763-05 Gender: Female Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Franceschi, Marisa DDS Provider ID: TPV13763-07 Gender: Female Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Freeman, Michael DDS Provider ID: TPVP138002-31 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Gallagher, Megan DMD Freeman, Michael DDS Provider ID: TPVP138002-36 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Gabel, James DDS Provider ID: TPV7257-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Gabel, James DDS Provider ID: TPV7257-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Provider ID: TPVP156277-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Gallagher, Megan DMD Provider ID: TPVP156277-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Gannon, Robert DDS Provider ID: TPVP145859-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Gannon, Robert DDS Provider ID: TPVP145859-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Garcia, Maritza DDS Provider ID: TPVP127988-32 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Garcia, Maritza DDS Provider ID: TPVP127988-37 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 467

Gollob, Harrison DDS Provider ID: TPVP131960-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Gollob, Harrison DDS Provider ID: TPVP131960-24 Gender: Male Greenberg Dental - Poinciana 1096 Cypress Pkwy Kissimmee, FL 34759 (407) 933-8222 Fax: (407) 933-6964 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 7:00 PM F 7:00 AM - 3:00 PM PCMH: No Gollob, Harrison DDS Provider ID: TPVP131960-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Gomara, Denise DDS Golomb, Alyson DMD Provider ID: TPVP123548-32 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Golomb, Alyson DMD Provider ID: TPVP123548-37 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Gomara, Denise DDS Provider ID: TPVP42496-02 Gender: Female Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Provider ID: TPVP42496-04 Gender: Female Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Gomara, Denise DDS Provider ID: TPVP42496-06 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Gomara, Denise DDS Provider ID: TPVP42496-07 Gender: Female Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No Gomara, Denise DDS Provider ID: TPVP42496-08 Gender: Female Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gonzalez, Lisset DDS Provider ID: TPVP153406-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Gonzalez, Lisset DDS Provider ID: TPVP153406-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Goodwin, Aaron DMD Provider ID: TPVP155473-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 468

Goodwin, Aaron DMD Provider ID: TPVP155473-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Greenberg, Andrew DDS Provider ID: TPV7501-65 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Greenberg, Andrew DDS Provider ID: TPV7501-72 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Holzman, William DDS Guarnieri, Sam DDS Provider ID: TPV16969-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP159196-14 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Guarnieri, Sam DDS Provider ID: TPV16969-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Howard, Belisa DMD Provider ID: TPV19150-52 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Holzman, William DDS Provider ID: TPVP159196-11 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Hua, Yang DDS Provider ID: TPVP148395-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Hua, Yang DDS Provider ID: TPVP148395-37 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Kamat, Amit DDS Provider ID: TPV18557-68 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Johnson, Jonathan DDS Provider ID: TPV18142-19 Gender: Male Children and Teen Group of Florida 225 Imperial Blvd Lakeland, FL 33803 (863) 644-4739 Fax: (863) 644-1333 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Kasem, Shovon DDS Provider ID: TPVP130870-32 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Kamat, Amit DDS Provider ID: TPV18557-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 469

Kasem, Shovon DDS Provider ID: TPVP130870-37 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Lazar, Adam DDS Katsur, Justin DDS Provider ID: TPV16372-82 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Koren, Daniel DMD Provider ID: TPV17175-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Koren, Daniel DMD Provider ID: TPV17175-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Provider ID: TPV19831-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Lazar, Adam DDS Provider ID: TPV19831-68 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Le, Nhu DMD Provider ID: TPVP137102-31 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Le, Nhu DMD Provider ID: TPVP137102-36 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Le, Nhu DDS Provider ID: TPVP140218-01 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Leung, Melanie DDS Provider ID: TPVP160139-01 Gender: Female Walding Associates 444 W Pipkin Rd Lakeland, FL 33813 (863) 619-6600 Fax: (863) 619-6644 00 Yrs/99 Yrs Languages: Spanish MTTH 7:30 AM - 5:00 PM W 7:30 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 470

Lombana-Cano, Edward DDS Provider ID: TPV19947-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Lombana-Cano, Edward DDS Provider ID: TPV19947-68 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Mantel, David DDS Provider ID: TPVP147883-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Marti Bagfasarov, Anjelika Mantel, David DDS Provider ID: TPVP147883-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Marin Jimenez, Laura DDS Provider ID: TPVP149944-33 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Marin Jimenez, Laura DDS Provider ID: TPVP149944-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

DDS Provider ID: TPVP156868-01 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No Marti Bagfasarov, Anjelika DDS Provider ID: TPVP156868-02 Gender: Female Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McKenzie, Karen DDS Provider ID: TPV18154-01 Gender: Female Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No McKenzie, Karen DDS Provider ID: TPV18154-05 Gender: Female Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

McKenzie, Karen DDS Provider ID: TPV18154-09 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

Mora, Viviana DMD Provider ID: TPVP147325-09 Gender: Female Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

McKenzie, Karen DDS Provider ID: TPV18154-10 Gender: Female Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No

Mora, Viviana DMD Provider ID: TPVP147325-10 Gender: Female Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No

McKenzie, Karen DDS Provider ID: TPV18154-11 Gender: Female Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Nasseri, Sanaz DMD Provider ID: TPVP137756-30 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Mora, Viviana DMD Provider ID: TPVP147325-01 Gender: Female Coast Dental - South Lakeland 4744 S Florida Ave Lakeland, FL 33813 (863) 644-1226 Fax: (863) 644-3756 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 471

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Nguyen, Dzung DDS Nasseri, Sanaz DMD Provider ID: TPVP137756-35 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Nguyen, Duy DDS Provider ID: TPVP44031-45 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Nguyen, Duy DDS Provider ID: TPVP44031-50 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Provider ID: TPV14906-35 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Nguyen, Dzung DDS Provider ID: TPV14906-40 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Nguyen, Hoang DMD Provider ID: TPVP127348-32 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Nguyen, Hoang DMD Provider ID: TPVP127348-37 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Nunez, Erick DDS Provider ID: TPV17439-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Nunez, Erick DDS Provider ID: TPV17439-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 472

Ortiz-Pimentel, Edgar DMD Provider ID: TPVP164680-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Patel, Janisha DDS Provider ID: TPVP137940-31 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Patel, Janisha DDS Provider ID: TPVP137940-36 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Patel, Ripal DDS Patel, Janisha DDS Provider ID: TPVP140120-01 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Patel, Kinjalben DMD Provider ID: TPVP137746-49 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Patel, Ripal DDS Provider ID: TPV19097-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPV19097-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Patel, Yesha DMD Provider ID: TPVP155477-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Patel, Yesha DMD Provider ID: TPVP155477-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Penland, Edina DMD Provider ID: TPVP155466-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Penland, Edina DMD Provider ID: TPVP155466-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Pham, Quyen DMD Provider ID: TPVP153400-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 473

Pham, Quyen DMD Provider ID: TPVP153400-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Priemer, Ryan DMD Provider ID: TPVP155616-09 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Raffoul, Georges DMD Provider ID: TPVP156867-02 Gender: Male Coast Dental - South Lakeland 4744 S Florida Ave Lakeland, FL 33813 (863) 644-1226 Fax: (863) 644-3756 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Rivera, Abneris DDS Raju, Stevy DMD Provider ID: TPVP147447-02 Gender: Male Children and Teen Group of Florida 225 Imperial Blvd Lakeland, FL 33803 (863) 644-4739 Fax: (863) 644-1333 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Reyes, Monika DMD Provider ID: TPVP138459-33 Gender: Female Dental View 814 Spring Lake Square Winter Haven, FL 33881 (863) 268-2300 Fax: (863) 268-2399 00 Yrs/99 Yrs Languages: Polish M-F 11:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Rivera, Abneris DDS Provider ID: TPVP131126-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPVP131126-37 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Rizziello, Derrick DDS Provider ID: TPVP134891-32 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Rizziello, Derrick DDS Provider ID: TPVP134891-37 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Rodriguez, Ana DDS Provider ID: TPVP123797-01 Gender: Female Doh - Polk County Health Department 1805 Hobbs Rd Auburndale, FL 33823 (863) 965-6333 Fax: (863) 968-5096 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Ana DDS Provider ID: TPVP123797-02 Gender: Female Doh - Polk County Health Department 1700 Baker Ave East Haines City, FL 33844 (863) 421-3204 Fax: (863) 419-3497 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Ana DDS Provider ID: TPVP123797-03 Gender: Female Doh - Polk County Health Department 2090 E Clower St Bartow, FL 33830 (863) 534-7258 Fax: (863) 534-7114 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Rodriguez, Ana DDS Provider ID: TPVP123797-04 Gender: Female Doh - Polk County Health Department 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2636 Fax: (863) 413-2747 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 474

Romero- Quevedo, Margarita DDS Provider ID: TPVP150232-33 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Romero- Quevedo, Margarita DDS Provider ID: TPVP150232-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Rosario, Jesse DMD Provider ID: TPVP137714-31 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Rumbel, Richard DDS Rosario, Jesse DMD Provider ID: TPVP137714-36 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Rumbel, Richard DDS Provider ID: TPV11518-01 Gender: Male Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No Rumbel, Richard DDS Provider ID: TPV11518-05 Gender: Male Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Provider ID: TPV11518-09 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

Santos, Luis DMD Provider ID: TPVP127430-10 Gender: Male Doh - Polk County Health Department 1700 Baker Ave East Haines City, FL 33844 (863) 421-3204 Fax: (863) 419-3497 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-05 Gender: Male Central Florida Health Care 305 W Central Ave Lake Wales, FL 33853 (863) 855-9718 Fax: (863) 678-4399 00 Yrs/99 Yrs Languages: Spanish M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Rumbel, Richard DDS Provider ID: TPV11518-10 Gender: Male Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No

Santos, Luis DMD Provider ID: TPVP127430-11 Gender: Male Doh - Polk County Health Department 2090 E Clower St Bartow, FL 33830 (863) 534-7258 Fax: (863) 534-7114 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-07 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4294 00 Yrs/99 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM PCMH: No

Rumbel, Richard DDS Provider ID: TPV11518-11 Gender: Male Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Santos, Luis DMD Provider ID: TPVP127430-12 Gender: Male Doh - Polk County Health Department 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2636 Fax: (863) 413-2747 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-08 Gender: Male Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/99 Yrs Languages: French M-W 7:30 AM - 5:30 PM PCMH: No

Santos, Luis DMD Provider ID: TPVP127430-09 Gender: Male Doh - Polk County Health Department 1805 Hobbs Rd Auburndale, FL 33823 (863) 965-6333 Fax: (863) 968-5096 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-03 Gender: Male Central Florida Health Care 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-8574 00 Yrs/99 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM PCMH: No

Seifert, Thomas DDS Provider ID: TPV6990-09 Gender: Male Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7996 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 475

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Shafii, Fariba DDS Seoane, Andres DMD Provider ID: TPVP145411-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Seoane, Andres DMD Provider ID: TPVP145411-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Serrano, Yahaira DDS Provider ID: TPV18429-64 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPV13663-01 Gender: Female Mulberry Dental Care Inc 105 N Church Ave Mulberry, FL 33860 (863) 869-8888 Fax: (863) 869-8880 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 4:30 PM F 8:00 AM - 3:00 PM PCMH: No Sider, Brian DDS Provider ID: TPV19541-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Smillie, Joseph DMD Provider ID: TPVP147132-25 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Smillie, Joseph DMD Provider ID: TPVP147132-53 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Suri, Niki DDS Provider ID: TPVP129517-32 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Suri, Niki DDS Provider ID: TPVP129517-37 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 476

Tran, Faye DDS Provider ID: TPV19334-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Tran, Faye DDS Provider ID: TPV19334-68 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Tran, Ivy DMD Provider ID: TPVP156562-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Varela, Monica DDS Tran, Ivy DMD Provider ID: TPVP156562-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Van, Tim DMD Provider ID: TPVP156786-10 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Van, Tim DMD Provider ID: TPVP156786-53 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Provider ID: TPV19700-63 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Varela, Monica DDS Provider ID: TPV19700-66 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Vasquez, Kristine DMD Provider ID: TPVP145180-33 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Vasquez, Kristine DMD Provider ID: TPVP145180-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Voaonsri, Nopparat DMD Provider ID: TPVP156791-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Voaonsri, Nopparat DMD Provider ID: TPVP156791-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

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Vu, Clara DMD Provider ID: TPVP153365-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Vu, Clara DMD Provider ID: TPVP153365-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Walding III, Stephen DMD Provider ID: TPVP42791-01 Gender: Male Walding Associates 444 W Pipkin Rd Lakeland, FL 33813 (863) 619-6600 Fax: (863) 619-6644 00 Yrs/99 Yrs Languages: Spanish MTTH 7:30 AM - 5:00 PM W 7:30 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Dentistry - cont. Ward, Michael DDS Walker, Aaron DDS Provider ID: TPV19575-63 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Walker, Aaron DDS Provider ID: TPV19575-68 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Ward, Michael DDS Provider ID: TPV12570-64 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Provider ID: TPV12570-69 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Yu, Lina DMD Provider ID: TPVP153383-10 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Yu, Lina DMD Provider ID: TPVP153383-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

General Practice Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc Du 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc Fr 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:00 AM - 6:00 PM F 7:00 AM - 5:30 PM PCMH: No Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc LA 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

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Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc LA 601 S Florida Ave Ste 6 Lakeland, FL 33801 (863) 688-0841 Fax: (863) 616-9709 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-F 8:00 AM - 5:00 PM PCMH: No Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc Mu 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Aime Celian, Beatrice MD Provider ID: 1356327 Gender: Female Central Florida Health Care Inc Wi 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs Languages: Spanish, French, Creole M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Surgery Altaras, Rona MD Provider ID: 1163613 Gender: Male Lakeland Regional Health 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1321 Fax: (863) 284-1730 00 Yrs/130 Yrs Languages: French, German M-F 8:00 AM - 5:00 PM PCMH: No

Coughlin, John MD Provider ID: 5639 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Pediatric Surgery Center LLC Odessa M-F 9:00 AM - 5:00 PM PCMH: No

Barrios, Juan MD Provider ID: 497663 Gender: Male Lakeland Regional Medical Center 3030 Harden Blvd Ste 108 Lakeland, FL 33803 (863) 284-1700 Fax: (863) 284-1728 02 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM PCMH: No

Dicicco, Richard MD Provider ID: 648444 Gender: Male Greater Tampa Bay Physician Special 2304 Lakeland Hills Blvd Lakeland, FL 33805 (813) 877-6000 Fax: (813) 877-6002 12 Yrs/130 Yrs Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Carifi, Vincent MD Provider ID: 2598 Gender: Male Haines City Hma Physician Managemen 171 Webb Dr Ste 1 Davenport, FL 33837 (863) 421-7276 Fax: (863) 421-7109 12 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Carifi, Vincent MD Provider ID: 2598 Gender: Male Haines City Hma Physician Managemen 40124 Hwy 27 Ste 205 Davenport, FL 33837 (407) 498-3763 Fax: (407) 498-3791 12 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No

Durham, Rodney MD Provider ID: 938087 Gender: Male Lakeland Regional Surgery Associate 1629 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1259 Fax: (863) 284-1786 16 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fridley, Donald DO Provider ID: 1272064 Gender: Male Baycare Medical Group Inc 2000 Osprey Blvd Ste 110 Bartow, FL 33830 (863) 519-1799 Fax: (863) 519-1798 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Fridley, Donald DO Provider ID: 1272064 Gender: Male Baycare Medical Group Inc 7599 Cypress Gardens Blvd Winter Haven, FL 33884 (863) 324-4725 Fax: (863) 324-4783 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Gaugler, Andrew DO Provider ID: 1265962 Gender: Male Lakeland Regional Health Syste 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Gaugler, Andrew DO Provider ID: 1265962 Gender: Male Lakeland Regional Health Syste 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1321 Fax: (863) 687-1730 00 Yrs/130 Yrs PCMH: No Hart, Hugo MD Provider ID: 1120052 Gender: Male Vascular Center of Orlando PA 121 Webb Dr Ste 300 Davenport, FL 33837 (863) 291-6313 Fax: (863) 421-4687 00 Yrs/130 Yrs Florida Hospital Orlando M-F 8:00 AM - 5:00 PM PCMH: No

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Howard III, Fred MD Provider ID: 529675 Gender: Male Lake Wales Clinic Corp 1120 Carlton Ave Ste 1100 Lake Wales, FL 33853 (863) 679-1986 Fax: (863) 379-6307 00 Yrs/130 Yrs Lake Wales Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Howard III, Fred MD Provider ID: 529675 Gender: Male Lake Wales Clinic Corp 407 S 11th St Lake Wales, FL 33853 (863) 676-0852 Fax: (863) 679-7832 00 Yrs/130 Yrs Lake Wales Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Ismail, Sajid DO Provider ID: 1355809 Gender: Male Heart and Vascular Institute of Flo 1110 Druid Cir Ste A Lake Wales, FL 33853 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Ismail, Sajid DO Provider ID: 1355809 Gender: Male Heart and Vascular Institute of Flo 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Surgery - cont. Ismail, Sajid DO Provider ID: 1355809 Gender: Male Heart and Vascular Institute of Flo 405 Lionel Way Davenport, FL 33837 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Jean Pierre, P Jacques MD Provider ID: 1212750 Gender: Male Lakeland Regional Health Systems, I 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Meyer, Christopher MD Provider ID: 244505 Gender: Male Lake Wales Clinic Corp 1120 Carlton Ave Ste 1500 Lake Wales, FL 33853 (863) 679-2707 Fax: (863) 676-3621 16 Yrs/130 Yrs Lake Wales Medical Center M-F 8:00 AM - 4:30 PM PCMH: No Meyer, Christopher MD Provider ID: 910537 Gender: Male Florida Vien Care Specialists LLC 22411 US Hwy 27 Ste A Lake Wales, FL 33859 (321) 252-0327 Fax: (863) 215-7085 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Ochotorena Garrovillo, Mel MD Provider ID: 304335 Gender: Male Garrovillo Surgical Care LLC 425 S 11th St Ste 1 Lake Wales, FL 33853 (863) 421-5216 Fax: (863) 422-8476 00 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Languages: Tagalog M 9:00 AM - 3:00 PM PCMH: No Ochotorena Garrovillo, Mel MD Provider ID: 304335 Gender: Male Garrovillo Surgical Care LLC 101 Park Place Blvd Ste C Davenport, FL 33837 (863) 421-5216 Fax: (863) 422-8476 00 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Languages: Tagalog M-TH 9:00 AM - 4:00 PM F 9:00 AM - 3:00 PM PCMH: No Patel, Seema MD Provider ID: 1259207 Gender: Female Lakeland Regional Medical System 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Patel, Seema MD Provider ID: 1259207 Gender: Female Lakeland Regional Medical System 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1321 Fax: (863) 284-1730 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Quinones, Rafael MD

Rajaram, Perumalswamy MD Provider ID: 1311447 Gender: Female Heart of Florida Reg Med Center 40124 Hwy 27 Ste 104 Davenport, FL 33837 (863) 421-7626 Fax: (863) 419-2422 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Seetahal, Shiva MD

Provider ID: 1167882 Gender: Male Bartow Regional Medical Center 4729 US Hwy 98 S Ste 101 Lakeland, FL 33812 (863) 701-2053 Fax: (863) 646-5834 18 Yrs/130 Yrs Bartow Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Quinones, Rafael MD Provider ID: 551236 Gender: Male Southpoint Medical Group 4729 US Hwy 98 S Ste 101 Lakeland, FL 33812 (863) 701-2053 Fax: (863) 646-5834 00 Yrs/130 Yrs Bartow Regional Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Provider ID: 1310272 Gender: Male Heart of Florida Physician Group 40124 Hwy 27 Ste 104 Davenport, FL 33837 (863) 421-7626 Fax: (863) 419-2422 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Seoane, Debra MD Provider ID: 292019 Gender: Female Lakeland Regional Medical Center 1629 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1259 Fax: (863) 284-1786 03 Yrs/130 Yrs Lakeland Reg Medical Center M-TH 9:00 AM - 3:30 PM PCMH: No Silvestri, Fred MD Provider ID: 1150452 Gender: Male General, Vascular, and Thoracic Sur 1120 Carlton Ave Ste 1500 Lake Wales, FL 33853 (863) 679-2707 Fax: (863) 676-3621 18 Yrs/130 Yrs Lake Wales Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk General Surgery - cont. Silvestri, Fred MD Provider ID: 1150452 Gender: Male Lake Wales Clinic Corp 407 S 11th St Lake Wales, FL 33853 (860) 679-0852 Fax: (863) 679-7832 18 Yrs/130 Yrs Lake Wales Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Sinclair, Karlene MD Provider ID: 225644 Gender: Female Sinclair Surgical PA 131 Webb Dr Ste B Davenport, FL 33837 (863) 421-4407 Fax: (863) 422-2888 00 Yrs/130 Yrs Heart of Florida Reg Med Center ORHS-South Lake Hospital M-F 8:30 AM - 4:30 PM PCMH: No Skarda, Janet MD Provider ID: 288960 Gender: Female Lakeland Regional Medical Center 3030 Harden Blvd Ste 108 Lakeland, FL 33803 (863) 284-1700 Fax: (863) 284-1728 03 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Sobowale, Olumide MD Provider ID: 297899 Gender: Male Lakeland Regional Medical Center 1629 Lakeland Hills Blvd Lakeland, FL 33805 (863) 284-1716 Fax: (863) 284-1786 03 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 3:30 PM PCMH: No Sontchi, Richard MD Provider ID: 1361060 Gender: Male Lakeland Regional Health 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sontchi, Richard MD Provider ID: 1361060 Gender: Male Lakeland Regional Medical Center 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1321 Fax: (863) 284-1730 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Wall, Ward MD Provider ID: 240101 Gender: Male Lakeland Regional Medical Center 1629 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1259 Fax: (863) 284-1786 03 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 3:30 PM PCMH: No

Gynecological Oncology Hlalah, Osama MD Boothby, Richard MD Provider ID: 226751 Gender: Male Lakeland Regional Health Systems Inc 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gynecology Bornstein, Ilan MD Provider ID: 1418075 Gender: Male Lake Wales Clinic Corp 11255 State Rd 60 E Lake Wales, FL 33853 (615) 778-8537 Fax: (615) 628-6877 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Hematology & Oncology Hlalah, Osama MD Provider ID: 516635 Gender: Male Bond Clinic PA 1342 SR 60 East Lake Wales, FL 33853 (863) 679-1552 Fax: (863) 293-3635 00 Yrs/130 Yrs Winter Haven Hospital Languages: Arabic M-F 8:00 AM - 5:00 PM PCMH: No

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Provider ID: 516635 Gender: Male Bond Clinic PA 500 E Central Ave Winter Haven, FL 33880 (863) 293-1191 Fax: (863) 293-3635 00 Yrs/130 Yrs Winter Haven Hospital Languages: Arabic M-F 8:00 AM - 5:00 PM PCMH: No Nakka, Sushma MD Provider ID: 462448 Gender: Female Lakeland Regional Health Systems Inc 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 02 Yrs/130 Yrs Languages: Spanish, Hindi M-F 8:00 AM - 5:00 PM PCMH: No

Infectious Disease Haight, Daniel MD Provider ID: 14438 Gender: Male Seen At Polk County Health Dept 1255 Brice Blvd Bartow, FL 33830 (863) 519-8233 Fax: (863) 519-8304 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Internal Medicine Bhashyam, Siva MD Provider ID: 1095324 Gender: Male Mid Florida Cardiovascular Center L 400 Ave K SE Ste 5 Winter Haven, FL 33880 (863) 269-0210 Fax: (888) 235-9876 18 Yrs/130 Yrs Florida Hospital Waterman Languages: Hindi, Telugu, Kannada M-F 8:00 AM - 5:00 PM PCMH: No Chauhan, Ketul MD Provider ID: 522583 Gender: Male Premier Heart and Vascular Center P 1417 Lakelnd Hls Blvd Ste 104 Lakeland, FL 33805 (863) 858-6666 Fax: (813) 788-7691 18 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Carrollwood Florida Hospital Zephyrhills Languages: Hindi M 9:00 AM - 4:00 PM PCMH: No Heart, Rami DO Provider ID: 1297790 Gender: Male Heart and Vascular Plc 1110 Druid Cir Ste A Lake Wales, FL 33853 (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Heart, Rami DO Provider ID: 1297790 Gender: Male Heart and Vascular Plc 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Heart, Rami DO Provider ID: 1297790 Gender: Male Heart and Vascular Plc 405 Lionel Way Davenport, FL 33837 (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Ismail, Imran DO Provider ID: 752241 Gender: Male Heart and Vascular Institute of Flo 325 Ave B NW Winter Haven, FL 33881 (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ismail, Imran DO Provider ID: 752241 Gender: Male Heart and Vascular Institute of Flo 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Khadim, Ghazanfar MD Provider ID: 456632 Ismail, Imran DO Gender: Male Provider ID: 752241 Florida Heart Institute Gender: Male 1500 Lakeland Hills Blvd Heart and Vascular Institute Lakeland, FL 33805 of Flo (813) 780-6687 405 Lionel Way Fax: (813) 788-6554 Davenport, FL 33837 18 Yrs/130 Yrs (863) 424-3278 Bayfront Health Dade City Fax: (863) 420-9701 Florida Hospital Zephyrhills 12 Yrs/130 Yrs South Florida Baptist Hospital M-F 9:00 AM - 5:00 PM Languages: Spanish, Chinese, PCMH: No Burmese MT 12:00 AM - 5:00 PM Soma, Vikas MD PCMH: No Provider ID: 1031058 Interventional Cardiology Gender: Male Premier Heart and Vascular Center P Ismail, Imran DO 1417 Lakelnd Hls Blvd Ste 104 Provider ID: 752241 Lakeland, FL 33805 Gender: Male (813) 788-1400 Heart and Vascular Institute Fax: (813) 788-7691 of Flo 18 Yrs/130 Yrs 1110 Druid Cir M-F 8:30 AM - 4:00 PM Lake Wales, FL 33853 PCMH: No (863) 424-3278 Fax: (863) 420-9701 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Maternal Fetal Medicine Baacke, Keri MD Provider ID: 1344794 Gender: Female Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 1234 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group of Florida 1234 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Maternal Fetal Medicine - Nirgudkar, Pranita MD cont. Provider ID: 1352153 Fry III, Alland MD Provider ID: 310079 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 1234 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kalter, Craig MD Provider ID: 6302 Gender: Male Pediatrix Medical Group of Florida 1234 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 12 Yrs/130 Yrs Florida Hospital Tampa M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Female Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/130 Yrs Languages: Hindi, Marathi M-F 9:00 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 1234 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Medical Oncology Avashia, Jaydev MD Provider ID: 1419284 Gender: Male Florida Cancer Specialists 2 State Rd 60 W Lake Wales, FL 33853 (863) 679-9000 Fax: (863) 679-9005 18 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Tamil M-F 8:00 AM - 5:00 PM PCMH: No

Avashia, Jaydev MD Provider ID: 1419284 Gender: Male Florida Cancer Specialists 339 Cypress Pkwy Ste 180 Kissimmee, FL 34759 (407) 933-1877 Fax: (407) 933-1817 18 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Tamil M-F 8:00 AM - 5:00 PM PCMH: No Avashia, Jaydev MD Provider ID: 1419284 Gender: Male Florida Cancer Specialists 40107 US Hwy 27 Ste 200 Davenport, FL 33837 (863) 421-9705 Fax: (863) 421-9779 18 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Tamil M-F 8:00 AM - 5:00 PM PCMH: No Haider, Kamal MD Provider ID: 8968 Gender: Male Lakeland Regional Health Systems In 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Lakeland Reg Medical Center Languages: Spanish, Urdu, Punjabi MT 10:30 AM - 5:00 PM PCMH: No

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Ross, Susan MD Provider ID: 22639 Gender: Female Central Florida Cancer Institute 2 SR 60 W Lake Wales, FL 33853 (863) 679-2960 Fax: (863) 679-2781 18 Yrs/130 Yrs Heart of Florida Reg Med Center Orlando Regional Medical Center Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No Ross, Susan MD Provider ID: 22639 Gender: Female Central Florida Cancer Institute 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 679-2960 Fax: (863) 293-8877 18 Yrs/130 Yrs Heart of Florida Reg Med Center Orlando Regional Medical Center Winter Haven Hospital M-F 9:00 AM - 5:00 PM PCMH: No Ross, Susan MD Provider ID: 22639 Gender: Female Central Florida Cancer Institute 40107 Hwy 27 Davenport, FL 33837 (863) 419-6092 Fax: (863) 419-1695 18 Yrs/130 Yrs Heart of Florida Reg Med Center Orlando Regional Medical Center Winter Haven Hospital M-F 8:00 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Medical Oncology - cont. Ross, Susan MD Ross, Susan MD Provider ID: 942691 Gender: Female Florida Cancer Specialists 2 State Rd 60 W Lake Wales, FL 33853 (407) 933-1877 Fax: (407) 933-1817 18 Yrs/130 Yrs Dr P Phillips Hospital Heart of Florida Reg Med Center Lake Wales Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Ross, Susan MD Provider ID: 942691 Gender: Female Ross Cancer Center 1255 State Rd 60 E Ste 300 Lake Wales, FL 33853 (407) 933-1877 Fax: (407) 933-1817 18 Yrs/130 Yrs Dr P Phillips Hospital Heart of Florida Reg Med Center Lake Wales Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Ross, Susan MD Provider ID: 942691 Gender: Female Ross Cancer Center 131 Patterson Rd Haines City, FL 33844 (407) 933-1877 Fax: (407) 933-1817 18 Yrs/130 Yrs Dr P Phillips Hospital Heart of Florida Reg Med Center Lake Wales Medical Center M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 942691 Gender: Female Ross Cancer Center 40107 Hwy 27 Davenport, FL 33837 (407) 933-1877 Fax: (407) 933-1817 18 Yrs/130 Yrs Dr P Phillips Hospital Heart of Florida Reg Med Center Lake Wales Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Sharma, Kamal DO Provider ID: 1226228 Gender: Female Baycare Medical Group Inc 200 Ave F NE Winter Haven, FL 33881 (863) 292-4670 Fax: (863) 292-4671 18 Yrs/130 Yrs Winter Haven Hospital M-F 9:00 AM - 5:00 PM PCMH: No Trindade, Antonio MD Provider ID: 792146 Gender: Male Lakeland Regional Health System Inc 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 18 Yrs/130 Yrs Florida Hospital Heartland Highlands Regional Medical Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Venigalla, Madhavi MD Provider ID: 413555 Gender: Female Lakeland Regional Caner Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6567 02 Yrs/130 Yrs Languages: Telugu M-F 8:00 AM - 5:00 PM PCMH: No

Neonatal Perinatal Medicine Chua, Caroline MD Provider ID: 750954 Gender: Female 40100 Hwy 27 Davenport, FL 33837 (863) 419-2399 00 Yrs/17 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No

Nephrology

Hou, Peng MD Provider ID: 463700 Gender: Male Bond Community Clinic 500 E Central Ave Winter Haven, FL 33880 (863) 293-1191 Fax: (863) 293-3635 18 Yrs/130 Yrs Winter Haven Hospital Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No Huynh, Bao-Chau MD Provider ID: 468082 Gender: Male Advanced Kidney Care of Central Flo 161 Webb Dr Ste 200 Davenport, FL 33837 (863) 226-4676 Fax: (888) 716-2003 18 Yrs/130 Yrs Heart of Florida Reg Med Center Orlando Regional Medical Center Languages: Vietnamese M-F 8:00 AM - 5:00 PM PCMH: No

Aguayo, Jose MD Larranaga, Jorge MD Provider ID: 192352 Provider ID: 1127047 Gender: Male Central Florida Kidney Care PA Gender: Male The Vascular Clinic and 1745 Lakeland Hills Blvd Cosmetic Ve Lakeland, FL 33805 106 Park Place Blvd Ste B (863) 688-0576 Davenport, FL 33837 Fax: (863) 686-5907 (407) 518-4982 18 Yrs/130 Yrs Fax: (407) 518-1748 Bartow Regional Medical 18 Yrs/130 Yrs Center Florida Hospital Orlando Lake Wales Medical Center Health Central Lakeland Reg Medical Center Orlando Regional Medical Languages: Spanish Center M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 484

Last update 08/14/2017

Specialty Physicians Polk Nephrology - cont. Larranaga, Jorge MD Provider ID: 1127047 Gender: Male The Vascular Clinic and Cosmetic Ve 107 Park Place Blvd Davenport, FL 33837 (407) 518-4982 Fax: (407) 518-1748 18 Yrs/130 Yrs Florida Hospital Orlando Health Central Orlando Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Larranaga, Jorge MD Provider ID: 1127047 Gender: Male The Vascular Clinic and Cosmetic Ve 294 Patterson Rd Haines City, FL 33844 (407) 518-4982 Fax: (407) 518-1748 18 Yrs/130 Yrs Florida Hospital Orlando Health Central Orlando Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Larranaga, Jorge MD Provider ID: 1127047 Gender: Male The Vascular Clinic and Cosmetic Ve 339 Cypress Pkwy Kissimmee, FL 34759 (407) 518-4982 Fax: (407) 518-1748 18 Yrs/130 Yrs Florida Hospital Orlando Health Central Orlando Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Maldonado-Colon, Bermily Hostler, T Richard MD Sallman, Alan MD MD Provider ID: 9605 Provider ID: 13345 Gender: Male Provider ID: 711050 Gender: Male Central Florida MRI Gender: Female Bond Community Clinic 180 Ave A SE Central Florida Kidney Care PA 500 E Central Ave Winter Haven, FL 33880 1745 Lakeland Hills Blvd Winter Haven, FL 33880 (863) 293-1101 Lakeland, FL 33805 (863) 293-1191 Fax: (863) 293-6106 (863) 688-0576 Fax: (863) 293-3635 00 Yrs/130 Yrs Fax: (863) 686-5907 16 Yrs/130 Yrs Heart of Florida Reg Med 18 Yrs/130 Yrs Winter Haven Hospital Center Bartow Regional Medical M-F 8:00 AM - 5:00 PM Winter Haven Hospital Center PCMH: No M-F 7:30 AM - 5:00 PM Lake Wales Medical Center Lakeland Reg Medical Center Vilches, Ricardo MD PCMH: No Languages: Spanish Provider ID: 814 Hostler, T Richard MD M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Central Florida Kidney Care PA Provider ID: 9605 Gender: Male 1745 Lakeland Hills Blvd Neurology and Nurosurgery McClendon, Michele DO Lakeland, FL 33805 Assoc PA Provider ID: 201658 (863) 688-0576 50 2nd St SE Gender: Female Fax: (863) 686-5907 Winter Haven, FL 33880 Bond Community Clinic 18 Yrs/130 Yrs (863) 293-2107 500 E Central Ave Bartow Regional Medical Fax: (863) 294-9314 Winter Haven, FL 33880 Center 00 Yrs/130 Yrs (863) 293-1191 Lake Wales Medical Center Heart of Florida Reg Med Lakeland Reg Medical Center Fax: (863) 293-3635 Center Languages: Spanish 18 Yrs/130 Yrs Winter Haven Hospital M-F 8:00 AM 5:00 PM Winter Haven Hospital M-F 7:30 AM - 5:00 PM PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Neurology Joy, Juan MD Navani, Anil MD Provider ID: 9604 Delgado, Alain MD Provider ID: 225826 Gender: Male Provider ID: 204141 Gender: Male Neurology and Nurosurgery Gender: Male Kidney and Hypertension Assoc PA Center Neurology and Nurosurgery 50 2nd St SE Assoc PA 104 Patterson Rd Winter Haven, FL 33880 50 2nd St SE Haines City, FL 33844 (863) 293-2107 Winter Haven, FL 33880 (321) 214-0028 Fax: (863) 294-9314 (863) 293-2107 Fax: (407) 429-3833 18 Yrs/130 Yrs Fax: (863) 294-9314 18 Yrs/130 Yrs Heart of Florida Reg Med 18 Yrs/130 Yrs Florida Hospital Orlando Center Heart of Florida Reg Med Languages: Spanish Lake Wales Medical Center Center M-F 7:30 AM - 5:00 PM Winter Haven Hospital Orlando Regional Medical PCMH: No Languages: Spanish Center M-F 7:30 AM - 5:00 PM M-F 8:30 AM - 5:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 485

Last update 08/14/2017

Specialty Physicians Polk Neurology - cont. Khara, Jaswinder MD Provider ID: 227997 Gender: Male Sebring Neurology Clinic PA 121 Webb Dr Davenport, FL 33837 (863) 353-2666 Fax: (863) 471-6762 18 Yrs/130 Yrs Highlands Regional Medical M 9:00 AM - 4:00 PM PCMH: No Morales, Allamm MD Provider ID: 859 Gender: Male Lakeland Regional Medical Center 1324 Lakeland Hills Blvd Lakeland, FL 33805 (352) 460-4587 Fax: (321) 953-3647 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Mousli, Hasan MD Provider ID: 1355846 Gender: Male Brain and Spine Sleep Institute LL 1120 Carlton Ave Ste 1300 Lake Wales, FL 33853 (863) 676-6383 Fax: (863) 676-3124 05 Yrs/130 Yrs Lake Wales Medical Center Languages: Arabic M-F 8:00 AM - 5:00 PM PCMH: No

Mousli, Hasan MD Provider ID: 1355846 Gender: Male Brain and Spine Sleep Institute LL 2250 Osprey Blvd Ste 108 Bartow, FL 33830 (863) 676-6386 Fax: (863) 676-3124 05 Yrs/130 Yrs Lake Wales Medical Center Languages: Arabic M-F 8:00 AM - 5:00 PM PCMH: No Qureshi, Mussarat MD Provider ID: 276542 Gender: Female Pediatric Neurology Center PA 5133 S Florida Ave Lakeland, FL 33813 (863) 687-1600 Fax: (863) 687-1688 00 Yrs/18 Yrs Lakeland Reg Medical Center Languages: Urdu M-F 8:30 AM - 4:30 PM PCMH: No Riaz, Shahid MD Provider ID: 220244 Gender: Male Neurodiagnostic Center of Cntrl Florida PA 40124 Hwy 27 Ste 204 Davenport, FL 33837 (863) 421-4700 Fax: (863) 421-4715 18 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No

Neuro-Oncology Ebrahim, Hassan MD Provider ID: 1204844 Gender: Male 200 Ave F NE Winter Haven, FL 33881 (863) 292-4670 Fax: (863) 292-4671 18 Yrs/130 Yrs Winter Haven Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Neurosurgery Amann, John MD Provider ID: 9606 Gender: Male Neurology and Nurosurgery Assoc PA 50 2nd St SE Winter Haven, FL 33880 (863) 293-2107 Fax: (863) 294-9314 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lakeland Reg Medical Center Winter Haven Hospital M-F 7:30 AM - 5:00 PM PCMH: No Campanelli, Michael DO Provider ID: 373453 Gender: Male 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 486

Campanelli, Michael DO Provider ID: 373453 Gender: Male Lakeland Regional Medical Center 1325 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6542 Fax: (863) 603-6529 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Field, Melvin MD Provider ID: 1129778 Gender: Male Orlando Neurosurgery 500 E Central Ave Winter Haven, FL 33880 (407) 425-7470 Fax: (407) 425-7470 12 Yrs/130 Yrs M 9:00 AM - 1:00 PM PCMH: No Lau, Tsz MD Provider ID: 787069 Gender: Male USF Physicians Group 1325 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6542 Fax: (863) 603-6529 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Chinese M-F 8:00 AM - 5:00 PM PCMH: No Torres Gluck, Jose MD Provider ID: 752140 Gender: Male 1325 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6542 Fax: (863) 603-6529 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics Alvarez, Pedro MD Provider ID: 2630 Gender: Male Womens Care Florida LLC 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 577-1949 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Alvarez, Pedro MD Provider ID: 2630 Gender: Male Womens Care Florida LLC 1733 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 577-1949 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Damian, Gracia MD Provider ID: 2949 Gender: Female Womens Care Florida LLC 1733 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 688-8423 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Damian, Gracia MD Provider ID: 373911 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 Fax: (863) 940-2897 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

McEndree, Terri MD Provider ID: 225232 Gender: Female Womens Care Florida LLC 1733 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 577-1949 12 Yrs/130 Yrs Florida Hospital Zephyrhills Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Nixon, Jennifer MD Provider ID: 221076 Martino-Villanueva, Maria MD Gender: Female Womens Care Florida LLC 1729 Lakeland Hills Blvd Provider ID: 623384 Lakeland, FL 33805 Gender: Female (863) 688-1528 Womens Care Florida LLC Fax: (863) 577-1949 1729 Lakeland Hills Blvd 12 Yrs/130 Yrs Lakeland, FL 33805 Lakeland Reg Medical Center (863) 688-1528 M-F 9:00 AM - 5:00 PM Fax: (863) 577-1949 PCMH: No 12 Yrs/130 Yrs Lakeland Reg Medical Center Nixon, Jennifer MD M-F 9:00 AM - 5:00 PM Provider ID: 221076 PCMH: No Gender: Female Martino-Villanueva, Maria MD Womens Care Florida LLC 1733 Lakeland Hills Blvd Lakeland, FL 33805 Provider ID: 623384 (863) 688-1528 Gender: Female Fax: (863) 577-1949 Womens Care Florida LLC 12 Yrs/130 Yrs 1733 Lakeland Hills Blvd Lakeland Reg Medical Center Lakeland, FL 33805 M-F 9:00 AM - 5:00 PM (813) 688-1528 PCMH: No Fax: (863) 577-1949 12 Yrs/130 Yrs Lakeland Reg Medical Center Puretz, Jeffrey MD Provider ID: 2632 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No Womens Care Florida LLC 1729 Lakeland Hills Blvd McEndree, Terri MD Lakeland, FL 33805 Provider ID: 225232 (863) 688-1528 Gender: Female Fax: (863) 577-1949 Womens Care Florida LLC 12 Yrs/130 Yrs 1729 Lakeland Hills Blvd Lakeland Reg Medical Center Lakeland, FL 33805 M-F 9:00 AM - 5:00 PM (863) 688-1528 PCMH: No Fax: (863) 577-1949 12 Yrs/130 Yrs Florida Hospital Zephyrhills Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 487

Puretz, Jeffrey MD Provider ID: 2632 Gender: Male Womens Care Florida LLC 1733 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 577-1949 12 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Obstetrics/Gynecology Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Aksu, Ahmet MD Provider ID: 817803 Gender: Male Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Brandon Surgery Center Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Alvarez, Pedro MD cont. Provider ID: 373893 Alkass, Mark MD Provider ID: 17268 Gender: Male Heart of Florida OB/GYN Association 220 Ave O SE Winter Haven, FL 33880 (863) 421-7600 Fax: (863) 288-2894 12 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Amb Surgical Center MWTHF 9:00 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Alkass, Mark MD Provider ID: 17268 Gender: Male Heart of Florida OB/GYN Association 2221 North Blvd W Davenport, FL 33837 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Amb Surgical Center M-F 8:00 AM - 5:00 PM PCMH: No Alkass, Mark MD Provider ID: 17268 Gender: Male Heart of Florida OB/GYN Association 421 Linden Ln Lake Wales, FL 33853 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Amb Surgical Center M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Andah, Edmund MD Provider ID: 365468 Gender: Male Heart of Florida OB-GYN Associ 1001 State Rd 60 E Lake Wales, FL 33853 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center M 9:00 AM - 5:00 PM T 1:00 AM - 5:00 PM PCMH: No Andah, Edmund MD Provider ID: 365468 Gender: Male Heart of Florida OB-GYN Associ 220 Ave O SE Winter Haven, FL 33880 (863) 288-2889 Fax: (863) 288-2894 12 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No

Andah, Edmund MD Provider ID: 365468 Gender: Male Heart of Florida OB-GYN Associ 2221 North Blvd W Davenport, FL 33837 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Baldwin, Melisha MD Provider ID: 655231 Gender: Female Tampa Obstetrics PA 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Best, Erin MD Provider ID: 795193 Gender: Female 916 Hwy 542 Dundee, FL 33838 (863) 419-3333 Fax: (863) 419-3249 05 Yrs/130 Yrs Languages: Hindi, Arabic M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:00 PM PCMH: No Best, Erin MD Provider ID: 795193 Gender: Female Central Florida Health Care Inc 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 05 Yrs/130 Yrs Languages: Hindi, Arabic M-F 9:00 AM - 5:00 PM PCMH: No

Best, Erin MD Provider ID: 795193 Gender: Female Bazley, Robert MD Central Florida Health Care, Provider ID: 1196777 Inc Gender: Male 201 Magnolia Ave SW Florida Department of Health Winter Haven, FL 33880 In Pol (863) 291-5111 3241 Lakeland Hills Blvd Fax: (863) 299-7999 Lakeland, FL 33805 05 Yrs/130 Yrs (863) 413-2620 Languages: Hindi, Arabic Fax: (863) 499-2612 M-F 7:30 AM - 6:00 PM 18 Yrs/130 Yrs PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Betancourt, Fernando MD Best, Erin MD Provider ID: 795193 Gender: Female 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 05 Yrs/130 Yrs Languages: Hindi, Arabic M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 488

Provider ID: 900198 Gender: Male Lakeland Womens Health Center Inc 4444 S Florida Ave Lakeland, FL 33813 (863) 644-7541 Fax: (863) 646-4308 12 Yrs/130 Yrs Lee Memorial Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Denardis, Michael DO cont. Provider ID: 439499 Branch, Mia MD Provider ID: 1310816 Gender: Female Haines City Hma Physician Managemen 410 Lionel Way Davenport, FL 33837 (863) 419-2420 Fax: (863) 419-2429 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Cain, Mary MD Provider ID: 678053 Gender: Female USF Physicians Group 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2620 Fax: (863) 413-3640 00 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Clarke, Cheryl MD Provider ID: 1364948 Gender: Female Central Florida Health Care, Inc. 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 229-7950 Fax: (863) 229-7999 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Gender: Male Mid Florida OB GYN Hospitalist 200 Ave F NE Winter Haven, FL 33881 (863) 297-1899 Fax: (863) 297-1867 00 Yrs/130 Yrs Osceola Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Denardis, Michael DO Provider ID: 439499 Gender: Male Poinciana Womens Health Center 1018 Cypress Pkwy Kissimmee, FL 34759 (407) 518-1074 Fax: (407) 279-5617 00 Yrs/130 Yrs Osceola Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Duke II, Billy MD Provider ID: 512792 Gender: Male Winter Haven Hospital OB/ GYN Physici 101 Ave O SE The Regency Center Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 12 Yrs/130 Yrs Lakeland Reg Medical Center Winter Haven Hospital MTWTHFSatSun 7:00 AM 7:00 PM PCMH: No

Edwards, Eric MD Provider ID: 1356319 Gender: Male Tampa Obstetrics PA Exodus Womens 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 654-2273 Fax: (813) 413-8563 16 Yrs/130 Yrs Florida Hospital Orlando Orlando Regional Medical Center M-F 8:00 AM - 5:30 PM PCMH: No Ericsson, Dawn MD Provider ID: 540647 Gender: Female Exodus Women's Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2229 Fax: (813) 654-1384 05 Yrs/130 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:30 PM PCMH: No Fanarjian, Nicole MD Provider ID: 985158 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM PCMH: No

www.wellcare.com/Florida | 489

Felski, Emil DO Provider ID: 1229396 Gender: Male Planned Parenthood of Southwest and 2250 E Edgewood Dr Lakeland, FL 33803 (407) 677-1234 Fax: (407) 677-1001 12 Yrs/130 Yrs M-F 8:45 AM - 4:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Haddox, Linda MD Provider ID: 911164 Gender: Female Winter Haven Hospital OB/ GYN Physici 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 02 Yrs/130 Yrs Florida Hospital Memorial Medical Center Halifax Hospital Medical Center MTTHF 8:00 AM - 5:00 PM W 8:00 AM - 7:00 PM PCMH: No Hechtman, Jill MD Provider ID: 274423 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (863) 687-2229 Fax: (813) 654-1384 00 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Jones, Kurt MD cont. Provider ID: 1124806 Hechtman, Jill MD Provider ID: 274805 Gender: Female Tampa Obstetrics PA 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:30 PM PCMH: No Jackson, Darwin MD Provider ID: 807109 Gender: Male Lakeland Womens Health Center Inc 4444 S Florida Ave Lakeland, FL 33813 (863) 644-7541 Fax: (863) 646-4308 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Johnson, Michele MD Provider ID: 1311451 Gender: Female Heart of Florida Physician Group 410 Lionel Way Davenport, FL 33837 (863) 419-2420 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Jones, Kurt MD Provider ID: 1124806 Gender: Male Central Florida Health Care, Inc. 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 18 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No

Gender: Male Central Florida Health Care, Inc. 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 18 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 7:30 AM - 5:00 PM PCMH: No Jones, Kurt MD Provider ID: 1124806 Gender: Male Central Florida Health Care, Inc. 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 18 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No Jones, Malcolm MD Provider ID: 796301 Gender: Male Lakeland Womens Health Center Inc 4444 S Florida Ave Lakeland, FL 33813 (863) 644-7541 Fax: (863) 646-4308 12 Yrs/130 Yrs M-F 8:30 AM - 5:30 PM Sat 8:30 AM - 2:30 PM PCMH: No King, Vanessa MD Provider ID: 695915 Gender: Female Winter Haven Hospital Physician SVS 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 02 Yrs/21 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Lemert, Robert MD Provider ID: 367614 Gender: Male Celebration Obstetrics & Gynecology 2209 North Blvd W Ste C Davenport, FL 33837 (863) 424-4321 Fax: (407) 566-2499 12 Yrs/130 Yrs Florida Hospital Orlando Orlando Regional Medical Center Osceola Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Levine, Paul MD Provider ID: 1627 Gender: Male Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (863) 687-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Levine, Paul MD Provider ID: 2539 Gender: Male Tampa Obstetrics PA 215 Imperial Blvd Ste B-2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Languages: Spanish, Creole M-F 8:00 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 490

Lubbers, Maegan MD Provider ID: 1241841 Gender: Female Celebration Obstetrics & Gynecology 2209 North Blvd W Ste C Davenport, FL 33837 (407) 566-2229 Fax: (407) 566-2499 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mahbub, Farah MD Provider ID: 1264784 Gender: Female Celebration Obstetrics & Gynecology 2209 North Blvd W Ste C Davenport, FL 33837 (407) 915-3468 Fax: (407) 566-2499 16 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Mallick, Sobiah MD Provider ID: 1199089 Gender: Female Tampa Obstetrics PA 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No Mallick, Sobiah MD Provider ID: 1199089 Gender: Female Tampa Obstetrics PA 215 Imperial Blvd Ste B-2 Lakeland, FL 33803 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Nixon, Jennifer MD cont. Martino-Villanueva, Maria MD Provider ID: 755697 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 12 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No McEndree, Terri MD Provider ID: 758434 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 12 Yrs/130 Yrs Bayfront Health Dade City Florida Hospital Zephyrhills M-F 8:00 AM - 5:00 PM PCMH: No Mushonga, Nyarai MD Provider ID: 1189381 Gender: Female Florida Woman Care LLC 353 Cypress Pkwy Kissimmee, FL 34759 (407) 333-0496 Fax: (407) 333-0497 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 373912 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 688-8423 12 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ojeda, Ezer MD Provider ID: 552896 Gender: Male Winter Haven Hospital OB/ GYN Physici 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 12 Yrs/130 Yrs Sarasota Memorial Hospital M 6:00 AM - 6:00 PM PCMH: No Ortiz, Edwin MD Provider ID: 783354 Gender: Male Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM PCMH: No

Palazzolo, Mark DO Provider ID: 464088 Gender: Male Hunters Creek Womens Health Center 200 Ave F NE Winter Haven, FL 33881 (863) 297-1899 Fax: (863) 297-1867 00 Yrs/130 Yrs Osceola Regional Medical Center Languages: Spanish MTTHF 9:00 AM - 5:00 PM W 9:00 AM - 5:30 PM PCMH: No Patel, Urmila MD Provider ID: 233172 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (863) 687-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 9:00 AM - 5:00 PM PCMH: No Patel, Urmila MD Provider ID: 240842 Gender: Female Tampa Obstetrics PA 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 491

Prabhakaran, Sujatha MD Provider ID: 796079 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish, Arabic, Bengali, Armenian M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM PCMH: No Puretz, Jeffrey MD Provider ID: 755962 Gender: Male Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 12 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Qadri, Syed MD Provider ID: 532026 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs Languages: Hindi, Urdu M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Rosa, Hector MD cont. Provider ID: 817797 Qadri, Syed MD Provider ID: 532026 Gender: Male Central Florida Health Care Inc 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs Languages: Hindi, Urdu M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Rodriguez-Benitez, Jose MD Provider ID: 458525 Gender: Male Winter Haven Hospital OB/ GYN Physici 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 00 Yrs/130 Yrs Orlando Regional Medical Center Osceola Regional Medical Center Winter Haven Hospital Languages: Spanish MTWTHFSatSun 7:00 AM 7:00 PM PCMH: No Romero, Stephanie MD Provider ID: 964944 Gender: Female USF Physicians Group 1733 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 688-8423 18 Yrs/130 Yrs St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Male Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM PCMH: No Salamanca, Edwin MD Provider ID: 4174 Gender: Male Heart of Florida OB/GYN Association 220 Ave O SE Winter Haven, FL 33880 (863) 421-7600 Fax: (863) 288-2894 12 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Amb Surgical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Salamanca, Edwin MD Provider ID: 4174 Gender: Male Heart of Florida OB/GYN Association 2221 North Blvd W Davenport, FL 33837 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Amb Surgical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Salamanca, Edwin MD Provider ID: 4174 Gender: Male Heart of Florida OB/GYN Association 421 Linden Ln Lake Wales, FL 33853 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center Winter Haven Amb Surgical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No San Martin, Julio MD Provider ID: 5093 Gender: Male Heart of Florida OB/GYN Association 220 Ave O SE Winter Haven, FL 33880 (863) 288-2889 Fax: (863) 288-2894 12 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No San Martin, Julio MD Provider ID: 5093 Gender: Male Heart of Florida OB/GYN Association 2221 North Blvd W Davenport, FL 33837 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 492

San Martin, Julio MD Provider ID: 5093 Gender: Male Heart of Florida OB/GYN Association 421 Linden Ln Lake Wales, FL 33853 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs Heart of Florida Reg Med Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Shafii, Sohrab MD Provider ID: 656 Gender: Male Tampa Obstetrics PA 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital Languages: Spanish, Faroese M-F 8:30 AM - 5:30 PM PCMH: No Shafii, Sohrab MD Provider ID: 772998 Gender: Male Tampa Obstetrics PA 215 Imperial Blvd Ste B 2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Florida Hospital Tampa St Josephs Hospital Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No Smith, Susan MD Provider ID: 1129135 Gender: Female Baycare Medical Group Inc 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Sterlacci, Susan MD cont. Smith, Susan MD Provider ID: 391370 Gender: Female Winter Haven Hospital OB/ GYN Physici 101 Ave O SE Lake Hamilton, FL 33851 (863) 294-7010 Fax: (863) 294-7041 12 Yrs/130 Yrs St Josephs Hospital Winter Haven Hospital MTWTHFSatSun 7:00 AM 7:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 215 Imperial Blvd Ste B-2 Lakeland, FL 33803 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Spencer, Debbie MD Provider ID: 1199077 Gender: Female Tampa Obstetrics PA 5537 Sheldon Rd Ste N Lakeland, FL 33805 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 810729 Gender: Female Winter Haven Hospital OB/ GYN Physici 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (863) 294-7041 18 Yrs/130 Yrs Winter Haven Hospital MTWTHFSat 7:00 AM - 7:00 PM Sun 7:00 AM - 6:00 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No Strathmann, Richard MD Provider ID: 609177 Gender: Male Exodus Womens Center Inc 215 Imperial Blvd Ste B-2 Lakeland, FL 33803 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM PCMH: No

Suarez, Adriana MD Provider ID: 1254509 Gender: Female Tampa Obstetrics, PA 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No Suarez, Adriana MD Provider ID: 1254509 Gender: Female Tampa Obstetrics, PA 215 Imperial Blvd B-2 Lakeland, FL 33803 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:30 PM PCMH: No Turnquest, Merse MD Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Turnquest, Merse MD Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No Turnquest, Merse MD Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Turnquest, Merse MD Provider ID: 1332855 Gender: Female Central Florida Health Care, Inc. 916 Old Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Villa, Maria MD Provider ID: 1326856 Gender: Female Women's Care Florida, LLC 1733 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-1528 Fax: (863) 688-8423 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 493

Last update 08/14/2017

Specialty Physicians Polk Obstetrics/Gynecology - Yankowitz, Jerome MD cont. Provider ID: 609495 Villa, Maria MD Provider ID: 1326856 Gender: Female Women's Care Florida, LLC 619 Midflorida Dr Ste 3 Lakeland, FL 33813 (863) 644-4496 Fax: (863) 644-4497 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Walker, Christopher MD Provider ID: 429361 Gender: Male Florida Woman Care LLC 353 Cypress Pkwy Kissimmee, FL 34759 (407) 333-0496 Fax: (407) 931-4393 12 Yrs/130 Yrs Downtown Surgery Center Florida Hospital Orlando Surgical License Ward Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Waterman II, Philip MD Provider ID: 686208 Gender: Male Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs Lee Memorial Hospital M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM PCMH: No

Berger, Adam MD Provider ID: TPV1972574408-0 Gender: Male Gender: Male USF Physicians Group Vitreous and Retina Consultants 1733 Lakeland Hills Blvd 250 Ave K SW Ste 200 Lakeland, FL 33805 Winter Haven, FL 33880 (863) 688-1528 (863) 297-5400 Fax: (813) 577-1946 Fax: (863) 293-8230 00 Yrs/130 Yrs South Florida Baptist Hospital 18 Yrs/99 Yrs USF Endoscopy & Surgery Winter Haven Hospital Center Languages: Korean Winter Haven Hospital M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Berger, Adam MD Ophthalmology Provider ID: TPV1972574408-0 Gender: Male Barnes, Raymond MD Vitreous and Retina Provider ID: TPV1679500854-0 Consultants Gender: Male 137 Patterson Rd Raymond F Barnes MD PA Haines City, FL 33844 1350 E Main St Ste A-3 (863) 422-5737 Bartow, FL 33830 Fax: (863) 422-2414 (863) 533-0441 18 Yrs/99 Yrs Fax: (863) 533-5593 Winter Haven Hospital 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Bartow Regional Medical PCMH: No Center Languages: French Breunig, Adam MD M-TH 7:30 AM - 5:00 PM Provider ID: TPV1295999183-0 F 7:30 AM - 12:00 PM Gender: Male PCMH: No Fischer Schemmer and Silbiger Berger, Adam MD 119 Patterson Rd Provider ID: TPV1972574408-0 Haines City, FL 33844 Gender: Male (863) 294-5457 Vitreous and Retina Fax: (863) 293-0343 Consultants 18 Yrs/99 Yrs 2815 Lakeland Hills Blvd Ste No Hospital Privileges200 Covering Arrangem Lakeland, FL 33805 MWTH 8:30 AM - 4:30 PM (863) 683-6699 T 1:30 AM - 4:30 PM Fax: (863) 688-3314 F 8:30 AM - 12:00 PM 18 Yrs/99 Yrs PCMH: No Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 494

Breunig, Adam MD Provider ID: TPV1295999183-0 Gender: Male Fischer Schemmer and Silbiger 4337 S Florida Ave Lakeland, FL 33813 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem MTTHF 8:30 AM - 11:30 PM W 8:30 AM - 4:30 PM PCMH: No Breunig, Adam MD Provider ID: TPV1295999183-0 Gender: Male Fischer Schemmer and Silbiger 5528 US Hwy 98 N Lakeland, FL 33809 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem MT 1:00 AM - 4:30 PM PCMH: No Breunig, Adam MD Provider ID: TPV1295999183-0 Gender: Male Fischer Schemmer and Silbiger 215 1st St N Ste 200 Winter Haven, FL 33881 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Ophthalmology - cont. Dorsett, Kevin MD Provider ID: TPV1760446314-0 Gender: Male Lakeland Eye Clinic PA 6743 US Hwy 98 Lakeland, FL 33809 (863) 688-5604 Fax: (863) 858-1052 15 Yrs/99 Yrs Lakeland Regional Med Center (Lakeland F M-F 8:00 AM - 5:00 PM PCMH: No Dorsett, Kevin MD Provider ID: TPV1760446314-0 Gender: Male Lakeland Eye Clinic PA 1247 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-5604 Fax: (863) 682-6052 15 Yrs/99 Yrs Lakeland Regional Med Center (Lakeland F M-F 8:00 AM - 5:00 PM PCMH: No Dorsett, Kevin MD Provider ID: TPV1760446314-0 Gender: Male Lakeland Eye Clinic PA 4708 S Florida Ave Lakeland, FL 33813 (863) 644-6455 Fax: (863) 619-8433 15 Yrs/99 Yrs Lakeland Regional Med Center (Lakeland F M-F 8:00 AM - 5:00 PM PCMH: No

Fischer, III, Frank MD Provider ID: TPV1497752687-0 Gender: Male Fischer Schemmer and Silbiger 254 E Stuart Ave Lake Wales, FL 33853 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs Winter Haven Hospital MWTH 8:30 AM - 4:30 PM T 8:30 AM - 11:30 PM F 1:30 AM - 4:30 PM PCMH: No

Fischer, Jr, Frank MD Provider ID: TPV1437152667-0 Gender: Male Fischer Schemmer and Silbiger 254 E Stuart Ave Lake Wales, FL 33853 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MWTH 8:30 AM - 4:30 PM T 8:30 AM - 11:30 PM F 1:30 AM - 4:30 PM PCMH: No

Fischer, III, Frank MD Provider ID: TPV1497752687-0 Gender: Male Fischer Schemmer and Silbiger 4337 S Florida Ave Lakeland, FL 33813 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs Winter Haven Hospital MTTHF 8:30 AM - 11:30 PM W 8:30 AM - 4:30 PM PCMH: No

Fischer, Jr, Frank MD Provider ID: TPV1437152667-0 Gender: Male Fischer Schemmer and Silbiger 215 1st St N Ste 200 Winter Haven, FL 33881 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Fischer, III, Frank MD Provider ID: TPV1497752687-0 Gender: Male Fischer Schemmer and Silbiger 215 1st St N Ste 200 Winter Haven, FL 33881 (863) 294-5457 Fax: (863) 293-0343 18 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Friedman, Scott MD Provider ID: TPV1497842314-0 Gender: Male Florida Retina Consultants 2202 Lakeland Hills Blvd Lakeland, FL 33805 (863) 682-7474 Fax: (863) 802-4587 00 Yrs/99 Yrs Winter Haven Hospital Languages: French M-F 8:00 AM - 5:00 PM PCMH: No Friedman, Scott MD Provider ID: TPV1497842314-1 Gender: Male Florida Retina Consultants 400 Ave K SE Bldg A Winter Haven, FL 33880 (863) 299-8288 Fax: (863) 298-6766 00 Yrs/99 Yrs Winter Haven Hospital Languages: French M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 495

Hamilton, Richard MD Provider ID: TPV1568412823-0 Gender: Male Vitreous and Retina Consultants 2815 Lakeland Hills Blvd Ste 200 Lakeland, FL 33805 (863) 683-6699 Fax: (863) 688-3314 18 Yrs/99 Yrs South Lake Hospital Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Hamilton, Richard MD Provider ID: TPV1568412823-0 Gender: Male Vitreous and Retina Consultants 250 Ave K SW Ste 200 Winter Haven, FL 33880 (863) 297-5400 Fax: (863) 293-8230 18 Yrs/99 Yrs South Lake Hospital Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Hamilton, Richard MD Provider ID: TPV1568412823-0 Gender: Male Vitreous and Retina Consultants 137 Patterson Rd Haines City, FL 33844 (863) 422-5737 Fax: (863) 422-2414 18 Yrs/99 Yrs South Lake Hospital Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Ophthalmology - cont. Leon, Marlen MD Provider ID: TPV1699935320-0 Gender: Female Lakeland Eye Clinic PA 6743 US Hwy 98 Lakeland, FL 33809 (863) 688-5604 Fax: (863) 858-1052 00 Yrs/18 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No Leon, Marlen MD Provider ID: TPV1699935320-0 Gender: Female Lakeland Eye Clinic PA 1247 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-5604 Fax: (863) 682-6052 00 Yrs/18 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No Leon, Marlen MD Provider ID: TPV1699935320-0 Gender: Female Lakeland Eye Clinic PA 4708 S Florida Ave Lakeland, FL 33813 (863) 644-6455 Fax: (863) 619-8433 00 Yrs/18 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No

Misch, David MD Provider ID: TPV1992775571-0 Gender: Male Vitreous and Retina Consultants 2815 Lakeland Hills Blvd Ste 200 Lakeland, FL 33805 (863) 683-6699 Fax: (863) 688-3314 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Moinfar, Nader MD Moon, Suk MD Provider ID: TPV1740206028-0 Provider ID: TPV1477524130-0 Gender: Male Gender: Male Florida Retina Consultants Vitreous and Retina Consultants 400 Ave K SE Bldg A 137 Patterson Rd Winter Haven, FL 33880 Haines City, FL 33844 (863) 299-8288 (863) 422-5737 Fax: (863) 298-6766 Fax: (863) 422-2414 18 Yrs/99 Yrs 18 Yrs/99 Yrs Winter Haven Hospital Winter Haven Hospital Languages: French M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

Misch, David MD Provider ID: TPV1992775571-0 Gender: Male Vitreous and Retina Consultants 250 Ave K SW Ste 200 Winter Haven, FL 33880 (863) 297-5400 Fax: (863) 293-8230 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: TPV1659327849-0 Gender: Male Fischer Schemmer and Silbiger 119 Patterson Rd Haines City, FL 33844 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MWTH 8:30 AM - 4:30 PM T 1:30 AM - 4:30 PM F 8:30 AM - 12:00 PM PCMH: No

Misch, David MD Provider ID: TPV1992775571-0 Gender: Male Vitreous and Retina Consultants 137 Patterson Rd Haines City, FL 33844 (863) 422-5737 Fax: (863) 422-2414 18 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Moon, Suk MD Provider ID: TPV1477524130-0 Gender: Male Vitreous and Retina Consultants 2815 Lakeland Hills Blvd Ste 200 Lakeland, FL 33805 (863) 683-6699 Fax: (863) 688-3314 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Moon, Suk MD Provider ID: TPV1477524130-0 Gender: Male Vitreous and Retina Consultants 250 Ave K SW Ste 200 Winter Haven, FL 33880 (863) 297-5400 Fax: (863) 293-8230 18 Yrs/99 Yrs Winter Haven Hospital Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 496

Moraczewski, Alexei MD

Moraczewski, Alexei MD Provider ID: TPV1659327849-0 Gender: Male Fischer Schemmer and Silbiger 254 E Stuart Ave Lake Wales, FL 33853 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MWTH 8:30 AM - 4:30 PM T 8:30 AM - 11:30 PM F 1:30 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Ophthalmology - cont. Moraczewski, Alexei MD Provider ID: TPV1659327849-0 Gender: Male Fischer Schemmer and Silbiger 4337 S Florida Ave Lakeland, FL 33813 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MTTHF 8:30 AM - 11:30 PM W 8:30 AM - 4:30 PM PCMH: No Moraczewski, Alexei MD Provider ID: TPV1659327849-0 Gender: Male Fischer Schemmer and Silbiger 5528 US Hwy 98 N Lakeland, FL 33809 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MT 1:00 AM - 4:30 PM PCMH: No Moraczewski, Alexei MD Provider ID: TPV1659327849-0 Gender: Male Fischer Schemmer and Silbiger 215 1st St N Ste 200 Winter Haven, FL 33881 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Randolph, John MD Provider ID: TPV1164621330-0 Gender: Male Vitreous and Retina Consultants 2815 Lakeland Hills Blvd Ste 200 Lakeland, FL 33805 (863) 683-6699 Fax: (863) 688-3314 06 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Schemmer, Gary MD Provider ID: TPV1265439517-0 Gender: Male Fischer Schemmer and Silbiger 4337 S Florida Ave Lakeland, FL 33813 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MTTHF 8:30 AM - 11:30 PM W 8:30 AM - 4:30 PM PCMH: No

Randolph, John MD Provider ID: TPV1164621330-0 Gender: Male Vitreous and Retina Consultants 250 Ave K SW Ste 200 Winter Haven, FL 33880 (863) 297-5400 Fax: (863) 293-8230 06 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No

Schemmer, Gary MD Provider ID: TPV1265439517-0 Gender: Male Fischer Schemmer and Silbiger 215 1st St N Ste 200 Winter Haven, FL 33881 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Randolph, John MD Provider ID: TPV1164621330-0 Gender: Male Vitreous and Retina Consultants 137 Patterson Rd Haines City, FL 33844 (863) 422-5737 Fax: (863) 422-2414 06 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Shimshak, Karen MD

Schemmer, Gary MD Provider ID: TPV1265439517-0 Gender: Male Fischer Schemmer and Silbiger 254 E Stuart Ave Lake Wales, FL 33853 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MWTH 8:30 AM - 4:30 PM T 8:30 AM - 11:30 PM F 1:30 AM - 4:30 PM PCMH: No

Provider ID: 1176793 Gender: Female Nemours Childrens Clinic, Grassland 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 497

Silbiger, Jonathan MD Provider ID: TPV1174520423-0 Gender: Male Fischer Schemmer and Silbiger 119 Patterson Rd Haines City, FL 33844 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MWTH 8:30 AM - 4:30 PM T 1:30 AM - 4:30 PM F 8:30 AM - 12:00 PM PCMH: No Silbiger, Jonathan MD Provider ID: TPV1174520423-0 Gender: Male Fischer Schemmer and Silbiger 4337 S Florida Ave Lakeland, FL 33813 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MTTHF 8:30 AM - 11:30 PM W 8:30 AM - 4:30 PM PCMH: No Silbiger, Jonathan MD Provider ID: TPV1174520423-0 Gender: Male Fischer Schemmer and Silbiger 5528 US Hwy 98 N Lakeland, FL 33809 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital MT 1:00 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Ophthalmology - cont. Silbiger, Jonathan MD Provider ID: TPV1174520423-0 Gender: Male Fischer Schemmer and Silbiger 215 1st St N Ste 200 Winter Haven, FL 33881 (863) 294-5457 Fax: (863) 293-0343 06 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Optician Eye Doctors Optical Outlets PA Provider ID: TPV1013108919-0 3654 Harden Blvd Lakeland, FL 33803 (863) 644-7242 Fax: (888) 702-4055 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1043401938-0 762 Eagle Ridge Dr Lake Wales, FL 33853 (863) 676-0911 Fax: (888) 422-8797 00 Yrs/99 Yrs M-F 10:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Eye Doctors Optical Outlets PA Provider ID: TPV1679764617-0 4121 US Hwy 98 N Ste A140 Lakeland, FL 33809 (863) 859-7100 Fax: (866) 863-3883 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Eye Doctors Optical Outlets PA Provider ID: TPV1891986865-0 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

Optometry Anderson, Angela OD Provider ID: TPV1265426977-0 Gender: Female Family Eyecare of Winter Haven PLLC 410 E Central Ave Winter Haven, FL 33880 (863) 293-0276 Fax: (863) 299-3172 04 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Bassion, Kellie OD Provider ID: TPV1861826679-0 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Bassion, Kellie OD Provider ID: TPV1861826679-0 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Betton, Kimberly OD Provider ID: TPV1427362359-0 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Betton, Kimberly OD Provider ID: TPV1427362359-0 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Betton, Kimberly OD Provider ID: TPV1427362359-0 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Blade, Pamela OD Provider ID: TPV1093028631-0 Gender: Female Eye Doctors Optical Outlets PA 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 498

Braudway, Sonya OD Provider ID: TPV1043282387-0 Gender: Female Vitreous and Retina Consultants 2815 Lakeland Hills Blvd Ste 200 Lakeland, FL 33805 (863) 683-6699 Fax: (863) 688-3314 06 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Braudway, Sonya OD Provider ID: TPV1043282387-0 Gender: Female Eye Doctors Optical Outlets PA 3654 Harden Blvd Lakeland, FL 33803 (863) 644-7242 Fax: (888) 702-4055 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Braudway, Sonya OD Provider ID: TPV1043282387-0 Gender: Female Eye Doctors Optical Outlets PA 4121 US Hwy 98 N Ste A140 Lakeland, FL 33809 (863) 859-7100 Fax: (866) 863-3883 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Braudway, Sonya OD Provider ID: TPV1043282387-0 Gender: Female Eye Doctors Optical Outlets PA 762 Eagle Ridge Dr Lake Wales, FL 33853 (863) 676-0911 Fax: (888) 422-8797 06 Yrs/99 Yrs M-F 10:00 AM - 9:00 PM Sat 10:00 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Braudway, Sonya OD Provider ID: TPV1043282387-0 Gender: Female Vitreous and Retina Consultants 250 Ave K SW Ste 200 Winter Haven, FL 33880 (863) 297-5400 Fax: (863) 293-8230 06 Yrs/99 Yrs Languages: Korean M-F 8:00 AM - 5:00 PM PCMH: No Braudway, Sonya OD Provider ID: TPV1043282387-0 Gender: Female Vitreous and Retina Consultants 137 Patterson Rd Haines City, FL 33844 (863) 422-5737 Fax: (863) 422-2414 06 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Buffano, Roxanne OD Provider ID: TPV1275765265-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Buffano, Roxanne OD Provider ID: TPV1275765265-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Buffano, Roxanne OD Provider ID: TPV1275765265-2 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Cabatana, Tisha OD Provider ID: TPV1538544333-0 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Buffano, Roxanne OD Provider ID: TPV1275765265-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Cabatana, Tisha OD Provider ID: TPV1538544333-0 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Buffano, Roxanne OD Provider ID: TPV1275765265-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Cabatana, Tisha OD Provider ID: TPV1538544333-0 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Buffano, Roxanne OD Provider ID: TPV1275765265-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Copley, Christian OD Provider ID: TPV1265665699-0 Gender: Male Lakeland Eye Clinic PA 1247 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-5604 Fax: (863) 682-6052 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Copley, Christian OD Provider ID: TPV1265665699-0 Gender: Male Lakeland Eye Clinic PA 4708 S Florida Ave Lakeland, FL 33813 (863) 644-6455 Fax: (863) 619-8433 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Dixon, Dustin OD Provider ID: TPV1245578491-1 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Dixon, Dustin OD Provider ID: TPV1245578491-1 Copley, Christian OD Gender: Male Provider ID: TPV1265665699-0 Myeyedr Optometry of Gender: Male Florida LLC Lakeland Eye Clinic PA 1695 N Broadway Dr 6743 US Hwy 98 Bartow, FL 33830 Lakeland, FL 33809 (863) 534-2020 (863) 688-5604 Fax: (863) 534-3674 Fax: (863) 858-1052 05 Yrs/99 Yrs 18 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 499

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Dixon, Dustin OD Provider ID: TPV1245578491-1 Gender: Male Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Dixon, Dustin OD Provider ID: TPV1245578491-2 Gender: Male Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Dixon, Dustin OD Provider ID: TPV1245578491-2 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Dixon, Dustin OD Provider ID: TPV1245578491-2 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Hamilton, Christopher OD Provider ID: TPV1558712158-0 Gender: Male Eye Doctors Optical Outlets PA 3654 Harden Blvd Lakeland, FL 33803 (863) 644-7242 Fax: (888) 702-4055 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Hamilton, Christopher OD Provider ID: TPV1558712158-0 Gender: Male Eye Doctors Optical Outlets PA 4121 US Hwy 98 N Ste A140 Lakeland, FL 33809 (863) 859-7100 Fax: (866) 863-3883 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Hamilton, Christopher OD Provider ID: TPV1558712158-0 Gender: Male Eye Doctors Optical Outlets PA 762 Eagle Ridge Dr Lake Wales, FL 33853 (863) 676-0911 Fax: (888) 422-8797 05 Yrs/99 Yrs M-F 10:00 AM - 9:00 PM Sat 10:00 AM - 5:30 PM PCMH: No

Hamilton, Christopher OD Provider ID: TPV1558712158-0 Gender: Male Eye Doctors Optical Outlets PA 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No Henne, Kevin OD Provider ID: 148297 Gender: Male 410 E Central Ave Winter Haven, FL 33880 (863) 293-0276 Fax: (863) 299-3172 00 Yrs/130 Yrs PCMH: No Henne, Kevin OD Provider ID: TPV1407847585-0 Gender: Male Family Eyecare of Winter Haven PLLC 410 E Central Ave Winter Haven, FL 33880 (863) 293-0276 Fax: (863) 299-3172 05 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Hoover, Sabina OD Provider ID: TPV1922459528-0 Gender: Female Lakeland Eye Clinic PA 6743 US Hwy 98 Lakeland, FL 33809 (863) 688-5604 Fax: (863) 858-1052 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 500

Hoover, Sabina OD Provider ID: TPV1922459528-0 Gender: Female Lakeland Eye Clinic PA 1247 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-5604 Fax: (863) 682-6052 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Hoover, Sabina OD Provider ID: TPV1922459528-0 Gender: Female Lakeland Eye Clinic PA 4708 S Florida Ave Lakeland, FL 33813 (863) 644-6455 Fax: (863) 619-8433 18 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Ismail, Esaam OD Provider ID: TPV1588728539-0 Gender: Male Eye Doctors Optical Outlets PA 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No Lewenson, Robert OD Provider ID: TPV1235181769-0 Gender: Male Eye Doctors Optical Outlets PA 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Lopez, Viviana OD Provider ID: TPV1447583950-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Lopez, Viviana OD Provider ID: TPV1447583950-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Lopez, Viviana OD Provider ID: TPV1447583950-2 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Lopez, Viviana OD Provider ID: TPV1447583950-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Lopez, Viviana OD Provider ID: TPV1447583950-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Naqvi, Zarrin OD Provider ID: TPV1942436993-0 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Naqvi, Zarrin OD Provider ID: TPV1942436993-1 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Lopez, Viviana OD Provider ID: TPV1447583950-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Naqvi, Zarrin OD Provider ID: TPV1942436993-0 Gender: Male Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Naqvi, Zarrin OD Provider ID: TPV1942436993-1 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Miller, Barbara OD Naqvi, Zarrin OD Provider ID: TPV1558466870-0 Provider ID: TPV1942436993-0 Gender: Female Gender: Male Eye Doctors Optical Outlets Myeyedr Optometry of PA Florida LLC 4121 US Hwy 98 N Ste A140 215 First St N Ste 100 Lakeland, FL 33809 Winter Haven, FL 33881 (863) 859-7100 (863) 299-8908 Fax: (866) 863-3883 Fax: (863) 291-0804 05 Yrs/99 Yrs 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 8:30 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No PCMH: No Naqvi, Zarrin OD Miller, Barbara OD Provider ID: TPV1942436993-1 Provider ID: TPV1558466870-0 Gender: Male Gender: Female Myeyedr Optometry of Florida LLC Eye Doctors Optical Outlets PA 4337 S Florida Ave 723 3rd St SW Lakeland, FL 33813 Winter Haven, FL 33880 (863) 619-2700 (863) 297-5067 Fax: (863) 648-9658 Fax: (866) 747-6836 06 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 10:00 AM - 4:00 PM PCMH: No

Neal, Terry OD Provider ID: TPV1366445819-2 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 501

Neal, Terry OD Provider ID: TPV1366445819-2 Gender: Male Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Neal, Terry OD Provider ID: TPV1366445819-2 Gender: Male Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Neal, Terry OD Provider ID: TPV1366445819-2 Gender: Male Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Neal, Terry OD Provider ID: TPV1366445819-2 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Neal, Terry OD Provider ID: TPV1366445819-2 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Ngar, Lucie OD Provider ID: TPV1447238274-0 Gender: Female Eye Doctors Optical Outlets PA 3654 Harden Blvd Lakeland, FL 33803 (863) 644-7242 Fax: (888) 702-4055 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Olson, Arlese OD Provider ID: TPV1063576171-0 Gender: Female Eye Doctors Optical Outlets PA 4121 US Hwy 98 N Ste A140 Lakeland, FL 33809 (863) 859-7100 Fax: (866) 863-3883 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Ngar, Lucie OD Provider ID: TPV1447238274-0 Gender: Female Eye Doctors Optical Outlets PA 4121 US Hwy 98 N Ste A140 Lakeland, FL 33809 (863) 859-7100 Fax: (866) 863-3883 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Olson, Arlese OD Provider ID: TPV1063576171-0 Gender: Female Eye Doctors Optical Outlets PA 762 Eagle Ridge Dr Lake Wales, FL 33853 (863) 676-0911 Fax: (888) 422-8797 05 Yrs/99 Yrs M-F 10:00 AM - 9:00 PM Sat 10:00 AM - 5:30 PM PCMH: No

Ngar, Lucie OD Provider ID: TPV1447238274-0 Gender: Female Eye Doctors Optical Outlets PA 762 Eagle Ridge Dr Lake Wales, FL 33853 (863) 676-0911 Fax: (888) 422-8797 05 Yrs/99 Yrs M-F 10:00 AM - 9:00 PM Sat 10:00 AM - 5:30 PM PCMH: No

Olson, Arlese OD Provider ID: TPV1063576171-0 Gender: Female Eye Doctors Optical Outlets PA 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

Olson, Arlese OD Provider ID: TPV1063576171-0 Gender: Female Eye Doctors Optical Outlets PA 3654 Harden Blvd Lakeland, FL 33803 (863) 644-7242 Fax: (888) 702-4055 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

Parrish, Gregory OD Provider ID: TPV1598759458-1 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 502

Parrish, Gregory OD Provider ID: TPV1598759458-1 Gender: Male Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Parrish, Gregory OD Provider ID: TPV1598759458-1 Gender: Male Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Parrish, Gregory OD Provider ID: TPV1598759458-2 Gender: Male Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Parrish, Gregory OD Provider ID: TPV1598759458-2 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Parrish, Gregory OD Provider ID: TPV1598759458-2 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Parrish, Gregory OD Provider ID: TPV1598759458-2 Gender: Male Myeyedr Optometry of Florida LLC 1611 State Rd 60 E Lake Wales, FL 33853 (863) 676-4500 Fax: (863) 676-2020 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Patel, Binal OD Provider ID: TPV1790036325-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Patel, Binal OD Provider ID: TPV1790036325-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 06 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Patel, Binal OD Provider ID: TPV1790036325-2 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Pearce, Jr, Willard OD Phillips, James OD Provider ID: TPV1386832905-0 Provider ID: TPV1598759219-2 Gender: Male Gender: Male Myeyedr Optometry of Myeyedr Optometry of Florida LLC Florida LLC 1611 State Rd 60 E 4337 S Florida Ave Lake Wales, FL 33853 Lakeland, FL 33813 (863) 676-4500 (863) 619-2700 Fax: (863) 676-2020 Fax: (863) 648-9658 05 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM M-F 8:30 AM - 6:00 PM PCMH: No PCMH: No

Patel, Binal OD Provider ID: TPV1790036325-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Phillips, James OD Provider ID: TPV1598759219-1 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Phillips, James OD Provider ID: TPV1598759219-2 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Patel, Binal OD Provider ID: TPV1790036325-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Phillips, James OD Provider ID: TPV1598759219-1 Gender: Male Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Phillips, James OD Provider ID: TPV1598759219-2 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Patel, Binal OD Provider ID: TPV1790036325-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 06 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Phillips, James OD Provider ID: TPV1598759219-2 Gender: Male Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Phillips, Stephen OD Provider ID: TPV1871587592-1 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 503

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Phillips, Stephen OD Provider ID: TPV1871587592-1 Gender: Male Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Phillips, Stephen OD Provider ID: TPV1871587592-2 Gender: Male Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Phillips, Stephen OD Provider ID: TPV1871587592-2 Gender: Male Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Phillips, Stephen OD Provider ID: TPV1871587592-2 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Phillips, Stephen OD Provider ID: TPV1871587592-2 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Puzzo, Melissa OD Renaud, Lauren OD Provider ID: TPV1669760799-2 Provider ID: TPV1780037887-0 Gender: Female Gender: Female Myeyedr Optometry of Eye Doctors Optical Outlets Florida LLC PA 4337 S Florida Ave 4121 US Hwy 98 N Ste A140 Lakeland, FL 33813 Lakeland, FL 33809 (863) 619-2700 (863) 859-7100 Fax: (863) 648-9658 Fax: (866) 863-3883 00 Yrs/99 Yrs 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM M-F 9:00 AM - 6:00 PM PCMH: No Sat 9:00 AM - 4:00 PM PCMH: No Puzzo, Melissa OD Puzzo, Melissa OD Provider ID: TPV1669760799-1 Provider ID: TPV1669760799-2 Renaud, Lauren OD Gender: Female Gender: Female Provider ID: TPV1780037887-0 Myeyedr Optometry of Myeyedr Optometry of Gender: Female Florida LLC Florida LLC Eye Doctors Optical Outlets 119 Patterson Rd 1251 Lakeland Hills Blvd PA Haines City, FL 33844 Lakeland, FL 33805 762 Eagle Ridge Dr (863) 421-2700 (863) 687-2260 Lake Wales, FL 33853 Fax: (863) 421-7629 Fax: (863) 595-0927 (863) 676-0911 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (888) 422-8797 M-F 8:30 AM - 6:00 PM M-F 8:30 AM - 6:00 PM 05 Yrs/99 Yrs PCMH: No PCMH: No M-F 10:00 AM - 9:00 PM Sat 10:00 AM - 5:30 PM Puzzo, Melissa OD Puzzo, Melissa OD PCMH: No Provider ID: TPV1669760799-1 Provider ID: TPV1669760799-2 Renaud, Lauren OD Gender: Female Gender: Female Myeyedr Optometry of Myeyedr Optometry of Provider ID: TPV1780037887-0 Florida LLC Florida LLC Gender: Female 1695 N Broadway Dr 5528 US Hwy 98 N Eye Doctors Optical Outlets Bartow, FL 33830 Lakeland, FL 33809 PA (863) 534-2020 (863) 853-2020 723 3rd St SW Fax: (863) 534-3674 Fax: (863) 557-2008 Winter Haven, FL 33880 00 Yrs/99 Yrs 00 Yrs/99 Yrs (863) 297-5067 M-F 9:00 AM - 6:00 PM M-F 8:30 AM - 6:00 PM Fax: (866) 747-6836 PCMH: No PCMH: No 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Puzzo, Melissa OD Renaud, Lauren OD Sat 10:00 AM - 4:00 PM Provider ID: TPV1669760799-2 Provider ID: TPV1780037887-0 PCMH: No Gender: Female Gender: Female Myeyedr Optometry of Eye Doctors Optical Outlets Roberts, David OD Florida LLC PA Provider ID: TPV1972665883-0 215 First St N Ste 100 3654 Harden Blvd Gender: Male Winter Haven, FL 33881 Lakeland, FL 33803 Myeyedr Optometry of (863) 299-8908 (863) 644-7242 Florida LLC Fax: (863) 291-0804 Fax: (888) 702-4055 1695 N Broadway Dr 00 Yrs/99 Yrs 05 Yrs/99 Yrs Bartow, FL 33830 M-F 8:30 AM - 6:00 PM M-F 9:00 AM - 6:00 PM (863) 534-2020 PCMH: No Sat 9:00 AM - 4:00 PM Fax: (863) 534-3674 PCMH: No 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 504

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Roberts, David OD Provider ID: TPV1972665883-0 Gender: Male Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Roberts, David OD Provider ID: TPV1972665883-0 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Roberts, David OD Provider ID: TPV1972665883-0 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Roberts, Elizabeth OD Provider ID: TPV1295722908-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Roberts, Elizabeth OD Provider ID: TPV1295722908-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Roberts, Elizabeth OD Provider ID: TPV1295722908-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Roberts, Elizabeth OD Provider ID: TPV1295722908-2 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Ruckman, Carli OD Provider ID: TPV1891075578-0 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 04 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Roberts, Elizabeth OD Provider ID: TPV1295722908-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Ruckman, Carli OD Provider ID: TPV1891075578-0 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 04 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Roberts, Elizabeth OD Provider ID: TPV1295722908-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Sadek, Ginger OD Provider ID: TPV1487088761-0 Gender: Female Eye Doctors Optical Outlets PA 3654 Harden Blvd Lakeland, FL 33803 (863) 644-7242 Fax: (888) 702-4055 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 505

Sadek, Ginger OD Provider ID: TPV1487088761-0 Gender: Female Eye Doctors Optical Outlets PA 4121 US Hwy 98 N Ste A140 Lakeland, FL 33809 (863) 859-7100 Fax: (866) 863-3883 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Sadek, Ginger OD Provider ID: TPV1487088761-0 Gender: Female Eye Doctors Optical Outlets PA 762 Eagle Ridge Dr Lake Wales, FL 33853 (863) 676-0911 Fax: (888) 422-8797 05 Yrs/99 Yrs M-F 10:00 AM - 9:00 PM Sat 10:00 AM - 5:30 PM PCMH: No Sadek, Ginger OD Provider ID: TPV1487088761-0 Gender: Female Eye Doctors Optical Outlets PA 723 3rd St SW Winter Haven, FL 33880 (863) 297-5067 Fax: (866) 747-6836 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No Salomon, Brad OD Provider ID: TPV1851385710-1 Gender: Male Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Salomon, Brad OD Provider ID: TPV1851385710-1 Gender: Male Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Salomon, Brad OD Provider ID: TPV1851385710-2 Gender: Male Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Salomon, Brad OD Provider ID: TPV1851385710-2 Gender: Male Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Salomon, Brad OD Provider ID: TPV1851385710-2 Gender: Male Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Brad OD Provider ID: TPV1851385710-2 Gender: Male Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Teresa OD Provider ID: TPV1891789517-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Teresa OD Provider ID: TPV1891789517-1 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Teresa OD Provider ID: TPV1891789517-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Katie OD Provider ID: TPV1154739852-2 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 00 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Teresa OD Provider ID: TPV1891789517-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Salomon, Teresa OD Provider ID: TPV1891789517-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 506

Last update 08/14/2017

Specialty Physicians Polk Optometry - cont. Salomon, Teresa OD Provider ID: TPV1891789517-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Thai, Pauline OD Provider ID: TPV1871808097-1 Gender: Female Myeyedr Optometry of Florida LLC 119 Patterson Rd Haines City, FL 33844 (863) 421-2700 Fax: (863) 421-7629 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Thai, Pauline OD Provider ID: TPV1871808097-1 Gender: Female Myeyedr Optometry of Florida LLC 1695 N Broadway Dr Bartow, FL 33830 (863) 534-2020 Fax: (863) 534-3674 05 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Thai, Pauline OD Provider ID: TPV1871808097-2 Gender: Female Myeyedr Optometry of Florida LLC 215 First St N Ste 100 Winter Haven, FL 33881 (863) 299-8908 Fax: (863) 291-0804 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Thai, Pauline OD Provider ID: TPV1871808097-2 Gender: Female Myeyedr Optometry of Florida LLC 4337 S Florida Ave Lakeland, FL 33813 (863) 619-2700 Fax: (863) 648-9658 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Thai, Pauline OD Provider ID: TPV1871808097-2 Gender: Female Myeyedr Optometry of Florida LLC 1251 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2260 Fax: (863) 595-0927 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No Thai, Pauline OD Provider ID: TPV1871808097-2 Gender: Female Myeyedr Optometry of Florida LLC 5528 US Hwy 98 N Lakeland, FL 33809 (863) 853-2020 Fax: (863) 557-2008 05 Yrs/99 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Orthopaedic Surgery Arango, David MD Provider ID: 470918 Gender: Male Royal Palm Orthopedics 23781 US Hwy 27 Ste 122 Lake Wales, FL 33859 (863) 324-6100 Fax: (863) 676-6107 00 Yrs/130 Yrs Winter Haven Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Arango, David MD Provider ID: 470918 Gender: Male Royal Palm Orthopedics and Sports M 1120 Carlton Ave Ste 1400 Lake Wales, FL 33853 (863) 324-6100 Fax: (863) 679-9182 00 Yrs/130 Yrs Winter Haven Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Crank Jr, Richard DO Provider ID: 913716 Gender: Male Lakeland Regional Health Systems In 3030 Harden Blvd Lakeland, FL 33803 (863) 687-1250 Fax: (863) 687-1258 00 Yrs/130 Yrs Lakeland Reg Medical Center Tampa General Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Arango, David MD Provider ID: 470918 Gender: Male Royal Palm Orthorpedics 1507 Lakelnd Hls Blvd Ste 107 Lakeland, FL 33805 (863) 324-6100 Fax: (863) 679-9182 00 Yrs/130 Yrs Winter Haven Hospital Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Cutrera, Norele MD Provider ID: 1264810 Gender: Female Lakeland Regional Health System 3030 Harden Blvd Lakeland, FL 33803 (863) 687-1250 Fax: (863) 687-1258 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Fajolu, Olukemi MD Provider ID: 1289486 Butler, Robert MD Gender: Female Provider ID: 1232209 Lakeland Regional Medical Gender: Male Orthopedic Medical Group of System 1324 Lakeland Hills Blvd Tampa B Lakeland, FL 33805 100 Ave I NE (863) 687-1321 Winter Haven, FL 33881 Fax: (863) 284-1730 (813) 684-2663 00 Yrs/130 Yrs Fax: (863) 299-3598 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No Winter Haven Hospital M-F 8:00 AM - 5:00 PM Fajolu, Olukemi MD PCMH: No Provider ID: 1289486 Gender: Female Cotton, John MD Lakeland Regional Medical Provider ID: 576434 System Gender: Male 3030 Harden Blvd Lakeland Regional Health Lakeland, FL 33803 Systems (863) 687-1250 3030 Harden Blvd Fax: (863) 687-1258 Lakeland, FL 33803 00 Yrs/130 Yrs (863) 687-1250 M-F 9:00 AM - 5:00 PM Fax: (863) 687-1258 PCMH: No 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 4:30 PM PCMH: No

www.wellcare.com/Florida | 507

Last update 08/14/2017

Specialty Physicians Polk Orthopaedic Surgery cont. Hall, Todd MD Provider ID: 171372 Gender: Female Lakeland Regional Orthopedics 3030 Harden Blvd Lakeland, FL 33803 (863) 687-1250 Fax: (863) 687-1258 02 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Hill, Nathan MD Provider ID: 202912 Gender: Male Hill Orthopedic Center 40124 Hwy 27 Ste 205 Davenport, FL 33837 (863) 422-1734 Fax: (863) 421-1986 12 Yrs/130 Yrs Dr P Phillips Hospital Heart of Florida Reg Med Center Lakeland Reg Medical Center Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Jester, Adam MD Provider ID: 1193406 Gender: Male Orthopeadic Medical Group 222 E Central Ave Winter Haven, FL 33880 (863) 299-3595 Fax: (813) 299-3598 00 Yrs/130 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Lamoreaux, David MD Provider ID: 564520 Gender: Male Midflorida Orthopaedic Associates 42719 Hwy 27 Ste 103 Davenport, FL 33837 (863) 877-2880 Fax: (863) 420-6723 00 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Magee, Michael MD Provider ID: 1109464 Gender: Male Hill Orthopedic Center, LLC 108 Park Place Blvd Ste C Davenport, FL 33837 (863) 422-1734 Fax: (863) 421-1975 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Manaswi, Abhijit MD Provider ID: 1344473 Gender: Male Haines City Hma Physician Managemen 40124 Hwy 27 Ste 101 Davenport, FL 33837 (863) 419-8922 Fax: (863) 419-8923 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Manaswi, Abhijit MD Provider ID: 1344473 Gender: Male Heart of Florida Physician Group An 3757 Pleasant Hill Rd Davenport, FL 33837 (860) 419-8922 Fax: (863) 419-8923 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Morgan, Jesse MD Provider ID: 14328 Gender: Male 1350 E Main St Ste B-5 Bartow, FL 33830 (863) 804-0200 Fax: (863) 804-0222 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No Pinkas, Daphne MD Provider ID: 1367548 Gender: Female Lakeland Regional Health Ortho 3030 Harden Blvd Lakeland, FL 33803 (863) 687-1250 Fax: (863) 687-1258 18 Yrs/110 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Kaufman, Seth DO Provider ID: 1310813 Gender: Male Heart of Florida Physician Group In 410 Lionel Way Ste 201 Davenport, FL 33837 (863) 547-8900 Fax: (863) 547-8901 18 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Pediatric Cardiology Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No

Sando, Mark MD Provider ID: 1172728 Gender: Male 100 Ave I NE Winter Haven, FL 33881 (813) 684-2663 Arrillaga, Frances MD Fax: (863) 299-3598 00 Yrs/130 Yrs South Florida Baptist Hospital Provider ID: 333773 Winter Haven Hospital Gender: Female PCMH: No Pediatrix Medical Group of Florida Pain Management 1324 Lakeland Hills Blvd Lakeland, FL 33805 Honculada, Allan MD (863) 687-1100 Provider ID: 1094373 00 Yrs/21 Yrs Gender: Male Brandon Regional Hospital Pain Diagnostic and Florida Hospital Carrollwood Management Center Johns Hopkins All Childrens Hospital Inc 537 E Central Ave Ste B Languages: Spanish Winter Haven, FL 33880 MTWTHFSatSun 12:00 AM (863) 293-3656 11:59 PM Fax: (863) 293-7887 PCMH: No 50 Yrs/110 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Languages: Tagalog M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 508

Last update 08/14/2017

Specialty Physicians Polk Pediatric Cardiology cont. Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Blanchard, William MD Provider ID: 210652 Gender: Male Nemours Childrens Clinic Grassland 3030 Harden Blvd Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Braley, Katherine MD Provider ID: 1338140 Gender: Female Nemours Childrens Hospital 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Braley, Katherine MD Provider ID: 1338140 Gender: Female Nemours Childrens Hospital 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Crawford, Marguerite MD Provider ID: 314170 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Ebadi, Ameneh DO Provider ID: 1261799 Gender: Female Nemours Childrens Specialty Care, G 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fishberger, Steven MD Provider ID: 1234892 Gender: Male Nemours Childrens Specialty Care, G 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs Sacred Heart Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No

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Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Pediatric Cardiology cont. Huhta, James MD Provider ID: 225655 Gender: Male Pediatric Cardiology Associates 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/19 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Huhta, James MD Provider ID: 225655 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Ivsic, Tomislav MD Provider ID: 421430 Gender: Male Nemours Childrens Clinic, Grassland 3030 Harden Blvd Lakeland, FL 33803 (407) 650-7715 Fax: (407) 650-7124 00 Yrs/130 Yrs Languages: German M-F 8:00 AM - 5:00 PM PCMH: No

John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No

Kakavand, Bahram MD

John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No

Lacorte, Michael MD

John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 602072 Gender: Male Nemours Childrens Clinic Graaland 3030 Harden Blvd Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/17 Yrs Nemours Childrens Hospital Languages: German M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatric Cardiology Associates 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 101 Ave O SE Winter Haven, FL 33880 (727) 322-4830 00 Yrs/18 Yrs Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/18 Yrs Languages: Spanish MTWTHFSatSun 12:00 AM 11:59 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 917-6929 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Pediatric Cardiology cont. McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatric Cardiology Associates 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 101 Ave O SE Winter Haven, FL 33880 (863) 294-7010 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc PCMH: No McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Mehta, Mary MD Provider ID: 165300 Gender: Female Nemours Childrens Clinic, Grassland 3030 Harden Blvd Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs Sacred Heart Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Raptoulis, Arthur MD Provider ID: 15106 Gender: Male Pmg Cardiology Inc 1356 SR 60 East Ste 201 Lake Wales, FL 33853 (407) 647-4890 Fax: (407) 647-8620 00 Yrs/18 Yrs Arnold Palmer Hospital For Children Florida Hospital Orlando Orlando Regional Medical Center Languages: Italian, Greek, Polish M-F 9:00 AM - 5:00 PM PCMH: No Stapleton, Gary MD Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-3333 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Ear, Nose & Throat Andrews, Thomas MD Provider ID: 1246 Gender: Male Pediatric Otolaryngology Assoc 3310 Lakeland Hills Blvd Lakeland, FL 33805 (941) 927-8805 Fax: (941) 925-6339 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Cressman, Wade MD Provider ID: 8265 Gender: Male Pediatric Otolaryngology 3310 Lakeland Hills Blvd Lakeland, FL 33805 (941) 927-8805 Fax: (941) 925-6339 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Trowbridge, Rose MD Provider ID: 912630 Gender: Female Pediatric Otolaryngology 3310 Lakeland Hills Blvd Lakeland, FL 33805 (941) 927-8805 Fax: (941) 925-6339 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 8:00 AM - 5:00 PM PCMH: No

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Wasylik, Kathleen MD Provider ID: 431688 Gender: Female Pediatric Otolaryngology Head Nec 3310 Lakeland Hills Blvd Lakeland, FL 33805 (941) 927-8805 Fax: (941) 925-6339 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Gastroenterology Arasu, Thiru MD Provider ID: 4516 Gender: Male Thiru S Arasu MD 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Pediatric Surgery Center LLC Odessa Pediatric Surgery Centers LLC Languages: Hindi MWTHF 9:00 AM - 5:00 PM T 8:00 AM - 5:00 PM PCMH: No Condino, Adria DO Provider ID: 429785 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Pediatric Kaiser, Greg MD Gastroenterology - cont. Provider ID: 19532 Dhana, Leila MD Provider ID: 207634 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Ignacio, Joseph MD Provider ID: 197151 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/130 Yrs Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Plantation General Hospital Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM PCMH: No Irizarry, Karina MD Provider ID: 469781 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Mease Countryside Hospital Pediatric Surgery Centers LLC Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No McClenathan, Daniel MD Provider ID: 1347 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Rook, Michelle MD Provider ID: 958681 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 870-4948 Fax: (813) 554-8044 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish MT 8:00 AM - 1:00 PM PCMH: No

Wilsey Jr, Michael MD Provider ID: 200955 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Winesett, Michele MD Provider ID: 8416 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 987-2911 Fax: (813) 831-5062 00 Yrs/130 Yrs Brandon Regional Hospital Florida Hospital Tampa Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Hematology/ Oncology Ayala, Irmel MD Provider ID: 2522 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Grana, Nanette MD Provider ID: 451174 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Kerr, Jody MD Provider ID: 372911 Gender: Female Pediatric Physician Services 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No Sawczyn, Kelly MD Provider ID: 397206 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Stapleton, Stacie MD Provider ID: 401213 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Pediatric Nephrology Campos, Alfonso MD Provider ID: 7041 Gender: Male USF Physicians Group 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 259-8760 Fax: (813) 259-8765 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Neurosurgery Carey, Carolyn MD Provider ID: 173532 Gender: Female 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No Rodriguez, Luis MD Provider ID: 309778 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish, German M-F 9:00 AM - 5:00 PM PCMH: No

Tuite, Gerald MD Provider ID: 17798 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Tampa General Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Pulmonology Ajayi, Akinyemi MD Provider ID: 208937 Gender: Male Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs Arnold Palmer Hospital For Children Florida Hospital Orlando M-F 9:00 AM - 5:00 PM PCMH: No Ali Dinar, Tarig MD Provider ID: 1145973 Gender: Male Nemours Childrens Clinic, Grassland 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Gondor, Magdalen MD Provider ID: 19528 Gender: Female Outpatient Care Center 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 4:30 PM PCMH: No Houin, Paul MD Provider ID: 1004662 Gender: Male Pediatric Pulmonary Specialists PA 2625 S Florida Ave Lakeland, FL 33803 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M 9:00 AM - 5:00 PM PCMH: No Kriseman, Anthony MD Provider ID: 17783 Gender: Male All Childrens Outpatient Care Lakel 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4146 Fax: (727) 767-4218 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 4:30 PM PCMH: No Kuriakose, Kevin MD Provider ID: 777446 Gender: Male Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

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Livingston, Floyd MD Provider ID: 26657 Gender: Male Nemours Childrens Clinic Grasslands 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs Arnold Palmer Hospital For Children Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Penugonda, Madhuri MD Provider ID: 816127 Gender: Female Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Prpich, John MD Provider ID: 448916 Gender: Male Pediatric Pulmonary Specialists PA 2625 S Florida Ave Lakeland, FL 33803 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/21 Yrs St Josephs Hospital M 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Pediatric Pulmonology cont. Rosenberg, David MD Provider ID: 1424 Gender: Male Pediatric Pulmonary Specialists PA 2625 S Florida Ave Lakeland, FL 33803 (813) 870-1995 Fax: (813) 875-1889 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Lakeland Reg Medical Center St Josephs Hospital M 9:00 AM - 5:00 PM PCMH: No Sifain, Maggie MD Provider ID: 515650 Gender: Female Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs Orlando Regional Medical Center Languages: Arabic M-F 8:30 AM - 5:00 PM PCMH: No Verma, Shivani MD Provider ID: 515103 Gender: Female Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs Florida Hospital Orlando Orlando Regional Medical Center Languages: Hindi, Punjabi M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Surgery Coughlin, John MD Provider ID: 5639 Gender: Male 3310 Lakeland Hills Blvd Lakeland, FL 33805 (863) 802-6600 Fax: (863) 802-6639 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Pediatric Surgery Center LLC Odessa M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Urology Hoover, Dennis MD Provider ID: 2812 Gender: Male Lakeland At All Children's Specialt 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Kolligian, Mark MD Provider ID: 164682 Gender: Male Lakeland At All Childrens Specialt 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Polsky, Ethan MD Provider ID: 341141 Gender: Male Lakeland At All Childrens Specialt 3310 Lakeland Hills Blvd Lakeland, FL 33805 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Butto, Fouad MD Provider ID: 1321322 Gender: Male Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Cano Montoya, Angelica MD Provider ID: 1217559 Gender: Female Kidsville Pediatrics I PA 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Sat 9:30 AM - 12:00 PM PCMH: No

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Hernandez Montalvo, Myriam MD Provider ID: 1250120 Gender: Female Kidsville Pediatrics I PA 2201 North Blvd W Davenport, FL 33837 (863) 419-0688 Fax: (863) 419-9547 00 Yrs/21 Yrs MTWF 8:30 AM - 5:00 PM TH 8:30 AM - 50:0 PM Sat 9:30 AM - 12:00 PM PCMH: No Kumar, Sujata MD Provider ID: 1328900 Gender: Female Central Florida Health Care 601 S Florida Ave Lakeland, FL 33801 (863) 688-0841 Fax: (863) 616-9709 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Dun 916 Dundee Rd Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Fro 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Pediatrics - cont. Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Lak 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Mul 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kumar, Sujata MD Provider ID: 1328900 Gender: Female The Central Florida Health Care Win 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Pedodontics Harrell, Laurie DDS Provider ID: TPVP43596-33 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

Harrell, Laurie DDS Provider ID: TPVP43596-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Montgomery, Nancy DMD Provider ID: TPVP134209-02 Gender: Female Children and Teen Group of Florida 225 Imperial Blvd Lakeland, FL 33803 (863) 644-4739 Fax: (863) 644-1333 00 Yrs/99 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No Perez, Marina DDS Provider ID: TPVP156976-38 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Van, Vincent DDS Provider ID: TPVP83315-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Van, Vincent DDS Provider ID: TPVP83315-36 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Yeung, Vincent DDS Provider ID: TPVP125205-33 Gender: Male Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No

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Yeung, Vincent DDS Provider ID: TPVP125205-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Periodontics Cherry, Elizabeth DDS Provider ID: TPVP44394-33 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No Perelmuter, Steven DMD Provider ID: TPVP42333-36 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Periodontics - cont. Sabzehei, Bahareh DDS

Physical Medicine & Rehabilitation Beauchamp, Magda MD

Provider ID: TPVP66334-39 Gender: Female Greenberg Dental Orthodontics PA 1475 6th St NW Winter Haven, FL 33881 (863) 226-0261 Fax: (863) 226-0238 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Sabzehei, Bahareh DDS Provider ID: TPVP66334-41 Gender: Female Greenberg Dental Orthodontics 4969 US Hwy 98 N Lakeland, FL 33809 (863) 614-0044 Fax: (863) 272-7566 00 Yrs/99 Yrs Languages: Spanish MT 11:00 AM - 7:00 PM WTHF 7:00 AM - 3:00 PM PCMH: No Sabzehei, Bahareh DDS Provider ID: TPVP66334-46 Gender: Female Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Provider ID: 1097120 Gender: Female Baycare Medical Group 200 Ave F NE Winter Haven, FL 33881 (863) 293-1121 Fax: (863) 292-4179 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Guzman-Villar, Brenda MD Provider ID: 1015550 Gender: Female Integrated Rehab Consultants LLC 1919 Lakeland Hills Blvd Lakeland, FL 33805 (914) 390-4363 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:30 PM PCMH: No Hartman, Eric MD Provider ID: 1129143 Gender: Male Baycare Medical Group Inc 200 Ave F NE Winter Haven, FL 33881 (863) 293-1121 Fax: (863) 292-4179 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ocasio Silva, Maria MD Provider ID: 1324844 Gender: Female Nemours Childrens Specialty Care 3030 Harden Blvd Bldg 2 Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Plastic & Reconstructive Karr, Jeffrey DPM Surgery Provider ID: 26905 Plank, David MD Provider ID: 1335751 Gender: Male Mid Florida Dermatology Associates 2302 North Blvd W Ste A Davenport, FL 33837 (407) 299-7333 Fax: (407) 293-2049 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Tripathi, Shreekant MD Provider ID: 529275 Gender: Male Lakeland Regional Medical Center 3030 Harden Blvd Ste 108 Lakeland, FL 33803 (863) 284-1700 Fax: (863) 284-1728 02 Yrs/130 Yrs Central Florida Surgicenter Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Podiatry Holland, Ann DPM Provider ID: 199305 Gender: Female Dundee Podiatry Services PA 28079 Hwy 27 Dundee, FL 33838 (863) 439-4000 Fax: (863) 439-2257 00 Yrs/130 Yrs Florida Hospital Heartland M-F 9:00 AM - 2:00 PM PCMH: No

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Gender: Male 5421 S Florida Ave Lakeland, FL 33813 (863) 646-5960 Fax: (863) 644-2847 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Poncheri, Kelly DPM Provider ID: 674444 Gender: Female Poncheri, Kelly A DPM 5050 S Florida Ave Lakeland, FL 33813 (863) 644-1313 Fax: (863) 644-7272 00 Yrs/130 Yrs Bartow Regional Medical Center M-W 7:00 AM - 3:30 PM TH 7:00 AM - 1:00 PM PCMH: No Wong, William DPM Provider ID: 229501 Gender: Male William Wong DPM PA 927 S Florida Ave Lakeland, FL 33803 (863) 686-1081 Fax: (863) 687-6333 00 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish, Chinese M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM PCMH: No

Preventive Medicine Senatorov, Vladimir MD Provider ID: 1272016 Gender: Male Central Florida Health Care, Inc. 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Preventive Medicine cont. Senatorov, Vladimir MD Provider ID: 1272017 Gender: Male Central Florida Health Care, Inc. 106 Northw 9th St Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Senatorov, Vladimir MD Provider ID: 1272019 Gender: Male Central Florida Health Care, Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Senatorov, Vladimir MD Provider ID: 1272020 Gender: Male Central Florida Health Care, Inc. 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM PCMH: No

Senatorov, Vladimir MD Provider ID: 1272022 Gender: Male Central Florida Health Care, Inc 225 Lincoln Ave Lake Wales, FL 33853 (863) 678-4360 Fax: (863) 678-4399 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Senatorov, Vladimir MD Provider ID: 1272023 Gender: Male Central Florida Health Care, Inc. 916 Old Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No Senatorov, Vladimir MD Provider ID: 1272024 Gender: Male Central Florida Health Care, Inc. 601 S Florida Ave Lakeland, FL 33801 (863) 688-0841 Fax: (863) 616-9709 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM PCMH: No

Prosthodontics

Griggs, Adam DO Provider ID: 14450 Galindo-Ramirez, Ricardo DDS Gender: Male Pulmonary Disease Specialists PA Provider ID: TPVP156550-10 40124 Hwy 27 Ste 202 Gender: Male Davenport, FL 33837 Greenberg Dental (863) 419-0104 Orthodontics Fax: (863) 421-6507 4969 US Hwy 98 N 18 Yrs/130 Yrs Lakeland, FL 33809 Heart of Florida Reg Med (863) 614-0044 Center Fax: (863) 272-7566 ORHS-South Lake Hospital 00 Yrs/99 Yrs Orlando Regional Medical Languages: Spanish Center MT 11:00 AM - 7:00 PM Languages: Spanish WTHF 7:00 AM - 3:00 PM M-TH 8:30 AM - 5:00 PM PCMH: No F 8:30 AM - 4:00 PM Galindo-Ramirez, Ricardo DDS PCMH: No Provider ID: TPVP156550-38 Gender: Male Greenberg Dental Orthodontics 2926 S Florida Ave Lakeland, FL 33803 (863) 226-6229 Fax: (863) 333-5633 00 Yrs/99 Yrs Languages: Spanish MT 7:00 AM - 3:00 PM WTH 11:00 AM - 7:00 PM F 8:00 AM - 4:00 PM Sat 8:00 AM - 2:00 PM PCMH: No

Lama, Maximo MD Provider ID: 618125 Gender: Male Florida Lung, Asthma & Sleep Specialists 4553 Pleasant Hill Rd Kissimmee, FL 34759 (407) 483-8965 Fax: (407) 507-2616 18 Yrs/100 Yrs Florida Hospital Orlando Languages: Spanish M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:00 PM PCMH: No

Lucio, James MD Provider ID: 225861 Gender: Male Ameh, Joseph MD Pulmonary Disease Specialists Provider ID: 371756 40124 Hwy 27 Ste 202 Gender: Male Davenport, FL 33837 Pulmonary Disease Specialists (863) 419-0104 40121 Hwy 27 Ste 202 Fax: (863) 421-6507 Davenport, FL 33837 18 Yrs/130 Yrs (863) 419-0104 Heart of Florida Reg Med Fax: (863) 421-6507 Center 18 Yrs/130 Yrs Orlando Regional Medical Heart of Florida Reg Med Center Center Plantation General Hospital Osceola Regional Medical Languages: Spanish Center M-TH 8:30 AM - 5:00 PM St Cloud Reg Medical Center F 8:30 AM - 4:00 PM Languages: Spanish, French PCMH: No M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM PCMH: No

Pulmonary Disease

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Last update 08/14/2017

Specialty Physicians Polk Pulmonary Disease - cont.

Radiation Oncology

Sha, Sandra MD Provider ID: 210391 Gender: Female 40107 Hwy 27 Davenport, FL 33837 (863) 419-6092 Fax: (863) 419-1695 18 Yrs/130 Yrs Heart of Florida Reg Med Center Lake Wales Medical Center Lakeland Reg Medical Center Languages: Chinese M-F 9:00 AM - 5:00 PM PCMH: No

Nazario, Rhoderick MD Bhutiani, Inder MD Provider ID: 212418 Provider ID: 1121146 Gender: Male Gender: Male Pulmonary Disease Specialists Radiation Oncology Associates Pl 40124 Hwy 27 Ste 202 200 Ave F NE Davenport, FL 33837 Winter Haven, FL 33881 (863) 419-0104 (863) 297-1865 Fax: (863) 421-6507 Fax: (863) 291-6025 18 Yrs/130 Yrs 00 Yrs/130 Yrs Heart of Florida Reg Med Center Florida Hospital Heartland Osceola Regional Medical Heart of Florida Reg Med Center Center St Cloud Reg Medical Center Winter Haven Hospital Sha, Sandra MD Languages: Spanish M-F 8:00 AM - 5:00 PM M-TH 8:30 AM - 5:00 PM PCMH: No Provider ID: 210391 F 8:30 AM - 4:00 PM Gender: Female Guerrier, Kris MD PCMH: No Central Florida Cancer Provider ID: 423391 Institute Urdaneta-Jaimes, Jose MD Gender: Female 1730 Lakeland Hills Blvd Lakeland Regional Caner Lakeland, FL 33805 Center (863) 284-6950 Provider ID: 385478 3525 Lakeland Hills Blvd Fax: (863) 284-6951 Gender: Male 18 Yrs/130 Yrs Pulmonary Disease Specialists Lakeland, FL 33805 (863) 603-6565 PA Heart of Florida Reg Med Fax: (863) 603-6575 Center 40124 Hwy 27 Ste 202 Lake Wales Medical Center 02 Yrs/130 Yrs Davenport, FL 33837 Lakeland Reg Medical Center Languages: Spanish (863) 419-0104 Languages: Chinese M-F 8:00 AM - 4:30 PM Fax: (863) 421-6507 M-F 9:00 AM - 5:00 PM PCMH: No 18 Yrs/130 Yrs PCMH: No Heart of Florida Reg Med Heysek, Randy MD Center Sha, Sandra MD Osceola Regional Medical Provider ID: 176129 Provider ID: 210391 Center Gender: Male St Cloud Reg Medical Center Gender: Female Central Florida Cancer Languages: Spanish Entral Florida Cancer Institute Institute M-TH 8:30 AM - 5:00 PM 201 Magnolia Ave SW 2 SR 60 W F 8:30 AM - 4:00 PM Winter Haven, FL 33880 Lake Wales, FL 33853 PCMH: No (863) 293-6375 (863) 679-2960 Fax: (863) 293-8877 Fax: (863) 679-2781 18 Yrs/130 Yrs 18 Yrs/130 Yrs Heart of Florida Reg Med Heart of Florida Reg Med Center Center Lake Wales Medical Center Lakeland Reg Medical Center South Florida Baptist Hospital Lakeland Reg Medical Center Languages: Chinese Languages: Spanish M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Radiology - Interventional & Vascular Sehgal, Manu MD Provider ID: 1097137 Gender: Male Vascular Intervention Partners, LLC 1015 6th St NW Winter Haven, FL 33881 (863) 299-3081 Fax: (863) 299-3960 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sleep Medicine Livingston, Floyd MD Provider ID: 26657 Gender: Male Nemours Childrens Clinic Grasslands 3030 Harden Blvd Ste 105 Lakeland, FL 33803 (407) 650-7000 Fax: (407) 650-7124 00 Yrs/18 Yrs Arnold Palmer Hospital For Children Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Thoracic & Cardiovascular Surgery Dodd, David MD Provider ID: 1136248 Gender: Male Baycare Medical Group Inc 200 Ave F NE Winter Haven, FL 33881 (863) 292-4043 Fax: (863) 229-7523 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Thoracic & Cardiovascular D'Angelo, Michael MD Surgery - cont. Sowka, Lawrence MD Provider ID: 758049 Gender: Male Bartow Regional Medical Center 2200 Osprey Blvd Lake Alfred, FL 33850 (863) 533-8111 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Sowka, Lawrence MD Provider ID: 758049 Gender: Male Central Imaging Center/Vein Care SP 1305 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-2334 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Urology Akintan, Bade MD Provider ID: 816658 Gender: Male Central Florida Cancer Institute 2 State Rd 60 W Lake Wales, FL 33853 (863) 679-2960 Fax: (863) 679-2781 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1421734 Gender: Male CHS/ Haines City Hma Physician Mana 410 Lionel Way Ste 203 Davenport, FL 33837 (863) 419-2156 Fax: (863) 419-2157 00 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No D'Angelo, Michael MD Provider ID: 1421734 Gender: Male Heart of Florida Regional Medical C 40100 US Hwy 27 Davenport, FL 33837 (863) 422-4971 Fax: (863) 419-2429 00 Yrs/130 Yrs Heart of Florida Reg Med Center M-F 8:00 AM - 5:00 PM PCMH: No Greene, Graham MD Provider ID: 524247 Gender: Male Lakeland Regional Cancer Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 18 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Greene, Graham MD Provider ID: 524247 Gender: Male Lakeland Regional Health Systems 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 18 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Hodge Jr, Gameel Byron MD

Smith, Matthew MD Provider ID: 214821 Gender: Male Lakeland Regional Caner Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 18 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Vascular Surgery Provider ID: 266580 Gender: Male Lakeland Regional Caner Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 18 Yrs/130 Yrs Lakeland Reg Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Oommen, Mathew MD Provider ID: 753996 Gender: Male Baycare Medical Group 200 Ave F NE Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 00 Yrs/130 Yrs Winter Haven Hospital M-F 9:00 AM - 5:00 PM PCMH: No Shrom, Stanley MD Provider ID: 499089 Gender: Male Southpoint Medical Group 4729 US Hwy 98 S Ste 101 Lakeland, FL 33812 (863) 646-5789 Fax: (863) 646-5834 00 Yrs/130 Yrs Bartow Regional Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

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D'Alessandro, Matthew DO Provider ID: 1244436 Gender: Male Heart Vascular Institute of Florid 1110 Druid Cir Ste A Lake Wales, FL 33853 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No D'Alessandro, Matthew DO Provider ID: 1244436 Gender: Male Heart Vascular Institute of Florid 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No D'Alessandro, Matthew DO Provider ID: 1244436 Gender: Male Heart Vascular Institute of Florid 405 Lionel Way Davenport, FL 33837 (863) 424-3278 Fax: (863) 420-9701 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Polk Vascular Surgery - cont. De Jesus Gomez, Gustavo MD Provider ID: 1159484 Gender: Male Choice Health Care Inc 3035 Lakeland Hills Blvd Ste 4 Lakeland, FL 33805 (863) 577-8346 Fax: (863) 577-2422 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No De Jesus Gomez, Gustavo MD Provider ID: 1235218 Gender: Male Rapha Vascular Specialists Inc 3035 Lakeland Hills Blvd Ste 4 Lakeland, FL 33805 (863) 577-8346 Fax: (863) 577-2422 18 Yrs/130 Yrs Bartow Regional Medical Center M-F 9:00 AM - 6:00 PM PCMH: No Hannum, Scott DO Provider ID: 279304 Gender: Male The Vascular Clinic & Cosmetic Vein 106 Park Place Blvd Ste B Davenport, FL 33837 (407) 518-4982 Fax: (407) 518-1748 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hannum, Scott DO Provider ID: 279304 Gender: Male The Vascular Clinic & Cosmetic Vein 107 Park Place Blvd Davenport, FL 33837 (407) 518-4982 Fax: (407) 518-1748 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Hannum, Scott DO Provider ID: 279304 Gender: Male The Vascular Clinic & Cosmetic Vein 294 Patterson Rd Haines City, FL 33844 (407) 518-4982 Fax: (407) 518-1748 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Martin, Samuel MD Provider ID: 1114650 Gender: Male Vascular Vein Center, PA 121 Webb Dr Ste 300 Davenport, FL 33837 (863) 291-6313 Fax: (863) 421-4687 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Sowka, Lawrence MD Provider ID: 758049 Gender: Male Bartow Regional Medical Center 2200 Osprey Blvd Lake Alfred, FL 33850 (863) 533-8111 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Sowka, Lawrence MD Provider ID: 758049 Gender: Male Central Imaging Center/Vein Care SP 1305 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-2334 00 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Specialty Physicians Sarasota Allergy & Immunology

Windom, Hugh MD Mumma, Michael MD Provider ID: 171096 Provider ID: 25662 Ballow, Mark MD Gender: Male Gender: Male Provider ID: 756716 Windom Allergy Asthma Sinus Florida Cardiac Consultants Inc Gender: Male 3570 S Tuttle Ave 600 Nokomis Ave S Ste 101 Windom Allergy Asthma Sinus Sarasota, FL 34239 Venice, FL 34285 3570 S Tuttle Ave (941) 927-4888 (941) 485-8190 Sarasota, FL 34239 Fax: (941) 927-5808 Fax: (941) 483-9036 (941) 927-4888 02 Yrs/130 Yrs 16 Yrs/130 Yrs Fax: (941) 927-5808 Doctors Hospital Sarasota Doctors Hospital Sarasota 02 Yrs/130 Yrs Languages: Spanish Sarasota Memorial Hospital Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM MT 10:00 AM - 4:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No PCMH: No

Cardiology

Ly, Jean Marie MD Georgiev, Maria MD Provider ID: 914442 Gender: Female Windom Allergy Asthma Sinus Provider ID: 1181629 3570 S Tuttle Ave Gender: Female Sarasota, FL 34239 Senior Friendship Centers (941) 927-4888 1900 Brother Geenen Way Fax: (941) 927-5808 Sarasota, FL 34236 00 Yrs/130 Yrs (941) 566-3220 M-F 8:00 AM - 5:00 PM Fax: (941) 955-8214 PCMH: No 50 Yrs/110 Yrs Languages: Spanish, German, Ly, Jean Marie MD Bulgarian, Czech Provider ID: 914442 M-TH 8:00 AM - 4:00 PM Gender: Female F 9:00 AM - 12:00 PM Windom Allergy Asthma and PCMH: No Sinus 4040 Sawyer Rd Mathew, Dilip MD Sarasota, FL 34233 Provider ID: 366043 (941) 927-4888 Gender: Male Fax: (941) 927-5080 Heart Rhythm Consultants 00 Yrs/130 Yrs 1921 Waldemere St Ste 301 MW 8:30 AM - 5:00 PM Sarasota, FL 34239 T 8:30 AM - 6:00 PM (941) 484-6758 TH 7:30 AM - 4:30 PM Fax: (941) 404-4451 F 8:30 AM - 12:30 PM 18 Yrs/130 Yrs PCMH: No Sarasota Memorial Hospital St Josephs Hospital Weiss, William MD Venice Regional Medical Center Provider ID: 1181663 Languages: Malayalam Gender: Male M-F 9:00 AM - 5:00 PM Senior Friendship Centers PCMH: No 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs Languages: Spanish, Hindi, Czech M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Pacifico, Daniel MD Provider ID: 25664 Gender: Male Florida Cardiac Consultants Inc 1540 S Tamiami Trl Ste 401 Sarasota, FL 34239 (941) 917-0060 Fax: (941) 957-4248 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Pacifico, Daniel MD Provider ID: 25664 Gender: Male Florida Cardiac Consultants Inc 600 Nokomis Ave S Ste 101 Venice, FL 34285 (941) 485-8190 Fax: (941) 483-9036 18 Yrs/130 Yrs Sarasota Memorial Hospital MT 10:00 AM - 4:00 PM PCMH: No Shah, Abid MD Provider ID: 1007225 Gender: Male Abid A Shah MD 5741 Bee Ridge Rd Ste 420 Sarasota, FL 34233 (941) 377-7490 Fax: (941) 377-6245 00 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Urdu, Persian Farsi M-F 9:00 AM - 5:00 PM PCMH: No

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Weckesser, Barry MD Provider ID: 191537 Gender: Male The Heart Institute of Venice PLLC 1370 E Venice Ave Ste 102 Venice, FL 34285 (941) 412-0026 Fax: (941) 412-0027 16 Yrs/130 Yrs Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Child Neurology Portman, Steven MD Provider ID: 380259 Gender: Male University Health Park 6151 Lake Osprey Dr 3rd Fl Sarasota, FL 34240 (941) 355-0077 Fax: (941) 907-3476 00 Yrs/21 Yrs Sarasota Memorial Hospital M-W 12:00 AM - 7:00 PM PCMH: No

Chiropractic Grappin, Carl DC Provider ID: TPV11065-01 Gender: Male Grappin Clinic of Chiropractic PA 12511 S Tamiami Trl North Port, FL 34287 (941) 426-9551 Fax: (941) 426-9552 00 Yrs/99 Yrs MWTH 9:00 AM - 6:00 PM TF 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Chiropractic - cont.

Rice, Wayne DC Provider ID: TPV10442-01 Grappin, Linda DC Gender: Male Provider ID: TPV11067-01 Rice Chiropractic Clinic Gender: Female 1435 E Venice Ave Ste 107 Grappin Clinic of Chiropractic Venice, FL 34292 PA (941) 484-0940 12511 S Tamiami Trl Fax: (941) 485-4831 North Port, FL 34287 00 Yrs/99 Yrs (941) 426-9551 MW 7:30 AM - 6:00 PM Fax: (941) 426-9552 T 3:00 AM - 4:00 PM 00 Yrs/99 Yrs TH 3:00 AM - 6:00 PM Languages: Spanish F 7:30 AM - 11:00 PM MWTH 9:00 AM - 6:00 PM PCMH: No TF 9:00 AM - 1:00 PM Ear, Nose & Throat PCMH: No Hawthorne, Robert DC Provider ID: TPV10732-02 Gender: Male Robert J Hawthorne DC 4001 Swift Rd Ste B Sarasota, FL 34231 (941) 400-7079 Fax: (941) 927-7264 00 Yrs/99 Yrs MWF 7:30 AM - 6:00 PM TTHSat 7:30 AM - 12:00 PM PCMH: No Price, Jeffre DC Provider ID: TPV10441-01 Gender: Male Price Chiropractic 13355 S Tamiami Trl North Port, FL 34287 (941) 426-1235 Fax: (941) 426-4464 00 Yrs/99 Yrs MWTH 8:30 AM - 6:00 PM T 8:00 AM - 12:30 PM PCMH: No Rhodes, Dennis DC Provider ID: TPV10491-01 Gender: Male Venice Chiropractic Center 420 S Nokomis Ave Venice, FL 34285 (941) 488-7442 Fax: (941) 488-7444 00 Yrs/99 Yrs MWF 9:00 AM - 6:00 PM TTH 9:00 AM - 5:00 PM PCMH: No

Austin, Mitchell MD Provider ID: 1333457 Gender: Male Gulf Coast Hma Physician Management 315 Nokomis Ave S Venice, FL 34285 (941) 485-7888 Fax: (941) 484-1915 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Marlowe, Andrew MD Provider ID: 152414 Gender: Male 5432 Bee Ridge Rd Ste 150 Sarasota, FL 34233 (941) 379-3277 Fax: (941) 379-6277 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital MWTH 8:30 AM - 4:00 PM T 1:30 AM - 4:00 PM PCMH: No

Marrs, Chad MD Provider ID: 753442 Gender: Male Andrew Marlowe MD PA 5432 Bee Ridge Rd Ste 150 Sarasota, FL 34233 (941) 379-3277 Fax: (941) 379-6277 00 Yrs/130 Yrs Lakewood Ranch Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Shea, Roger MD Provider ID: 25676 Gender: Male 5432 Bee Ridge Rd Ste 140 Sarasota, FL 34233 (941) 371-2244 Fax: (941) 371-1144 00 Yrs/21 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Endocrinology, Diabetes, Metabolism Chaykin, Louis MD Provider ID: 1170546 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs Languages: Spanish, German, Bulgarian, Czech M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

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Endodontics Gargasz, Bret DDS Provider ID: TPVP42269-16 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Family Practice Patricoski, Thomas MD Provider ID: 1331303 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 00 Yrs/130 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No Siegal, Jeffrey MD Provider ID: 532640 Gender: Male Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: Yes, Level 2

Last update 08/14/2017

Specialty Physicians Sarasota Gastroenterology Byju, Kizhakevilayil MD Provider ID: 1180196 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM PCMH: No Murchie, Brent MD Provider ID: 1404220 Gender: Male Gastroenterology Associates of Sara 2089 Hawthorne St Ste 200 Sarasota, FL 34239 (941) 365-6556 Fax: (941) 365-6678 18 Yrs/110 Yrs Sarasota Memorial Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

General Dentistry Adderly, Erica DDS Provider ID: TPVP131028-07 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Arshadi, Eftekhar DMD Provider ID: TPVP83705-01 Gender: Female Siesta Family Dentistry 2171 Siesta Dr Sarasota, FL 34239 (941) 556-9538 Fax: (941) 706-4348 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Bacchelli, Lara DMD Provider ID: TPVP156856-15 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Barrett, Steven DDS Provider ID: TPV12124-64 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Boswell, Gibson DMD Provider ID: TPVP156855-15 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Brito, Daryl DMD Provider ID: TPVP145792-18 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Bradley, Ashley DMD Provider ID: TPVP153368-15 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Bushati, Ivo DMD Provider ID: TPVP134886-14 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Branscombe, Tyler DMD Provider ID: TPVP134684-14 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Caputo, Michael DDS Provider ID: TPVP156605-53 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 523

Last update 08/14/2017

Specialty Physicians Sarasota General Dentistry - cont. Franceschi, Marisa DDS Carbonell, Kevin DMD Provider ID: TPVP152393-15 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Dockus, Matthew DMD Provider ID: TPVP157263-15 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Eckels, Shane DDS Provider ID: TPVP134881-43 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Provider ID: TPV13763-08 Gender: Female Coast Dental - Beneva 3466 Clark Rd Ste 410 Sarasota, FL 34231 (941) 927-1705 Fax: (941) 927-6626 00 Yrs/99 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Genninger, Jasen DMD Provider ID: TPVP148171-16 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Greenberg, Andrew DDS Provider ID: TPV7501-59 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Hall, Joshua DMD Provider ID: TPVP156847-15 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Jimenez, Baltasar DDS Provider ID: TPVP43975-02 Gender: Male Beneva Dental Care 5917 S Beneva Rd Sarasota, FL 34238 (941) 924-2939 Fax: (941) 924-2026 00 Yrs/99 Yrs Languages: Spanish MW 1:00 AM - 5:00 PM TTH 9:30 AM - 2:30 PM PCMH: No

Kanach, Paul DMD Provider ID: TPVP137705-15 Jenkins, James DDS Gender: Male Provider ID: TPVP125937-01 Greenberg Dental Gender: Male Orthodontics Doh - Sarasota County Health 4280 Bee Ridge Rd Department Sarasota, FL 34233 6950 Outreach Way (941) 363-6381 North Port, FL 34287 Fax: (941) 315-9136 (941) 861-3888 00 Yrs/99 Yrs Fax: (941) 861-3893 Languages: Spanish 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM Languages: Spanish TW 11:00 AM - 7:00 PM M-TH 7:00 AM - 4:00 PM Sat 8:00 AM - 3:00 PM F 7:30 AM - 12:30 PM PCMH: No PCMH: No Katsur, Justin DDS Jenkins, James DDS Provider ID: TPV16372-76 Provider ID: TPVP125937-02 Gender: Male Gender: Male Greenberg Dental Doh - Sarasota County Health Orthodontics Department 4280 Bee Ridge Rd 2200 Ringling Blvd Sarasota, FL 34233 Sarasota, FL 34237 (941) 363-6381 (941) 861-2935 Fax: (941) 315-9136 Fax: (941) 861-2845 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: French MTHF 7:00 AM - 3:00 PM M-F 7:00 AM - 5:00 PM TW 11:00 AM - 7:00 PM PCMH: No Sat 8:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 524

Last update 08/14/2017

Specialty Physicians Sarasota General Dentistry - cont. Mazariegos, Stephanie DMD

Nalley, Brittany DMD Provider ID: TPVP158535-15 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Phan, Christine DMD Provider ID: TPVP127987-42 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Ngo, Denise DDS Malik, Chander DDS Misischia, William DDS Provider ID: TPVP134878-14 Provider ID: TPVP125938-02 Gender: Female Provider ID: TPVP125942-01 Gender: Male Greenberg Dental Gender: Male Doh - Sarasota County Health Doh - Sarasota County Health Orthodontics Department 4280 Bee Ridge Rd Department 2200 Ringling Blvd Sarasota, FL 34233 6950 Outreach Way Sarasota, FL 34237 (941) 363-6381 North Port, FL 34287 (941) 861-2935 Fax: (941) 315-9136 (941) 861-3888 Fax: (941) 861-2845 00 Yrs/99 Yrs Fax: (941) 861-3893 00 Yrs/99 Yrs Languages: Spanish 00 Yrs/99 Yrs Languages: French MTHF 7:00 AM - 3:00 PM Languages: Spanish M-F 7:00 AM - 5:00 PM TW 11:00 AM - 7:00 PM M-TH 7:00 AM - 4:00 PM PCMH: No Sat 8:00 AM - 3:00 PM F 7:30 AM - 12:30 PM PCMH: No PCMH: No Martinez, Magela DMD Patel, Kinjalben DMD Provider ID: TPVP137758-42 Misischia, William DDS Gender: Female Provider ID: TPVP137746-43 Provider ID: TPVP125942-02 Greenberg Dental Gender: Female Gender: Male Orthodontics Doh - Sarasota County Health Greenberg Dental 4280 Bee Ridge Rd Orthodontics Department Sarasota, FL 34233 4280 Bee Ridge Rd 2200 Ringling Blvd (941) 363-6381 Sarasota, FL 34233 Sarasota, FL 34237 Fax: (941) 315-9136 (941) 363-6381 (941) 861-2935 00 Yrs/99 Yrs Fax: (941) 315-9136 Fax: (941) 861-2845 Languages: Spanish 00 Yrs/99 Yrs 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM Languages: Spanish Languages: French TW 11:00 AM - 7:00 PM MTHF 7:00 AM - 3:00 PM M-F 7:00 AM - 5:00 PM Sat 8:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM PCMH: No PCMH: No Sat 8:00 AM - 3:00 PM PCMH: No

Rivera, Jade DMD Provider ID: TPVP155459-15 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Malik, Chander DDS Provider ID: TPVP125938-01 Gender: Male Doh - Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-3888 Fax: (941) 861-3893 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 4:00 PM F 7:30 AM - 12:30 PM PCMH: No

Provider ID: TPVP156700-15 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

www.wellcare.com/Florida | 525

Rizner, Amanda DMD Provider ID: TPVP131828-42 Gender: Female Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota General Dentistry - cont. Stein, Paul DDS Provider ID: TPVP125698-01 Gender: Male Doh - Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-3888 Fax: (941) 861-3893 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 4:00 PM F 7:30 AM - 12:30 PM PCMH: No

Trivedi, Mehulkumar DMD Provider ID: TPVP153681-15 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Sierra-Nieves, Elsie DMD Provider ID: TPVP150243-01 Gender: Female Doh - Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-3888 Fax: (941) 861-3893 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 4:00 PM F 7:30 AM - 12:30 PM Stein, Paul DDS PCMH: No Wade, Brianne DMD Provider ID: TPVP125698-02 Sierra-Nieves, Elsie DMD Gender: Male Provider ID: TPVP156720-15 Provider ID: TPVP150243-02 Doh - Sarasota County Health Gender: Female Department Gender: Female Greenberg Dental Orthodontics Doh - Sarasota County Health 2200 Ringling Blvd Department Sarasota, FL 34237 4280 Bee Ridge Rd 2200 Ringling Blvd (941) 861-2935 Sarasota, FL 34233 Sarasota, FL 34237 Fax: (941) 861-2845 (941) 363-6381 (941) 861-2935 00 Yrs/99 Yrs Fax: (941) 315-9136 Fax: (941) 861-2845 Languages: French 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 7:00 AM - 5:00 PM Languages: Spanish Languages: French PCMH: No MTHF 7:00 AM - 3:00 PM M-F 7:00 AM - 5:00 PM TW 11:00 AM - 7:00 PM Teresi, Kirsten DMD PCMH: No Sat 8:00 AM - 3:00 PM Provider ID: TPVP155452-15 PCMH: No Skordas, Fotios DDS Gender: Female General Practice Provider ID: TPVP115835-01 Greenberg Dental Orthodontics Gender: Male 4280 Bee Ridge Rd Rucker, Elsy MD Fa Skordas DDS MS Pl Sarasota, FL 34233 7129 Curtiss Ave Ste 2 Provider ID: 1185472 (941) 363-6381 Sarasota, FL 34231 Gender: Female Fax: (941) 315-9136 (941) 922-8811 Florida Dept. of Health 00 Yrs/99 Yrs Sarasota County Fax: (941) 922-8745 Languages: Spanish 2200 Ringling Blvd 00 Yrs/99 Yrs MTHF 7:00 AM - 3:00 PM Sarasota, FL 34237 Languages: Spanish TW 11:00 AM - 7:00 PM (941) 861-2900 M-TH 9:00 AM - 5:00 PM Sat 8:00 AM - 3:00 PM Fax: (941) 861-2828 F 9:00 AM - 12:00 PM PCMH: No 00 Yrs/130 Yrs Sat 8:30 AM - 3:00 PM Blake Medical Center PCMH: No Manatee Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2

www.wellcare.com/Florida | 526

General Surgery Chandler, Nicole MD Provider ID: 461033 Gender: Female Pediatric Physician Services 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No

Geriatric Medicine Reeder, Robert MD Provider ID: 1258891 Gender: Male Florida Department of Health In Sar 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Gynecology Skaggs, William MD Provider ID: 1202836 Gender: Male Senior Friendship Centers 2350 Scenic Dr Venice, FL 34293 (941) 556-3220 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Aneja, Lalit MD Provider ID: 1346036 Gender: Male Florida Cancer Specialists Pl 901 Tamiami Trl S Ste A-2 Venice, FL 34285 (941) 484-3531 Fax: (941) 486-1701 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Brown, Richard MD Provider ID: 25616 Gender: Male Hematology 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 Glick, Alexander MD (941) 377-9993 Fax: (941) 343-0026 Provider ID: 1356316 18 Yrs/130 Yrs Gender: Male Sarasota Memorial Hospital Florida Cancer Specialists Pl 3085 Bobcat Village Center Rd M-F 9:00 AM - 5:00 PM PCMH: No North Port, FL 34288 (941) 257-2280 Brown, Richard MD Fax: (941) 423-8946 18 Yrs/130 Yrs Provider ID: 25616 Bayfront Health Punta Gorda Fawcett Memorial Hospital Gender: Male Languages: Russian Florida Cancer Specialists M-F 9:00 AM - 5:00 PM 1970 Golf St PCMH: No Sarasota, FL 34236 (941) 957-1000 Hematology & Oncology Fax: (941) 951-2117 18 Yrs/130 Yrs Aneja, Lalit MD Sarasota Memorial Hospital Provider ID: 1346036 M-F 8:30 AM - 5:00 PM Gender: Male PCMH: No Florida Cancer Specialists Pl Buck, Richard MD 714 Doctors Dr Englewood, FL 34223 Provider ID: 230117 (941) 460-1300 Gender: Male Fax: (941) 460-1306 Florida Cancer Specialists 18 Yrs/130 Yrs 1970 Golf St M-F 9:00 AM - 5:00 PM Sarasota, FL 34236 PCMH: No (941) 957-1000 Fax: (941) 951-2117 Aneja, Lalit MD 18 Yrs/130 Yrs Provider ID: 1346036 M-F 8:30 AM - 5:00 PM Gender: Male PCMH: No Florida Cancer Specialists Pl 836 Sunset Lake Blvd Ste 101 Venice, FL 34292 (941) 408-0500 Fax: (941) 496-8558 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Buck, Richard MD Provider ID: 230117 Gender: Male Florida Cancer Specialists Pl 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Chu, Luis MD Provider ID: 25620 Gender: Male 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Chu, Luis MD Provider ID: 25620 Gender: Male Florida Cancer Specialists Pl 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Garcia, Rodrigo MD Provider ID: 229940 Gender: Male Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs Lakewood Ranch Medical Center Sarasota Memorial Hospital Winter Haven Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 527

Garcia, Rodrigo MD Provider ID: 229940 Gender: Male Florida Cancer Specialists 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs Lakewood Ranch Medical Center Sarasota Memorial Hospital Winter Haven Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Harandi, Amir MD Provider ID: 1359350 Gender: Male Florida Cancer Specialists Pl 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Jacob, Blessy MD Provider ID: 1131685 Gender: Female Florida Cancer Specialists 836 Sunset Lake Blvd Ste 101 Venice, FL 34292 (941) 408-0500 Fax: (941) 496-8558 18 Yrs/130 Yrs Bayfront Health Dade City Englewood Community Hospital (MP) Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Hematology & Oncology Koehler, Kevin MD - cont. Provider ID: 1356293 Jacob, Blessy MD Provider ID: 1131685 Gender: Female Florida Cancer Specialists P L 714 Doctors Dr Englewood, FL 34223 (941) 460-1300 Fax: (941) 460-1306 18 Yrs/130 Yrs Bayfront Health Dade City Englewood Community Hospital (MP) Memorial Hospital of Tampa M-F 9:00 AM - 5:00 PM PCMH: No Kayali, Fadi MD Provider ID: 698432 Gender: Male Florida Cancer Specialist Pl 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Kayali, Fadi MD Provider ID: 698432 Gender: Male Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Koehler, Kevin MD Provider ID: 1356293 Gender: Male Florida Cancer Specialists Pl 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Gender: Male Florida Cancer Specialists Pl 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Lifton, Robin MD Provider ID: 278663 Gender: Female Florida Cancer Specialists 714 Doctors Dr Englewood, FL 34223 (941) 460-1300 Fax: (941) 460-1306 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Lunin, Scott MD Provider ID: 306802 Gender: Male Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs Bayfront Health Punta Gorda Fawcett Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Soriano, Andres MD Provider ID: 954157 Gender: Male Florida Cancer Specialists 836 Sunset Lake Blvd Ste 101 Venice, FL 34292 (941) 408-0500 Fax: (941) 496-8558 18 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Lunin, Scott MD Wright-Browne, Vance MD Provider ID: 306802 Gender: Male Provider ID: 408804 Florida Cancer Specialists Gender: Male 3085 Bobcat Village Center Rd Florida Cancer Specialists North Port, FL 34288 3085 Bobcat Village Center Rd (941) 257-2280 North Port, FL 34288 Fax: (941) 423-8946 (941) 257-2280 18 Yrs/130 Yrs Fax: (941) 423-8946 Bayfront Health Punta Gorda 18 Yrs/130 Yrs Fawcett Memorial Hospital Bayfront Health Punta Gorda Lifton, Robin MD M-F 9:00 AM - 5:00 PM Fawcett Memorial Hospital PCMH: No Provider ID: 278663 M-F 9:00 AM - 5:00 PM Gender: Female PCMH: No Patel, Anjan MD Florida Cancer Specialists Pl Provider ID: 1026817 Infectious Disease 901 Tamiami Trl S Gender: Male Venice, FL 34285 Florida Cancer Specialists (941) 484-3531 Bhattacharyya, Rishi MD 600 N Cattlemen Rd Ste 200 Fax: (941) 486-1701 Sarasota, FL 34232 18 Yrs/130 Yrs Provider ID: 1139220 (941) 377-9993 M-F 8:30 AM - 5:00 PM Gender: Male Fax: (941) 343-0026 PCMH: No Infectious Diseases Associates 18 Yrs/130 Yrs 1425 S Osprey Ave Ste 1 Lubiner, Eric DO Doctors Hospital Sarasota Sarasota, FL 34239 Sarasota Memorial Hospital Provider ID: 193017 (941) 366-9060 Languages: Gujarati Gender: Male Fax: (941) 552-1588 M-F 9:00 AM - 5:00 PM Florida Cancer Specialists 12 Yrs/130 Yrs 3085 Bobcat Village Center Rd PCMH: No Doctors Hospital Sarasota North Port, FL 34288 M-F 8:30 AM - 5:00 PM Percent, Ivor MD (941) 257-2280 PCMH: No Provider ID: 478998 Fax: (941) 423-8946 Gender: Male 18 Yrs/130 Yrs 3085 Bobcat Village Center Rd Bayfront Health Punta Gorda North Port, FL 34288 Fawcett Memorial Hospital (941) 257-2280 Languages: Spanish Fax: (941) 423-8946 M-F 9:00 AM - 5:00 PM 18 Yrs/120 Yrs PCMH: No Bayfront Health Punta Gorda Fawcett Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 528

Last update 08/14/2017

Specialty Physicians Sarasota Infectious Disease - cont. Farooq, Ahmed MD Dunn, Michael MD Provider ID: 938262 Gender: Male Community Aids Network 1231 N Tuttle Ave Sarasota, FL 34237 (727) 321-3854 Fax: (941) 951-1795 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-TH 9:00 AM - 5:00 PM PCMH: No Dunn, Michael MD Provider ID: 938262 Gender: Male Comprehensive Care Center Inc 14243 Tamiami Trl North Port, FL 34287 (941) 888-2144 Fax: (941) 888-2063 18 Yrs/130 Yrs Memorial Hospital of Tampa St Josephs Hospital M-F 9:00 AM - 5:00 PM PCMH: No Elliott, Brian MD Provider ID: 1259238 Gender: Male Comprehensive Care Center Inc DBA C 1231 N Tuttle Ave Sarasota, FL 34237 (941) 366-0134 Fax: (941) 951-1795 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 717508 Gender: Male Metrolina Infectious Diseases PA 517 Riviera St Ste D Venice, FL 34285 (941) 244-9524 Fax: (941) 244-9526 00 Yrs/130 Yrs Englewood Community Hospital (MP) Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Gordillo, Manuel MD Provider ID: 12613 Gender: Male Infectious Disease Associates 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 953-7076 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Krinsky, Andrew MD Provider ID: 3792 Gender: Male Infectious Disease Consultants PA 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 953-7076 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Larkin, Julie MD Provider ID: 210681 Gender: Female Infectious Disease Associates 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 953-7076 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital Tampa General Hospital M-F 8:30 AM - 5:00 PM PCMH: No Mercado, Roberto MD Provider ID: 152688 Gender: Male Infectious Disease Associates 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 953-7076 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Milam, Michael MD Provider ID: 3793 Gender: Male Infectious Disease Associates 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 953-7076 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Paruolo, Joseph MD Provider ID: 1335653 Gender: Male Infectious Diseases Associates 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 552-1588 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 4:30 PM PCMH: No Tallapragada, Sudha MD Provider ID: 19980 Gender: Female Infectious Disease Associates 1425 S Osprey Ave Ste 1 Sarasota, FL 34239 (941) 366-9060 Fax: (941) 953-7076 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 14243 Tamiami Trl North Port, FL 34287 (941) 888-2144 Fax: (941) 888-2063 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-F 8:00 AM - 5:00 PM PCMH: No

Offner, Lenka MD Walsh Sr, Douglas DO Provider ID: 757534 Gender: Female Provider ID: 1258892 Infectious Diseases Associates Gender: Male 1425 S Osprey Ave Ste 1 Comprehensive Care Center Sarasota, FL 34239 DBA Commu (941) 366-9060 1231 N Tuttle Ave Fax: (941) 552-1575 Sarasota, FL 34237 00 Yrs/130 Yrs (941) 366-0134 Sarasota Memorial Hospital Fax: (941) 951-1795 Languages: Spanish, Faroese, 18 Yrs/130 Yrs Japanese, Czech M-F 8:00 AM - 5:00 PM M-F 8:30 AM - 5:00 PM PCMH: No PCMH: No

www.wellcare.com/Florida | 529

Last update 08/14/2017

Specialty Physicians Sarasota Internal Medicine Atiq, Shehla MD Provider ID: 1314025 Gender: Female Gulf Coast Hma Physician Management 1720 E Venice Ave Venice, FL 34292 (941) 483-9730 Fax: (941) 483-9745 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fergeson, Jennifer DO Provider ID: 1414948 Gender: Female Hugh H Windom MD PA 3570 S Tuttle Ave Sarasota, FL 34239 (941) 927-4888 Fax: (941) 927-5808 12 Yrs/130 Yrs M 8:30 AM - 5:30 PM T 8:30 AM - 6:00 PM WF 8:30 AM - 5:00 PM TH 7:30 AM - 5:00 PM PCMH: No Paredes, August MD Provider ID: 1207667 Gender: Male Senior Friendship Centers 2350 Scenic Dr Venice, FL 34293 (941) 584-0041 Fax: (941) 496-8627 50 Yrs/110 Yrs Languages: Spanish M-TH 8:30 AM - 4:30 PM PCMH: No Schreibman, Tanya MD Provider ID: 286830 Gender: Female Community Aids Network 1231 N Tuttle Ave Sarasota, FL 34237 (941) 366-0134 Fax: (941) 951-1795 12 Yrs/130 Yrs Languages: Creole M-F 8:00 AM - 5:00 PM PCMH: No

Tanyous, Walid MD Provider ID: 1315003 Gender: Male Gulf Coast Hma Physician Mgt LLC 8383 S Tamiami Trl Ste 115 Sarasota, FL 34238 (941) 244-9430 Fax: (941) 244-9437 18 Yrs/110 Yrs Languages: Spanish, German, Arabic M-F 8:00 AM - 5:00 PM PCMH: No Vega, Vilma MD Provider ID: 1248983 Gender: Female Comprehensive Care Center DBA Commu 14243 Tamiami Trl North Port, FL 34287 (941) 888-2144 Fax: (941) 888-2063 16 Yrs/130 Yrs Languages: Spanish, Czech, Slovak M-F 8:00 AM - 5:00 PM PCMH: No Warner, Daniel MD Provider ID: 1289526 Gender: Male Community Aids Network 1231 N Tuttle Ave Sarasota, FL 34237 (941) 366-0134 18 Yrs/130 Yrs M-TH 9:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Maternal Fetal Medicine Baacke, Keri MD Provider ID: 1344794 Gender: Female Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (941) 371-8100 Fax: (855) 527-5510 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Fines Dailey, Verlee MD Provider ID: 1068805 Gender: Female Pediatrix Medical Group 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (941) 371-8100 Fax: (813) 971-6985 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Fry III, Alland MD Provider ID: 310079 Gender: Male 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (941) 371-8100 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Giraldo Isaza, Maria MD Provider ID: 1177461 Gender: Female Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Sarasota, FL 34233 (941) 371-8100 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stirling, Kari MD Provider ID: 1178576 Gender: Female Pediatrix Medicala Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (941) 371-8100 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 530

Medical Oncology Eakle, Janice MD Provider ID: 227410 Gender: Female Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Eakle, Janice MD Provider ID: 227410 Gender: Female Florida Cancer Specialists 6310 Health Park Way Ste 200 Bradenton, FL 34202 (941) 907-4737 Fax: (941) 907-9493 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Eakle, Janice MD Provider ID: 227410 Gender: Female Florida Cancer Specialists Pl 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Glick, Alexander MD Provider ID: 1356316 Gender: Male Florida Cancer Specialists Pl 3085 Bobcat Village Center Rd North Port, FL 34288 (941) 257-2280 Fax: (941) 423-8946 18 Yrs/130 Yrs Bayfront Health Punta Gorda Fawcett Memorial Hospital Languages: Russian M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Medical Oncology - cont. Junagadhwalla, Mehnaz MD Gonter, Paul MD Provider ID: 221125 Gender: Male Florida Cancer Specialists 714 Doctors Dr Englewood, FL 34223 (941) 460-1300 Fax: (941) 460-1306 18 Yrs/130 Yrs Venice Regional Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Gonter, Paul MD Provider ID: 221125 Gender: Male Florida Cancer Specialists 836 Sunset Lake Blvd Ste 101 Venice, FL 34292 (941) 408-0500 Fax: (941) 496-8558 18 Yrs/130 Yrs Venice Regional Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Gonter, Paul MD Provider ID: 221125 Gender: Male Florida Cancer Specialists 901 Tamiami Trl S Venice, FL 34285 (941) 484-3531 Fax: (941) 486-1701 18 Yrs/130 Yrs Venice Regional Medical Center M-F 8:30 AM - 5:00 PM PCMH: No Junagadhwalla, Mehnaz MD Provider ID: 432664 Gender: Female Florida Cancer Specialists 714 Doctors Dr Englewood, FL 34223 (941) 460-1300 Fax: (941) 460-1306 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Provider ID: 432664 Gender: Female Florida Cancer Specialists 836 Sunset Lake Blvd Ste 101 Venice, FL 34292 (941) 308-0500 Fax: (941) 496-8558 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Junagadhwalla, Mehnaz MD Provider ID: 432664 Gender: Female Florida Cancer Specialists Pl 901 Tamiami Trl S Venice, FL 34285 (941) 484-3531 Fax: (941) 486-1701 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Patel, Manish MD Provider ID: 622381 Gender: Male Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 373-9820 18 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Patel, Manish MD Provider ID: 622381 Gender: Male Florida Cancer Specialists Pl 600 N Cattlemen Rd Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Silver, Caryn MD Provider ID: 282068 Gender: Female 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Silver, Caryn MD Provider ID: 282068 Gender: Female Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Wang, Judy MD Provider ID: 1168724 Gender: Female Florida Cancer Specialists 600 N Cattlemen Rd Ste 200 Sarasota, FL 34232 (941) 377-9993 Fax: (941) 343-0026 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Ghose, Ranjan MD Provider ID: 178234 Gender: Male Silverstein Zendel Weber & Cover 1921 Waldemere St Ste 413 Sarasota, FL 34239 (941) 917-6585 Fax: (941) 917-6514 16 Yrs/130 Yrs Doctors Hospital Sarasota Healthsouth Hospitals Sarasota Memorial Hospital M-F 8:30 AM - 4:30 PM PCMH: No Rodriguez, Betzaida MD Provider ID: 1205000 Gender: Female Nephrology Associates of Sarasota 1921 Waldemere St Ste 413 Sarasota, FL 34239 (941) 917-6585 Fax: (941) 917-6514 18 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 4:30 PM PCMH: No

Sastry, Ashok MD Provider ID: 348260 Gender: Male Nephrology Associates of Sarasota Nephrology 1921 Waldemere St Ste 413 Cho-Chung-Hing, Lorraine MD Sarasota, FL 34239 (941) 917-6585 Fax: (941) 917-6514 Provider ID: 291414 16 Yrs/130 Yrs Gender: Female Doctors Hospital Sarasota Florida Kidney Institute PA Sarasota Memorial Hospital 1500 E Venice Ave Unit 103 M-TH 9:00 AM - 5:00 PM Venice, FL 34292 F 9:00 AM - 4:30 PM (941) 485-4700 PCMH: No Fax: (941) 485-2888 18 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 531

Last update 08/14/2017

Specialty Physicians Sarasota Neurology Ditrapani Stephenson, Tonya MD Provider ID: 1326746 Gender: Female Gulf Coast Hma Physician Management 600 Nokomis Ave S Ste 204 Venice, FL 34285 (941) 486-6600 Fax: (941) 486-6610 00 Yrs/130 Yrs M-TH 8:30 AM - 4:30 PM F 8:30 AM - 1:00 PM PCMH: No Lexow, Stephen MD Provider ID: 1185579 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs Languages: Spanish M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No Morris, Laura MD Provider ID: 1196791 Gender: Female Senior Friendship Center 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 8:30 AM - 12:30 PM PCMH: No Vintayen, Enrico MD Provider ID: 1315893 Gender: Male Gulf Coast Hma Physician Management 600 Nokomis Ave S Ste 204 Venice, FL 34285 (941) 486-6600 Fax: (941) 486-6610 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Nuclear Medicine McDonald, Robert MD Provider ID: 905871 Gender: Male Florida Cancer Specialists 1970 Golf St Sarasota, FL 34236 (941) 957-1000 Fax: (941) 951-2117 18 Yrs/120 Yrs Gulf Coast Medical Center M-F 9:00 AM - 5:00 PM PCMH: No

Obstetrics/Gynecology

Baill, I Cori MD Provider ID: 1226223 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 365-3913 Fax: (941) 296-7806 00 Yrs/130 Yrs Languages: Spanish MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No Doyle-Vallery, Deanna MD

Addae, Yusif MD Provider ID: 660486 Gender: Male North Port Health Center 6950 Outreach Way North Port, FL 34287 (941) 861-3820 Fax: (941) 861-3829 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 7:00 AM - 6:00 PM PCMH: No Addae, Yusif MD Provider ID: 660486 Gender: Male Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Provider ID: 152428 Gender: Female Florida Womancare 1950 Arlington St Ste 203 Sarasota, FL 34239 (941) 379-6331 Fax: (941) 349-5343 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital Languages: Spanish, Russian MWTHF 9:00 AM - 4:30 PM T 9:00 AM - 7:00 PM PCMH: No Doyle-Vallery, Deanna MD

Easterling, Gary MD Provider ID: 25632 Gender: Male 1950 Arlington St Ste 203 Sarasota, FL 34239 (941) 379-6331 Fax: (941) 379-5443 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital Languages: Spanish, Russian MWTHF 9:00 AM - 4:30 PM T 9:00 AM - 7:00 PM PCMH: No Fanarjian, Nicole MD Provider ID: 985158 Gender: Female Planned Parenthood of Southwest An 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs Tampa General Hospital Languages: Spanish MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No

Felski, Emil DO Provider ID: 1229396 Gender: Male Provider ID: 152428 Planned Parenthood of Gender: Female Southwest and Florida Womancare 2345 Bobcat Village Center Rd 736 Central Ave Sarasota, FL 34236 North Port, FL 34288 (407) 677-1234 (941) 379-6331 Fax: (407) 677-1001 Fax: (941) 379-5443 12 Yrs/130 Yrs 12 Yrs/130 Yrs M-F 8:45 AM - 4:00 PM Doctors Hospital Sarasota Sat 9:00 AM - 3:00 PM Sarasota Memorial Hospital PCMH: No Languages: Spanish, Russian M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 532

Last update 08/14/2017

Specialty Physicians Sarasota Obstetrics/Gynecology - Goodman, Jerry MD cont. Fitzgerald, Frederick MD

Provider ID: 1192640 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs Languages: Spanish M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Jamison, Richard MD Provider ID: 272727 Gender: Male 1950 Arlington St Ste 203 Sarasota, FL 34239 (941) 379-6331 Fax: (941) 349-5343 12 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital MWTHF 9:00 AM - 4:30 PM T 9:00 AM - 7:00 PM PCMH: No

Kenton Haney, Julianne MD Provider ID: 1418042 Gender: Female Florida Woman Care 2439 Bee Ridge Rd Sarasota, FL 34239 (941) 365-5367 Fax: (941) 955-0453 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Provider ID: 1115047 Gender: Male Florida Department of Health In Sar 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 18 Yrs/130 Yrs Manuel, Margaux MD Sarasota Memorial Hospital Jones, Malcolm MD Hill, Washington MD Provider ID: 906367 Languages: Spanish Provider ID: 907084 Gender: Female M-F 8:00 AM - 5:00 PM Gender: Male 1950 Arlington St Ste 203 PCMH: No Provider ID: 1172798 All Womens Health Center of Sarasota, FL 34239 Gender: Male Garner, Kyle MD (941) 379-6331 Florida Department of Health Saraso 2700 S Tamiami Trl Provider ID: 366978 In Sar Fax: (941) 379-5443 Sarasota, FL 34239 Gender: Male 2200 Ringling Blvd 00 Yrs/130 Yrs (941) 366-7066 1950 Arlington St Ste 203 Sarasota, FL 34237 M-F 8:30 AM - 5:00 PM Fax: (941) 952-9885 Sarasota, FL 34239 (941) 861-2967 PCMH: No 12 Yrs/130 Yrs (941) 379-6331 Fax: (941) 861-2719 M-F 8:30 AM - 5:30 PM Manuel, Margaux MD Fax: (941) 379-5443 00 Yrs/130 Yrs Sat 8:30 AM - 2:30 PM Provider ID: 906367 12 Yrs/130 Yrs Sarasota Memorial Hospital PCMH: No Gender: Female Sarasota Memorial Hospital MT 7:00 AM - 5:00 PM 2345 Bobct Vlg Center Rd Ste MWTHF 9:00 AM - 4:30 PM PCMH: No Jothivijayarani, A MD 201 T 9:00 AM - 7:00 PM Howard, Arthur MD North Port, FL 34288 PCMH: No Provider ID: 306370 (941) 379-6331 Provider ID: 486568 Garner, Kyle MD Gender: Female Fax: (941) 379-5443 Gender: Male Provider ID: 366978 Sarasota County Health 00 Yrs/130 Yrs Sarasota County Health Dept Gender: Male Deparment M-F 9:00 AM - 5:00 PM 2200 Ringling Blvd Florida Woman Care LLC 2200 Ringling Blvd PCMH: No Sarasota, FL 34237 2345 Bobct Vlg Center Rd Ste Sarasota, FL 34237 (941) 861-2900 201 Micklavzina, Connie MD (941) 941-2900 Fax: (941) 861-2719 North Port, FL 34288 Fax: (941) 861-2719 12 Yrs/130 Yrs (941) 379-6331 00 Yrs/130 Yrs Provider ID: 656596 Sarasota Memorial Hospital Fax: (941) 379-5443 Blake Medical Center Gender: Female Languages: Spanish 12 Yrs/130 Yrs Manatee Memorial Hospital Sarasota County Health Dept M-F 8:00 AM - 4:00 PM Sarasota Memorial Hospital Sarasota Memorial Hospital 2200 Ringling Blvd PCMH: No M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Sarasota, FL 34237 PCMH: No PCMH: No Jackson, Darwin MD (941) 861-2900 Fax: (941) 861-2828 12 Yrs/130 Yrs Provider ID: 907096 Sarasota Memorial Hospital Gender: Male Languages: Spanish All Womens Health Center of Saraso M-F 7:00 AM - 6:00 PM 2700 S Tamiami Trl Sat 8:00 AM - 12:00 PM Sarasota, FL 34239 PCMH: No (941) 366-7066 Fax: (941) 952-9885 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 533

Last update 08/14/2017

Specialty Physicians Sarasota Obstetrics/Gynecology - Prabhakaran, Sujatha MD cont. Montano, Jolene MD Provider ID: 1324965 Gender: Female Advanced Gynecology and Obstetrics 2439 Bee Ridge Rd Sarasota, FL 34239 (941) 955-8076 Fax: (941) 955-0453 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ortiz, Edwin MD Provider ID: 783354 Gender: Male Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No Pearman, Carl MD Provider ID: 1178566 Gender: Male Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM PCMH: No

Provider ID: 796079 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish, Arabic, Bengali, Armenian MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No Rosa, Hector MD Provider ID: 817797 Gender: Male Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Spanish MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No Santos, Ramon MD Provider ID: 25741 Gender: Male Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 00 Yrs/130 Yrs Doctors Hospital Sarasota Languages: Spanish M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: No

Singer, Joseph MD Provider ID: 531249 Gender: Male Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2828 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 7:00 AM - 6:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Slackman, Robert MD Provider ID: 1187326 Gender: Male Planned Parenthood of Southwest and 736 Central Ave Sarasota, FL 34236 (941) 365-3913 12 Yrs/130 Yrs M 11:00 AM - 6:00 PM T 12:00 AM - 6:30 PM W 11:00 AM - 6:30 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No Stephens, Shawn MD Provider ID: 728140 Gender: Male Florida Woman Care 389 Commercial Ct Ste D2 Venice, FL 34292 (941) 359-8300 Fax: (941) 359-8310 00 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 6:00 PM PCMH: No

www.wellcare.com/Florida | 534

Trupiano, Christine MD Provider ID: 1358724 Gender: Female Sarasota County Health Department 1750 17th St Bldg E Sarasota, FL 34234 (941) 861-1400 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Trupiano, Christine MD Provider ID: 1358724 Gender: Female Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2934 Fax: (941) 861-2719 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Trupiano, Christine MD Provider ID: 1358724 Gender: Female Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-3820 Fax: (941) 861-2719 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Obstetrics/Gynecology - Anthony, Charles MD cont. Provider ID: TPV1518278142-0 Waterman II, Philip MD Provider ID: 686208 Gender: Male Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs Lee Memorial Hospital MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM PCMH: No

Ophthalmology Ahn, Byung-Joon MD Provider ID: TPV1649492711-0 Gender: Male Eye Associates of Manatee LLP 2111 Bee Ridge Rd Sarasota, FL 34239 (941) 925-8888 Fax: (941) 798-3995 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Ahn, Byung-Joon MD Provider ID: TPV1649492711-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No

Gender: Male Eye Associates of Manatee LLP 2111 Bee Ridge Rd Sarasota, FL 34239 (941) 925-8888 Fax: (941) 798-3995 12 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem Languages: Spanish, Korean M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Anthony, Charles MD Provider ID: TPV1518278142-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 12 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No Berger, Todd MD Provider ID: TPV1205836418-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 18 Yrs/99 Yrs Northside Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Davis, Jeffrey MD Foster, John MD Provider ID: TPV1275795775-0 Provider ID: TPV1396920906-0 Gender: Male Gender: Male Manatee-Sarasota Eye Clinic Eye Associates of Manatee LLP 1427 S Tamiami Trl 250 S Tamiami Trl Ste 103 Sarasota, FL 34239 Venice, FL 34285 (941) 366-4777 (941) 792-2020 Fax: (941) 746-1055 Fax: (941) 782-1089 00 Yrs/18 Yrs Manatee Memorial Hospital & 04 Yrs/99 Yrs Health Syste Blake Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Friedberg, Murray MD Edelman, Robert MD Provider ID: TPV1609874874-0 Provider ID: TPV1790783553-0 Gender: Male Gender: Male Manatee-Sarasota Eye Clinic Manatee-Sarasota Eye Clinic 1427 S Tamiami Trl 1427 S Tamiami Trl Sarasota, FL 34239 Sarasota, FL 34239 (941) 366-4777 (941) 366-4777 Fax: (941) 746-1055 Fax: (941) 746-1055 00 Yrs/18 Yrs 00 Yrs/18 Yrs Manatee Memorial Hospital & Manatee Memorial Hospital & Health Syste Health Syste Languages: Spanish Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Friedman, Robert MD Foster, John MD Provider ID: TPV1750327177-0 Provider ID: TPV1396920906-0 Gender: Male Gender: Male Eye Associates of Manatee LLP Eye Associates of Manatee LLP 2111 Bee Ridge Rd 2111 Bee Ridge Rd Sarasota, FL 34239 Sarasota, FL 34239 (941) 925-8888 (941) 925-8888 Fax: (941) 798-3995 Fax: (941) 798-3995 18 Yrs/99 Yrs 04 Yrs/99 Yrs Sarasota Memorial Hospital Blake Medical Center Languages: Spanish, Korean Languages: Spanish, Korean M 1:00 AM - 5:00 PM M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Last update 08/14/2017

Specialty Physicians Sarasota Ophthalmology - cont. Friedman, Robert MD Provider ID: TPV1750327177-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 18 Yrs/99 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Friedman, Scott MD Provider ID: TPV1497842314-0 Gender: Male Eye Associates of Manatee LLP 2111 Bee Ridge Rd Sarasota, FL 34239 (941) 925-8888 Fax: (941) 798-3995 00 Yrs/99 Yrs Winter Haven Hospital Languages: Spanish, Korean M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Friedman, Scott MD Provider ID: TPV1497842314-1 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 00 Yrs/99 Yrs Winter Haven Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Grabow, Harry MD Provider ID: TPV1356344188-0 Gender: Male Crystal River Eye Center LLC 3920 Bee Ridge Rd Bldg F Ste A Sarasota, FL 34233 (941) 921-7744 Fax: (941) 927-2726 05 Yrs/99 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Kasper, Jeffrey MD Provider ID: TPV1912907122-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 18 Yrs/99 Yrs Northside Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Mali, Joshua MD Provider ID: TPV1124261375-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 01 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No

Hector, Richard MD Khator, Pooja MD Provider ID: TPV1073511077-0 Provider ID: TPV1376592741-0 McCabe, Cathleen MD Provider ID: TPV1700840493-0 Gender: Male Gender: Female Gender: Female Eye Associates of Manatee Manatee-Sarasota Eye Clinic LLP Eye Associates of Manatee 1427 S Tamiami Trl LLP 2111 Bee Ridge Rd Sarasota, FL 34239 2111 Bee Ridge Rd Sarasota, FL 34239 (941) 366-4777 Sarasota, FL 34239 (941) 925-8888 Fax: (941) 746-1055 (941) 925-8888 Fax: (941) 798-3995 00 Yrs/18 Yrs Fax: (941) 798-3995 18 Yrs/99 Yrs Lakewood Ranch Medical 18 Yrs/99 Yrs Manatee Memorial Hospital & Center Health Syste Manatee Memorial Hospital & Sarasota Memorial Hospital Health Syste Languages: Spanish, Korean Languages: Spanish, Korean Languages: Spanish M 1:00 AM - 5:00 PM M 1:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No PCMH: No PCMH: No Mali, Joshua MD Hector, Richard MD Provider ID: TPV1124261375-0 Provider ID: TPV1073511077-0 Gender: Male Gender: Male Eye Associates of Manatee Eye Associates of Manatee LLP LLP 2111 Bee Ridge Rd 250 S Tamiami Trl Ste 103 Sarasota, FL 34239 Venice, FL 34285 (941) 925-8888 (941) 792-2020 Fax: (941) 798-3995 Fax: (941) 782-1089 01 Yrs/99 Yrs 18 Yrs/99 Yrs Manatee Memorial Hospital & No Hospital PrivilegesCovering Arrangem Health Syste Languages: Spanish, Korean M-F 8:00 AM - 5:00 PM M 1:00 AM - 5:00 PM PCMH: No TWTHF 8:00 AM - 5:00 PM PCMH: No

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McCabe, Cathleen MD Provider ID: TPV1700840493-0 Gender: Female Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 18 Yrs/99 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Ophthalmology - cont. Menezes, Allison MD Provider ID: TPV1992741078-0 Gender: Female Manatee-Sarasota Eye Clinic 1427 S Tamiami Trl Sarasota, FL 34239 (941) 366-4777 Fax: (941) 746-1055 00 Yrs/18 Yrs Sarasota Memorial Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Mishra, Prabin MD Provider ID: TPV1851361869-1 Gender: Male Community Eye Center PA 1988 Tamiami Trail South Venice, FL 34293 (941) 408-0145 Fax: (941) 408-0145 09 Yrs/99 Yrs No Hospital PrivilegesCovering Arrangem M-F 8:00 AM - 5:00 PM PCMH: No Plous, Oren MD Provider ID: TPV1467422659-0 Gender: Male Tampa Bay Retina PA 1961 Floyd St Ste B Sarasota, FL 34239 (941) 312-2769 Fax: (866) 426-2169 12 Yrs/99 Yrs Mease Countryside Hospital Morton Plant Hospital Winter Haven Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Optician Ross, Joseph MD Provider ID: TPV1780602482-0 Eye Doctors Optical Outlets Gender: Male PA Crystal River Eye Center LLC Provider ID: TPV1740471705-0 3920 Bee Ridge Rd Bldg F Ste A 4171 S Tamiami Trl Ste 34 Sarasota, FL 34233 Venice, FL 34293 (941) 921-7744 (941) 492-9181 Fax: (941) 927-2726 Fax: (941) 306-4786 12 Yrs/99 Yrs 00 Yrs/99 Yrs Citrus Memorial Hospital MTWF 9:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM TH 9:00 AM - 7:00 PM PCMH: No PCMH: No Schaible, Eric MD Provider ID: TPV1245238526-0 Gender: Male Community Eye Center PA 1988 Tamiami Trail South Venice, FL 34293 (941) 408-0145 Fax: (941) 408-0145 00 Yrs/99 Yrs Fawcett Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Eye Doctors Optical Outlets PA Provider ID: TPV1740471788-0 4848 S Tamiami Trl Sarasota, FL 34231 (941) 925-2010 Fax: (941) 893-3304 00 Yrs/99 Yrs MTTHF 9:00 AM - 6:00 PM W 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Optometry Silverman, Scott MD Provider ID: TPV1912905910-0 Batzer, Jon OD Gender: Male Provider ID: TPV1104824473-0 Manatee-Sarasota Eye Clinic Gender: Male 1427 S Tamiami Trl Community Eye Center PA Sarasota, FL 34239 1988 Tamiami Trail South (941) 366-4777 Venice, FL 34293 Fax: (941) 746-1055 (941) 408-0145 00 Yrs/18 Yrs Manatee Memorial Hospital & Fax: (941) 408-0145 Health Syste 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No Beck, Susan OD Spadafora, Joseph DO Provider ID: TPV1518096460-0 Provider ID: TPV1447258256-0 Gender: Female Gender: Male Skos Vision Center Inc Community Eye Center PA 3920 Bee Ridge Rd 1988 Tamiami Trail South Sarasota, FL 34233 Venice, FL 34293 (941) 923-3411 (941) 408-0145 Fax: (941) 921-3832 Fax: (941) 408-0145 05 Yrs/99 Yrs 18 Yrs/99 Yrs MWTH 8:30 AM - 5:30 PM Fawcett Memorial Hospital T 8:30 AM - 6:00 PM M-F 8:00 AM - 5:00 PM PCMH: No PCMH: No

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Billings, Rick OD Provider ID: TPV1194717678-0 Gender: Male Rick Billings OD 3900 Clark Rd Ste E 2 Sarasota, FL 34233 (941) 923-1119 Fax: (941) 923-1858 05 Yrs/99 Yrs Languages: Spanish, French MTWF 8:30 AM - 5:30 PM TH 8:30 AM - 6:00 PM PCMH: No Blom, Thomas OD Provider ID: TPV1699756981-0 Gender: Male Thomas Blom OD PA 2450 Bee Ridge Rd Sarasota, FL 34239 (941) 925-3937 Fax: (941) 925-4967 06 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Carr, William OD Provider ID: TPV1609803451-0 Gender: Male Eye Doctors Optical Outlets PA 4171 S Tamiami Trl Ste 34 Venice, FL 34293 (941) 492-9181 Fax: (941) 306-4786 05 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No Carr, William OD Provider ID: TPV1609803451-0 Gender: Male Eye Doctors Optical Outlets PA 4848 S Tamiami Trl Sarasota, FL 34231 (941) 925-2010 Fax: (941) 893-3304 05 Yrs/99 Yrs MTTHF 9:00 AM - 6:00 PM W 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Optometry - cont. Detweiler, Edwin OD Provider ID: TPV1154303923-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Long, Lori OD Provider ID: TPV1477685931-0 Gender: Female Eye Associates of Manatee LLP 2111 Bee Ridge Rd Sarasota, FL 34239 (941) 925-8888 Fax: (941) 798-3995 05 Yrs/99 Yrs Languages: Spanish, Korean M 1:00 AM - 5:00 PM TWTHF 8:00 AM - 5:00 PM PCMH: No Long, Lori OD Provider ID: TPV1477685931-0 Gender: Female Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Luu, Diane OD Provider ID: TPV1255414710-0 Gender: Female Eye Doctors Optical Outlets PA 4171 S Tamiami Trl Ste 34 Venice, FL 34293 (941) 492-9181 Fax: (941) 306-4786 05 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No

Morchesky, Darren OD Provider ID: TPV1033526793-0 Gender: Male Eye Doctors Optical Outlets PA 4171 S Tamiami Trl Ste 34 Venice, FL 34293 (941) 492-9181 Fax: (941) 306-4786 05 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No Paquin, Warren OD Provider ID: TPV1629128350-0 Gender: Male Manatee Family Eyecare PA 1236 Jacaranda Blvd Venice, FL 34292 (941) 496-4444 Fax: (941) 496-4223 03 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Rego, Robert OD Provider ID: TPV1851675524-1 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Rubin, David OD Provider ID: TPV1982682423-0 Gender: Male Eye Associates of Manatee LLP 250 S Tamiami Trl Ste 103 Venice, FL 34285 (941) 792-2020 Fax: (941) 782-1089 01 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Schatz, Scott OD Provider ID: TPV1154495141-0 Gender: Male Eye Doctors Optical Outlets PA 4171 S Tamiami Trl Ste 34 Venice, FL 34293 (941) 492-9181 Fax: (941) 306-4786 05 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No

Schatz, Scott OD Provider ID: TPV1154495141-0 Gender: Male Eye Doctors Optical Outlets PA 4848 S Tamiami Trl Sarasota, FL 34231 (941) 925-2010 Fax: (941) 893-3304 05 Yrs/99 Yrs MTTHF 9:00 AM - 6:00 PM W 9:00 AM - 7:00 PM Roberts, Tyler OD Sat 9:00 AM - 5:00 PM Provider ID: TPV1346658945-0 PCMH: No Gender: Male Shin, Susan OD Community Eye Center PA Provider ID: TPV1912948100-0 1988 Tamiami Trail South Gender: Female Venice, FL 34293 Eye Doctors Optical Outlets (941) 408-0145 PA Fax: (941) 408-0145 4171 S Tamiami Trl Ste 34 09 Yrs/99 Yrs Venice, FL 34293 M-F 8:00 AM - 5:00 PM (941) 492-9181 PCMH: No Fax: (941) 306-4786 18 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No

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Shin, Susan OD Provider ID: TPV1912948100-0 Gender: Female Eye Doctors Optical Outlets PA 4171 S Tamiami Trl Ste 34 Venice, FL 34293 (941) 492-9181 Fax: (941) 306-4786 18 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No Simoneau, Cheryl OD Provider ID: TPV1811950439-0 Gender: Female Community Eye Center PA 1988 Tamiami Trail South Venice, FL 34293 (941) 408-0145 Fax: (941) 408-0145 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Soto, Frederick OD Provider ID: 148468 Gender: Male 2650 S Tamiami Trl Sarasota, FL 34239 (941) 953-3111 Fax: (941) 366-5670 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Soto, Frederick OD Provider ID: TPV1417944364-0 Gender: Male Frederick E Soto Jr OD PA 2650 S Tamiami Trl Sarasota, FL 34239 (941) 953-3111 Fax: (941) 366-5670 06 Yrs/99 Yrs M-F 8:00 AM - 5:30 PM Sat 9:00 AM - 1:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Optometry - cont. Spalding, Chelsea OD Provider ID: TPV1790193399-0 Gender: Female Community Eye Center PA 1331 S Sumter Blvd North Port, FL 34287 (941) 423-8137 Fax: (941) 625-0131 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Spalding, Chelsea OD Provider ID: TPV1790193399-0 Gender: Female Community Eye Center PA 1988 Tamiami Trail South Venice, FL 34293 (941) 408-0145 Fax: (941) 408-0145 05 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stupp, Elliott OD Provider ID: TPV1932131331-0 Gender: Male Eye Doctors Optical Outlets PA 4171 S Tamiami Trl Ste 34 Venice, FL 34293 (941) 492-9181 Fax: (941) 306-4786 05 Yrs/99 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM PCMH: No Stupp, Elliott OD Provider ID: TPV1932131331-0 Gender: Male Eye Doctors Optical Outlets PA 4848 S Tamiami Trl Sarasota, FL 34231 (941) 925-2010 Fax: (941) 893-3304 05 Yrs/99 Yrs MTTHF 9:00 AM - 6:00 PM W 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No

Wood, Wayne OD Provider ID: TPV1437209087-0 Gender: Male Manatee Family Eyecare PA 1236 Jacaranda Blvd Venice, FL 34292 (941) 496-4444 Fax: (941) 496-4223 03 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Orthopaedic Surgery Connolly, Brendon MD Provider ID: 1319555 Gender: Male Brendon Connolly MD Pl Sarasota 4016 Sawyer Rd Sarasota, FL 34233 (941) 757-3521 Fax: (941) 714-0869 18 Yrs/110 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Farino, Gregory MD Provider ID: 475413 Gender: Male Sarasota Orthopedic Associates LLC 435 Commercial Ct Venice, FL 34292 (941) 951-2663 Fax: (941) 957-4437 00 Yrs/130 Yrs Lakewood Ranch Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Farino, Gregory MD Provider ID: 475413 Gender: Male Sarasota Orthopedic Associates LLC 6230 University Pkwy Ste 203 Sarasota, FL 34240 (941) 951-2663 Fax: (941) 957-4437 00 Yrs/130 Yrs Lakewood Ranch Medical Center Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Furman, Walter MD Provider ID: 25636 Gender: Male Sarasota Orthopedic Associates LLC 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 951-2663 Fax: (941) 957-4437 00 Yrs/18 Yrs Doctors Hospital Sarasota M-F 8:00 AM - 5:00 PM PCMH: No Morgan, Randall MD Provider ID: 288766 Gender: Male 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 360-2211 Fax: (941) 360-2233 00 Yrs/18 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Morgan Jr, Randall MD Provider ID: 379918 Gender: Male Sarasota Orthopedic Associates LLC 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Premier Surgery Center of Sarasota M-F 8:00 AM - 5:00 PM PCMH: No Moulton, Andrew MD Provider ID: 759837 Gender: Male Sarasota Orthopedic Associates 2750 Bahia Vista St Ste 110 Sarasota, FL 34239 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Lakewood Ranch Medical Center Sarasota Memorial Hospital Languages: Spanish, Japanese, Portuguese M-F 8:00 AM - 5:00 PM PCMH: No Page, Steven MD Provider ID: 1311023 Gender: Male Sarasota Orthopedic Associates 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 951-2663 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Orthopaedic Surgery cont. Silverstein, Jeffery MD Provider ID: 690714 Gender: Male Sarasota Orthopedic Associates,LLC 6230 University Pkwy Ste 203 Sarasota, FL 34240 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Premier Surgery Center of Sarasota M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Cardiology Arrillaga, Frances MD Provider ID: 333773 Gender: Female Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Florida Hospital Carrollwood Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Bernus, Anna MD Provider ID: 531121 Gender: Female Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Gonzalez, Javier MD Provider ID: 520104 Gender: Male Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Englewood, FL 34223 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital Mease Countryside Hospital Morton Plant North Bay Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Huhta, James MD Provider ID: 225655 Gender: Male Pediatric Cardiology Associates 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/19 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No John, Jonathan MD Provider ID: 241174 Gender: Male Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Lacorte, Michael MD Provider ID: 1084474 Gender: Male Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lawrence, David MD Provider ID: 1097145 Gender: Male Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Martinez, Richard MD Provider ID: 225656 Gender: Male Pediatric Cardiology Associates 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No McCormack, Jorge MD Provider ID: 225657 Gender: Male Pediatric Cardiology Associates 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

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McKenna, Daniel MD Provider ID: 345181 Gender: Male Pediatric Cardiology Associates 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No Ringewald, Jeremy MD Provider ID: 530281 Gender: Male Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/21 Yrs Brandon Regional Hospital St Josephs Hospital M-F 8:00 AM - 5:00 PM PCMH: No Stapleton, Gary MD Provider ID: 462628 Gender: Male Pediatric Physician Services Inc 5881 Rand Blvd Sarasota, FL 34238 (727) 767-3333 00 Yrs/21 Yrs Bayfront Medical Center Johns Hopkins All Childrens Hospital Inc Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Pediatric Cardiology cont.

Pediatric Gastroenterology

Suh, Elsa MD Dhana, Leila MD Provider ID: 225664 Provider ID: 207634 Gender: Male Gender: Female Pediatrix Medical Group of 5881 Rand Blvd Florida Sarasota, FL 34238 5741 Bee Ridge Rd Ste 540 (727) 822-4300 Sarasota, FL 34233 Fax: (727) 822-9515 (877) 537-4787 00 Yrs/130 Yrs Fax: (855) 527-5510 Johns Hopkins All Childrens 00 Yrs/21 Yrs Hospital Inc Bayfront Health Spring Hill M-F 9:00 AM - 5:00 PM Johns Hopkins All Childrens PCMH: No Hospital Inc South Florida Baptist Hospital Kaiser, Greg MD Languages: Spanish Provider ID: 19532 M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No 5881 Rand Blvd Sarasota, FL 34238 Pediatric Endocrinology (727) 822-4300 Fax: (727) 822-9515 Declue, Terry MD 00 Yrs/21 Yrs Provider ID: 8064 Johns Hopkins All Childrens Gender: Male Hospital Inc Pediatric Endocrine Tampa General Hospital Associates M-F 9:00 AM - 5:00 PM 1666 Mound St PCMH: No Sarasota, FL 34236 (813) 554-8420 Karjoo, Sara MD Fax: (813) 554-8377 Provider ID: 910740 00 Yrs/21 Yrs Gender: Female Johns Hopkins All Childrens 5881 Rand Blvd Hospital Inc Sarasota, FL 34238 St Josephs Hospital (727) 822-4300 Languages: Spanish, Creole Fax: (727) 456-1399 M-F 9:00 AM - 5:00 PM 00 Yrs/18 Yrs PCMH: No Johns Hopkins All Childrens Hospital Inc Lin, Tsu-Hui MD St Josephs Hospital Provider ID: 5142 M-F 7:30 AM - 5:00 PM Gender: Female PCMH: No Pediatric Endocrine Associates Linville, Tiffany MD 1666 Mound St Provider ID: 755125 Sarasota, FL 34236 Gender: Female (813) 554-8420 Pediatric Gastroenterology Fax: (813) 554-8377 Hepatolo 00 Yrs/21 Yrs 5881 Rand Blvd Florida Hospital Tampa Sarasota, FL 34238 St Josephs Hospital (239) 689-5100 Languages: Chinese Fax: (239) 689-5107 M-F 9:00 AM - 5:00 PM 00 Yrs/21 Yrs PCMH: No M 8:00 AM - 2:00 PM PCMH: No

McClenathan, Daniel MD Provider ID: 1347 Gender: Male 5881 Rand Blvd Sarasota, FL 34238 (727) 822-4300 Fax: (727) 822-9515 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Narwal, Shivinder MD Provider ID: 923120 Gender: Male Thiru S Arasu MD 5881 Rand Blvd Sarasota, FL 34238 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs Citrus Surgical Center Johns Hopkins All Childrens Hospital Inc Pediatric Surgery Centers LLC M-TH 9:00 AM - 5:00 PM F 9:30 AM - 5:30 PM PCMH: No

Pediatric Hematology/ Oncology Ayala, Irmel MD Provider ID: 2522 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Grana, Nanette MD Provider ID: 451174 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Kerr, Jody MD Provider ID: 372911 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Sawczyn, Kelly MD Provider ID: 397206 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Stapleton, Stacie MD Provider ID: 401213 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Pediatric Infectious Disease Berman, David DO Provider ID: 173540 Gender: Male Pediatric Physician Services 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 892-8270 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Dumois III, Juan MD Provider ID: 17774 Gender: Male Pediatric Physician Services 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4176 Fax: (727) 892-8270 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Messina, Allison MD Provider ID: 346501 Gender: Female Pediatric Physicians Services 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4160 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Orthopaedics Benfanti, Paul MD Provider ID: 587667 Gender: Male Childrens Orthopaedic and Scoliosis 5881 Rand Blvd Sarasota, FL 34238 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Languages: Spanish MT 9:00 AM - 12:00 PM PCMH: No Warnick, Drew MD Provider ID: 557201 Gender: Male Childrens Orthopaedic and Scoliosis 5881 Rand Blvd Sarasota, FL 34238 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No

Pediatric Orthopedic Surgery Phillips, Lee MD Provider ID: 1100601 Gender: Male Children's Orthopaedic Scoliosis S 5881 Rand Blvd Sarasota, FL 34238 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc MT 8:30 AM - 5:00 PM PCMH: No

Pediatric Surgery Chandler, Nicole MD Provider ID: 461033 Gender: Female Pediatric Physician Services 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No Walford, Nebbie MD Provider ID: 558061 Gender: Female Pediatric Physician Services Inc 5881 Rand Blvd Sarasota, FL 34238 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 4:00 PM PCMH: No

Pediatric Urology Hoover, Dennis MD Provider ID: 2812 Gender: Male Sarasota At All Children's Specialt 5881 Rand Blvd Sarasota, FL 34238 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

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Kolligian, Mark MD Provider ID: 164682 Gender: Male Sarasota At All Childrens Specialt 5881 Rand Blvd Sarasota, FL 34238 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No Polsky, Ethan MD Provider ID: 341141 Gender: Male Sarasota At All Childrens Specialt 5881 Rand Blvd Sarasota, FL 34238 (813) 874-7500 Fax: (813) 877-1397 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Tampa Bay Surgery Center M-F 8:00 AM - 5:00 PM PCMH: No

Pediatrics Butto, Fouad MD Provider ID: 1321322 Gender: Male Pediatrix Medial Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Pediatrics - cont. Dowidar, Sahar MD Provider ID: 1177490 Gender: Female Sarasota Co Health Dept 1750 17th St Bld E Sarasota, FL 34234 (941) 861-1400 Fax: (941) 861-2719 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: Yes, Level 2 Everett, Kari MD Provider ID: 1315781 Gender: Female Florida Department of Health In Sar 1750 17th St Bldg E Sarasota, FL 34234 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/21 Yrs Languages: Spanish M-F 7:00 AM - 6:00 PM PCMH: No

Gonzales, Eusebio MD Provider ID: 1183753 Gender: Male Florida Doh Sarasota County Health Dept 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/18 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Hoang, Jessie MD Provider ID: 1232197 Gender: Female Pediatric Physician Services Inc 1700 S Tamiami Trl Sarasota, FL 34239 (941) 917-7490 Fax: (941) 917-1308 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM PCMH: No

Lyons, David MD Provider ID: 1056492 Gender: Male Florida Dept of Health Sarasota County 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/18 Yrs Sarasota Memorial Hospital M-F 7:00 AM - 6:00 PM PCMH: No

Pedodontics Bowles, David DDS Provider ID: TPVP130996-01 Gender: Male David A Bowles DDS PA 2700 S Tamiami Trl Ste 7 Sarasota, FL 34239 (941) 365-0800 Fax: (941) 364-8160 00 Yrs/99 Yrs Languages: Spanish M-W 8:30 AM - 3:00 PM PCMH: No

Le, Yen MD Everett, Kari MD Provider ID: 1365522 Lapresti, Lisa DMD Provider ID: 1315781 Gender: Female Gender: Female Provider ID: TPVP25207-03 Florida Department of Health Florida Department of Health Gender: Female In Sar In Sar Kids Smiles Dental PLLC 2200 Ringling Blvd 2200 Ringling Blvd 5561 Broadcast Ct Sarasota, FL 34237 Sarasota, FL 34237 Sarasota, FL 34240 (941) 861-2900 (941) 861-2900 (941) 727-0025 Fax: (941) 861-2719 Fax: (941) 861-2719 Fax: (941) 260-9152 00 Yrs/130 Yrs 00 Yrs/21 Yrs 00 Yrs/99 Yrs Languages: Vietnamese Languages: Spanish Languages: Spanish M-W 7:00 AM - 6:00 PM M-F 7:00 AM - 6:00 PM MT 8:00 AM - 4:00 PM THF 6:00 AM - 6:00 PM PCMH: No W 8:00 AM - 2:00 PM PCMH: No PCMH: No Everett, Kari MD Provider ID: 1315781 Gender: Female Florida Department of Health In Sar 6950 Outreach Way North Port, FL 34287 (941) 861-2900 Fax: (941) 861-2719 00 Yrs/21 Yrs Languages: Spanish M-F 7:00 AM - 6:00 PM PCMH: No

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Lee, Sara DMD Provider ID: TPVP156988-15 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No Marcano, Zaida DDS Provider ID: TPVP97912-01 Gender: Female Doh - Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-3888 Fax: (941) 861-3893 00 Yrs/99 Yrs Languages: Spanish M-TH 7:00 AM - 4:00 PM F 7:30 AM - 12:30 PM PCMH: No Marcano, Zaida DDS Provider ID: TPVP97912-02 Gender: Female Doh - Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2935 Fax: (941) 861-2845 00 Yrs/99 Yrs Languages: French M-F 7:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Pedodontics - cont. Vales, Ana-Marai DDS Provider ID: TPVP132108-02 Gender: Female Kids Smiles Dental PLLC 5561 Broadcast Ct Sarasota, FL 34240 (941) 727-0025 Fax: (941) 260-9152 00 Yrs/99 Yrs Languages: Spanish MT 8:00 AM - 4:00 PM W 8:00 AM - 2:00 PM PCMH: No

Periodontics

Lento, Paul MD Provider ID: 914887 Gender: Male Sarasota Orthopedic Associates 6230 University Pkwy Ste 203 Sarasota, FL 34240 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Lakewood Ranch Medical Center Premier Surgery Center of Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Bardsley, Norman DDS Provider ID: TPVP66204-14 Gender: Male Greenberg Dental Orthodontics 4280 Bee Ridge Rd Sarasota, FL 34233 (941) 363-6381 Fax: (941) 315-9136 00 Yrs/99 Yrs Languages: Spanish MTHF 7:00 AM - 3:00 PM TW 11:00 AM - 7:00 PM Sat 8:00 AM - 3:00 PM PCMH: No

Panganiban, Rudolfo MD

Physical Medicine & Rehabilitation

Worobel, Michael DO Provider ID: 1422891 Gender: Male Pain Medicine Group 5741 Bee Ridge Rd Ste 210 Sarasota, FL 34233 (941) 365-5672 Fax: (941) 365-5854 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Lento, Paul MD Provider ID: 914887 Gender: Male Sarasota Orthopedic Associates 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Lakewood Ranch Medical Center Premier Surgery Center of Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 196712 Gender: Male Comprehensive Pain Mgmt 871 Venetia Bay Blvd Ste 350 Venice, FL 34285 (941) 488-5366 Fax: (941) 488-2167 18 Yrs/130 Yrs CRMC At Bayonet Point Medical Center of Trinity New Tampa Surgery Center M-F 8:30 AM - 4:30 PM PCMH: No

Podiatry Bernstein, Myron DPM Provider ID: 1362318 Gender: Male Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM PCMH: No Cropper, Robert DPM Provider ID: 176146 Gender: Male Robert M Cropper 7109 Curtiss Ave Sarasota, FL 34231 (941) 922-3840 Fax: (941) 924-8225 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital MTF 1:30 AM - 5:00 PM W 8:30 AM - 12:00 PM TH 8:30 AM - 5:00 PM PCMH: No Gallina, Michael DPM Provider ID: 1421887 Gender: Male Gulf Coast Foot and Ankle Associate 1211 Jacaranda Blvd Venice, FL 34292 (844) 366-9362 Fax: (941) 484-3748 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Giannone, Louis DPM Provider ID: 1331313 Gender: Male Gulf Coast Hma Physician Management 411 Commercial Ct Ste G Venice, FL 34292 (941) 412-3000 Fax: (941) 412-3005 00 Yrs/130 Yrs Languages: Spanish, Italian M-F 8:00 AM - 5:00 PM PCMH: No Gonzalez, Evguenia DPM Provider ID: 1093901 Gender: Female 4801 Swift Rd Ste F Sarasota, FL 34231 (941) 921-3000 Fax: (941) 921-3066 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Howard, Daniel DPM Provider ID: 224500 Gender: Male Sarasota Orthopedic Associates LLC 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Doctors Hospital Sarasota Premier Surgery Center of Sarasota Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Podiatry - cont. Katz, Michael DPM Provider ID: 1009726 Gender: Male Gulf Coast Foot and Ankle Associate 1211 Jacaranda Blvd Venice, FL 34292 (844) 366-9362 Fax: (941) 484-3748 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Stewart, Stephanie DPM Provider ID: 1094382 Gender: Female 4801 Swift Rd Ste F Sarasota, FL 34231 (941) 921-3000 Fax: (941) 921-3066 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sutton, William DPM Provider ID: 1099942 Gender: Male 4801 Swift Rd Ste F Sarasota, FL 34231 (941) 921-3000 Fax: (941) 921-3066 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM PCMH: No

Pulmonary Disease Barber, Laura MD Provider ID: 1314027 Gender: Female Gulf Coast Pulmonary Associates 333 Tamiami Trl S Ste 101 Venice, FL 34285 (941) 488-1906 Fax: (941) 244-9326 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM PCMH: No

Dawoodjee, Yousuf MD Provider ID: 1321546 Gender: Male Gulf Coast Hma Physician Management 333 Tamiami Trl S Ste 101 Venice, FL 34285 (941) 488-1906 Fax: (941) 244-9326 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Denholm, David MD Provider ID: 1318034 Gender: Male Gulf Coast Pulmonology Associates 209 Palermo Pl Venice, FL 34285 (941) 488-1906 Fax: (941) 244-9326 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Diener, Howard MD Provider ID: 25627 Gender: Male Suncoast Lung Center 3920 Bee Ridge Rd Bldg C Sarasota, FL 34233 (941) 923-8353 Fax: (941) 925-7064 18 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Fleegler, Bruce MD Provider ID: 25634 Gender: Male Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 16 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Goedicke, Heidi MD Provider ID: 1156458 Gender: Female Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4127 16 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Harcup, Craig MD Provider ID: 25641 Gender: Male Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 16 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Hurwitz, Kenneth MD

Loutfi, Rabih MD Provider ID: 458754 Gender: Male Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 16 Yrs/130 Yrs Sarasota Memorial Hospital Languages: French, Arabic M-F 8:30 AM - 5:00 PM PCMH: No Morgan, Kisha MD Provider ID: 300864 Gender: Female Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 16 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No Reddy, Lakshmi MD

Provider ID: 150110 Gender: Male Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 16 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No

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Provider ID: 1163935 Gender: Female Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 18 Yrs/110 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Seaman Jr, Joseph MD Provider ID: 447996 Gender: Male Lung Associates of Sarasota 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 16 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Pulmonary Disease - cont. Hollen, Tyler MD Wei, Michael MD Provider ID: 1123656 Gender: Male Pulmonary Associates of Charlotte C 571 Medical Dr Englewood, FL 34223 (941) 205-5864 Fax: (941) 205-5864 02 Yrs/130 Yrs Bayfront Health Punta Gorda Fawcett Memorial Hospital M 8:30 AM - 1:00 PM PCMH: No

Radiation Oncology Hollen, Tyler MD Provider ID: 1003640 Gender: Male 21st Century Oncology LLC 3210 Fruitville Rd Sarasota, FL 34237 (941) 364-8887 Fax: (941) 954-3222 12 Yrs/130 Yrs Sarasota Memorial Hospital Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Hollen, Tyler MD Provider ID: 1003640 Gender: Male 21st Century Oncology LLC 3663 Bee Ridge Rd Sarasota, FL 34233 (941) 924-8700 Fax: (941) 924-2320 12 Yrs/130 Yrs Sarasota Memorial Hospital Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1003640 Gender: Male 21st Century Oncology LLC 720 Doctors Dr Englewood, FL 34223 (941) 475-7128 Fax: (941) 473-2204 12 Yrs/130 Yrs Sarasota Memorial Hospital Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Porter, Alan MD Provider ID: 170278 Gender: Male 3663 Bee Ridge Rd Sarasota, FL 34233 (941) 924-8700 Fax: (941) 921-2320 00 Yrs/130 Yrs Doctors Hospital Sarasota Englewood Community Hospital (MP) Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Hollen, Tyler MD Provider ID: 1003640 Gender: Male 21st Century Oncology LLC 901 Tamiami Trl S Venice, FL 34285 (941) 373-6534 Fax: (941) 373-6532 12 Yrs/130 Yrs Sarasota Memorial Hospital Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No

Porter, Alan MD Provider ID: 170278 Gender: Male 720 Doctors Dr Englewood, FL 34223 (941) 475-7128 Fax: (941) 473-2204 00 Yrs/130 Yrs Doctors Hospital Sarasota Englewood Community Hospital (MP) Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Koshy, Mary MD Provider ID: 505100 Gender: Female 21st Century Oncology LLC 3210 Fruitville Rd Sarasota, FL 34237 (941) 364-8887 Fax: (941) 954-3222 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Porter, Alan MD Provider ID: 170278 Gender: Male 901 Tamiami Trl S Venice, FL 34285 (841) 485-2340 Fax: (941) 485-5378 00 Yrs/130 Yrs Doctors Hospital Sarasota Englewood Community Hospital (MP) Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Patrice, Stephen MD Provider ID: 25667 Gender: Male 21st Century Oncology Inc 3210 Fruitville Rd Sarasota, FL 34237 (941) 364-8887 Fax: (941) 954-3222 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:30 AM - 5:00 PM PCMH: No

Porter, Alan MD Provider ID: 170283 Gender: Male 3663 Bee Ridge Rd Sarasota, FL 34233 (941) 924-8700 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Porter, Alan MD Provider ID: 170283 Gender: Male Englewood Oncology 720 Doctors Dr Englewood, FL 34223 (941) 475-7128 Fax: (941) 473-2204 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 4:30 PM PCMH: No Porter, Alan MD Provider ID: 170283 Gender: Male Englewood Oncology 901 Tamiami Trl S Venice, FL 34285 (941) 475-7128 Fax: (941) 473-2204 00 Yrs/130 Yrs Doctors Hospital Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 4:30 PM PCMH: No Rice, David MD Provider ID: 294696 Gender: Male 21st Century Oncology LLC 571 Medical Dr Englewood, FL 34223 (941) 475-0022 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Rice, David MD Provider ID: 294696 Gender: Male 21st Century Oncology LLC 959 E Venice Ave Venice, FL 34292 (941) 485-8455 Fax: (941) 485-6934 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Radiation Oncology cont. Silverman, Larry MD Provider ID: 27026 Gender: Male 21st Century Oncology Inc 3210 Fruitville Rd Sarasota, FL 34237 (941) 364-8887 Fax: (941) 954-3222 00 Yrs/130 Yrs Doctors Hospital Sarasota Englewood Community Hospital (MP) Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Swor, Gray MD Provider ID: 202973 Gender: Female 21st Century Oncology 3663 Bee Ridge Rd Sarasota, FL 34233 (941) 924-8700 Fax: (941) 924-2320 16 Yrs/130 Yrs Englewood Community Hospital (MP) Lakeland Reg Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Swor, Gray MD Provider ID: 202973 Gender: Female 21st Century Oncology LLC 3210 Fruitville Rd Sarasota, FL 34237 (941) 364-8887 Fax: (941) 954-3222 16 Yrs/130 Yrs Englewood Community Hospital (MP) Lakeland Reg Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Sylvester, John MD Provider ID: 716590 Gender: Male 21st Century Oncology 3663 Bee Ridge Rd Sarasota, FL 34233 (941) 924-8700 Fax: (941) 924-2320 16 Yrs/130 Yrs Lakewood Ranch Medical Center Manatee Memorial Hospital Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Radiology - Interventional & Vascular Grubbs, Gerald MD Provider ID: 406790 Gender: Male Vascular Specialists of Venice 600 N Cattlemen Rd Ste 100 Sarasota, FL 34232 (941) 378-3231 Fax: (941) 343-0026 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Reproductive Endocrinology Plosker, Shayne MD Provider ID: 334481 Gender: Male 1918 Robinhood St Sarasota, FL 34231 (941) 361-6889 Fax: (813) 259-0882 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Rheumatology Atiq, Shehla MD Provider ID: 1314025 Gender: Female Gulf Coast Hma Physician Management 1720 E Venice Ave Venice, FL 34292 (941) 483-9730 Fax: (941) 483-9745 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Greenfield, David MD Provider ID: 1314029 Gender: Male Gulf Coast Medical Group Rheumatolo 1525 Tamiami Trl S Ste 601 Venice, FL 34285 (941) 497-4069 Fax: (941) 796-9145 00 Yrs/130 Yrs M-F 9:00 AM - 4:30 PM PCMH: No

Urology Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 1 S School Ave Ste 200 Sarasota, FL 34237 (941) 309-7000 Fax: (941) 308-8508 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M 7:30 AM - 7:00 PM T 8:00 AM - 5:00 PM PCMH: No

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Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 1211 Jacaranda Blvd Venice, FL 34292 (941) 492-2212 Fax: (941) 496-9307 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 2345 Bobct Vlg Center Rd Ste 201 North Port, FL 34288 (941) 257-2918 Fax: (941) 257-2921 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 375 Commercial Ct Venice, FL 34292 (941) 484-9966 Fax: (941) 493-3415 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Urology - cont. Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 5880 Rand Blvd Ste 209 Sarasota, FL 34238 (941) 917-6484 Fax: (941) 917-1306 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Bilik Jr, Alfred MD Provider ID: 1193539 Gender: Not Available 21st Century Oncology, LLC 997 US Hwy 41 Byp N Ste 202 Venice, FL 34285 (941) 484-6952 Fax: (941) 484-5825 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Coronato, Eric DO Provider ID: 1192983 Gender: Male 720 Doctors DR Englewood, FL 34223 (941) 625-1550 Fax: (941) 255-0794 18 Yrs/110 Yrs Bayfront Health Punta Gorda Englewood Community Hospital (MP) Fawcett Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 1 S School Ave Ste 200 Sarasota, FL 34237 (941) 309-7000 Fax: (941) 309-7012 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M 1:00 AM - 6:00 PM T 8:30 AM - 12:00 PM W 1:00 AM - 5:00 PM TH 8:00 AM - 5:00 PM PCMH: No Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 1211 Jacaranda Blvd Venice, FL 34292 (941) 492-2212 Fax: (941) 496-9307 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 2345 Bobct Vlg Center Rd Ste 201 North Port, FL 34288 (941) 257-2918 Fax: (941) 257-2921 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 375 Commercial Ct Ste E Venice, FL 34292 (941) 484-9966 Fax: (941) 493-3415 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Gapin, Tracy MD Provider ID: 1193044 Gender: Not Available 5880 Rand Blvd Ste 209 Sarasota, FL 34238 (941) 917-6484 Fax: (941) 917-1306 18 Yrs/110 Yrs Doctors Hospital Sarasota Lakewood Ranch Medical Center Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Klutke, Carl MD Provider ID: 1193315 Gender: Not Available 842 Sunset Lake Blvd Ste 403 Venice, FL 34292 (941) 485-3351 Fax: (941) 485-7677 18 Yrs/110 Yrs Venice Regional Medical Center M-F 8:00 AM - 5:00 PM PCMH: No Letson Jr, William MD Provider ID: 1193359 Gender: Not Available 1505 Tamiami Trl S Ste 405 Venice, FL 34285 (941) 497-7700 Fax: (941) 497-3703 18 Yrs/110 Yrs Englewood Community Hospital (MP) M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 548

Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 1 S School Ave Ste 200 Sarasota, FL 34237 (941) 309-7000 Fax: (941) 309-7012 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 2345 Bobct Vlg Center Rd Unit 201 North Port, FL 34288 (941) 257-2918 Fax: (941) 257-2921 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 375 Commercial Ct Ste E Venice, FL 34292 (941) 484-9966 Fax: (941) 493-3415 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 4120 Woodmere Park Blvd Ste 8A Venice, FL 34293 (941) 309-7000 Fax: (941) 309-7012 00 Yrs/130 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Specialty Physicians Sarasota Urology - cont. Perry, Matthew MD Provider ID: 676644 Gender: Male 21st Century Oncology LL 5880 Rand Blvd Ste 209 Sarasota, FL 34238 (941) 917-6484 Fax: (941) 917-1306 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tingle, William MD Provider ID: 1193488 Gender: Not Available 1 S School Ave Ste 200 Sarasota, FL 34237 (941) 309-7000 Fax: (941) 308-8508 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No Tingle, William MD Provider ID: 1193488 Gender: Not Available 1211 Jacaranda Blvd Venice, FL 34292 (941) 492-2212 Fax: (941) 496-9307 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No

Tingle, William MD

Weitzel, Andrew DO Provider ID: 1193518 Gender: Not Available Provider ID: 1193488 720 Doctors DR Gender: Not Available 2345 Bobcat Village Center Rd Sarasota, FL 34233 (941) 625-1550 North Port, FL 34288 Fax: (941) 255-0794 (941) 257-2918 18 Yrs/110 Yrs Fax: (941) 257-2921 Bayfront Health Punta Gorda 18 Yrs/110 Yrs Englewood Community Doctors Hospital Sarasota Hospital (MP) M 1:00 AM - 5:00 PM Fawcett Memorial Hospital T 1:00 AM - 7:00 PM M-F 8:00 AM - 5:00 PM W 8:00 AM - 12:00 PM PCMH: No TH 8:00 AM - 5:0 PM PCMH: No Williams, Thomas MD

Tingle, William MD Provider ID: 1193488 Gender: Not Available 375 Commercial Ct Ste E Venice, FL 34292 (941) 484-9966 Fax: (941) 493-3415 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No Tingle, William MD Provider ID: 1193488 Gender: Not Available 5880 Rand Blvd Ste 209 Sarasota, FL 34238 (941) 917-6484 Fax: (941) 917-1306 18 Yrs/110 Yrs Doctors Hospital Sarasota M 1:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM TH 8:00 AM - 5:0 PM PCMH: No

Provider ID: 1193531 Gender: Not Available 375 Commercial Ct Ste E Venice, FL 34292 (941) 484-9966 Fax: (941) 493-3415 18 Yrs/110 Yrs Sarasota Memorial Hospital M 8:00 AM - 12:00 PM T 11:00 AM - 7:00 PM W 8:00 AM - 5:30 PM PCMH: No Williams, Thomas MD Provider ID: 1193531 Gender: Not Available 5880 Rand Blvd Ste 209 Sarasota, FL 34238 (941) 917-6484 Fax: (941) 917-1306 18 Yrs/110 Yrs Sarasota Memorial Hospital M 8:00 AM - 12:00 PM T 11:00 AM - 7:00 PM W 8:00 AM - 5:30 PM PCMH: No

www.wellcare.com/Florida | 549

Last update 08/14/2017

Hospitals De Soto Hospital Desoto Memorial Hospital Provider ID: 21049 900 N Robert Ave Arcadia, FL 34266 (863) 494-3535 Fax: (863) 491-4328 00 Yrs/130 Yrs

www.wellcare.com/Florida | 550

Last update 08/14/2017

Hospitals Hardee Critical Access Hospital Florida Hospital Wauchula Provider ID: 20978 533 Carlton St Wauchula, FL 33873 (863) 773-3101 00 Yrs/130 Yrs

www.wellcare.com/Florida | 551

Last update 08/14/2017

Hospitals Highlands Hospital Florida Hospital Heartland Provider ID: 21310 4200 Sun N Lake Blvd Sebring, FL 33872 (863) 314-4466 Fax: (863) 402-3415 00 Yrs/130 Yrs Florida Hospital Lake Placid Provider ID: 9712 1210 US Hwy 27 N Lake Placid, FL 33852 (863) 465-3777 00 Yrs/130 Yrs Highlands Regional Medical Provider ID: 20972 3600 S Highlands Ave Sebring, FL 33870 (863) 385-6101 Fax: (863) 385-3489 00 Yrs/130 Yrs

www.wellcare.com/Florida | 552

Last update 08/14/2017

Hospitals Hillsborough Hospital Brandon Regional Hospital Provider ID: 20065 119 Oakfield Dr Brandon, FL 33511 (813) 681-5551 Fax: (855) 605-0208 00 Yrs/130 Yrs Columbia South Bay Hospital Provider ID: 20670 4016 SR 674 Sun City Center, FL 33573 (813) 634-3301 Fax: (855) 689-9424 00 Yrs/130 Yrs Florida Hospital Carrollwood Provider ID: 20066 7171 N Dale Mabry Hwy Tampa, FL 33614 (813) 932-2222 Fax: (813) 558-8018 00 Yrs/130 Yrs Florida Hospital Tampa Provider ID: 20512 3100 E Fletcher Ave Tampa, FL 33613 (813) 971-6000 Fax: (813) 979-7357 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 12220 Bruce B Downs Blvd Tampa, FL 33612 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 4518 S Manhattan Ave Tampa, FL 33611 (352) 239-2964 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 885 S Parsons Ave Brandon, FL 33511 (813) 436-5900 Fax: (813) 436-5901 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

St Josephs Hospital Provider ID: 20509 4211 Van Dyke Rd Lutz, FL 33558 (813) 443-7000 Fax: (813) 870-4048 00 Yrs/130 Yrs Languages: Spanish

Memorial Hospital of Tampa

Provider ID: 20156 6001 Webb Rd Tampa, FL 33615 (813) 885-6666 00 Yrs/130 Yrs

Provider ID: 20072 2901 W Swann Ave Tampa, FL 33609 (813) 873-6400 Fax: (813) 369-5870 00 Yrs/130 Yrs Shriners Hospitals For Children Tpa Provider ID: 575828 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7125 00 Yrs/130 Yrs

Tampa Community Hospital

Tampa General Hospital Provider ID: 20028 1 Tampa General Cir Tampa, FL 33606 (813) 844-7000 00 Yrs/130 Yrs

South Florida Baptist Hospital Provider ID: 24934 301 N Alexander St Plant City, FL 33563 (813) 757-1230 Fax: (813) 870-4248 00 Yrs/130 Yrs St Josephs Hospital Provider ID: 20509 3001 W MLK Jr Blvd Tampa, FL 33607 (813) 870-4000 Fax: (813) 870-4248 00 Yrs/130 Yrs Languages: Spanish St Josephs Hospital Provider ID: 20509 3030 W MLK Jr Blvd Tampa, FL 33607 (813) 879-4730 Fax: (813) 870-4048 00 Yrs/130 Yrs Languages: Spanish

www.wellcare.com/Florida | 553

Last update 08/14/2017

Hospitals Manatee Hospital Blake Medical Center Provider ID: 21164 2020 59th St W Bradenton, FL 34209 (941) 792-6611 Fax: (941) 798-6359 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 8340 Lakewd Rnch Blvd Ste 160 Bradenton, FL 34202 (941) 794-3118 Fax: (727) 767-8990 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Lakewood Ranch Medical Center Provider ID: 244706 8330 Lakewood Ranch Blvd Bradenton, FL 34202 (941) 782-2100 00 Yrs/130 Yrs Manatee Memorial Hospital Provider ID: 20883 206 2nd St E Bradenton, FL 34208 (941) 746-5111 00 Yrs/130 Yrs

www.wellcare.com/Florida | 554

Last update 08/14/2017

Hospitals Pasco Hospital Bayfront Health Dade City Provider ID: 162950 13100 Fort King Rd Dade City, FL 33525 (352) 521-1100 Fax: (352) 521-1578 00 Yrs/130 Yrs

Medical Center of Trinity Provider ID: 20948 5637 Marine Pkwy New Port Richey, FL 34652 (727) 834-5700 Fax: (727) 834-5963 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Medical Center of Trinity

CRMC At Bayonet Point Provider ID: 20482 14000 Fivay Rd Hudson, FL 34667 (727) 863-2411 Fax: (855) 520-9793 00 Yrs/130 Yrs Florida Hospital At Connerton Long Term Provider ID: 1042168 9441 Health Center Dr Land O Lakes, FL 34637 (813) 903-3700 Fax: (813) 903-3707 00 Yrs/130 Yrs

Provider ID: 20948 9330 State Rd 54 Trinity, FL 34655 (727) 834-4000 Fax: (727) 834-4912 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Morton Plant North Bay Hospital Provider ID: 20138 6600 Madison St New Prt Rchy, FL 34652 (727) 843-4500 Fax: (813) 635-7970 00 Yrs/130 Yrs

Florida Hospital Wesley Chapel Provider ID: 705709 2600 Bruce B Downs Blvd Wesley Chapel, FL 33544 (813) 929-5000 Fax: (813) 929-5480 00 Yrs/130 Yrs Florida Hospital Zephyrhills Provider ID: 304499 7050 Gall Blvd Zephyrhills, FL 33541 (813) 788-0411 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 4443 Rowan Rd New Port Richey, FL 34653 (727) 846-9900 Fax: (727) 846-5419 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 555

Last update 08/14/2017

Hospitals Pinellas Hospital Baycare Alliant Hospital Provider ID: 523841 601 Main St Dunedin, FL 34698 (727) 736-9999 Fax: (727) 736-9998 00 Yrs/130 Yrs Bayfront Medical Center Provider ID: 20012 701 6th St S Saint Petersburg, FL 33701 (727) 823-1234 Florida Hospital North Pinellas Provider ID: 20195 1395 S Pinellas Ave Tarpon Spgs, FL 34689 (727) 938-1935 Fax: (727) 942-5161 00 Yrs/130 Yrs Florida Hospital North Pinellas Provider ID: 20195 34106 US Hwy 19 N Palm Harbor, FL 34684 (727) 401-3900 Fax: (727) 401-3990 00 Yrs/130 Yrs Healthsouth Hospitals Provider ID: 149691 901 Clearwater Largo Rd N Largo, FL 33770 (727) 586-2999 Fax: (727) 588-3404 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 3850 Tampa Rd Bldg A Ste 200 Palm Harbor, FL 34684 (727) 789-0200 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 501 6th St S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/130 Yrs Languages: Spanish Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 900 Carillon Pkwy Saint Petersburg, FL 33716 (727) 571-1210 Fax: (727) 573-1958 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Largo Medical Center Provider ID: 20211 201 14th St SW Largo, FL 33770 (727) 586-1411 00 Yrs/130 Yrs Largo Medical Center Indian Rocks Provider ID: 20159 2025 Indian Rocks Rd S Largo, FL 33774 (727) 581-9474

Morton Plant Hospital Provider ID: 21478 300 Pinellas St Clearwater, FL 33756 (727) 462-7000 Fax: (813) 635-7970 00 Yrs/130 Yrs Northside Hospital Provider ID: 20019 6000 49th St N Saint Petersburg, FL 33709 (727) 521-4411 Fax: (727) 521-5007 00 Yrs/130 Yrs Palms of Pasadena Hospital Provider ID: 20845 1501 Pasadena Ave S Saint Petersburg, FL 33707 (727) 381-1000 00 Yrs/130 Yrs St Petersburg General Hospital Provider ID: 21074 6500 38th Ave N Saint Petersburg, FL 33710 (727) 384-1414 Fax: (727) 381-0275 00 Yrs/130 Yrs

Mease Countryside Hospital Provider ID: 20917 3231 McMullen Booth Rd Safety Harbor, FL 34695 (727) 725-6111 Fax: (813) 635-7970 00 Yrs/130 Yrs Mease Hospital Dunedin Provider ID: 20928 601 Main St Dunedin, FL 34698 (727) 733-1111 Fax: (727) 734-6887 00 Yrs/130 Yrs

www.wellcare.com/Florida | 556

Last update 08/14/2017

Hospitals Polk Hospital Bartow Regional Medical Center Provider ID: 276315 2200 Osprey Blvd Bartow, FL 33830 (863) 519-1800 Fax: (813) 999-8876 00 Yrs/130 Yrs

Winter Haven Hospital Provider ID: 20151 200 Ave F NE Winter Haven, FL 33881 (863) 293-1121 Fax: (813) 999-8876 00 Yrs/130 Yrs

Heart of Florida Reg Med Center Provider ID: 20499 40100 Hwy 27 Davenport, FL 33837 (863) 422-4971 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 3310 Lakeland Hills Blvd Lakeland, FL 33805 (727) 767-4160 Fax: (727) 767-8270 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Lake Wales Medical Center Provider ID: 208993 410 S 11th St Lake Wales, FL 33853 (863) 676-1433 Fax: (863) 676-3050 00 Yrs/130 Yrs Lakeland Reg Medical Center Provider ID: 20615 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 Fax: (863) 687-1009 00 Yrs/130 Yrs Poinciana Medical Center Provider ID: 830934 325 Cypress Pkwy Kissimmee, FL 34759 (407) 530-2000 Fax: (863) 547-8820 00 Yrs/130 Yrs

www.wellcare.com/Florida | 557

Last update 08/14/2017

Hospitals Sarasota Hospital Doctors Hospital Sarasota Provider ID: 20297 5731 Bee Ridge Rd Sarasota, FL 34233 (941) 342-1100 00 Yrs/130 Yrs Englewood Community Hospital (MP) Provider ID: 20317 700 Medical Blvd Englewood, FL 34223 (941) 475-6571 00 Yrs/130 Yrs

Venice Regional Medical Center Provider ID: 275946 420 Tamiami Trl S Venice, FL 34285 (941) 483-7161 Fax: (941) 483-7170 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM Venice Regional Medical Center Provider ID: 275946 540 The Rialto Venice, FL 34285 (941) 483-7225 Fax: (941) 483-7699 00 Yrs/130 Yrs

Healthsouth Hospitals Provider ID: 149672 6400 Edgelake Dr Sarasota, FL 34240 (941) 921-8778 Fax: (941) 921-8657 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc Provider ID: 20032 5881 Rand Blvd Sarasota, FL 34238 (941) 927-8805 Fax: (941) 927-6339 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sarasota Memorial Hospital Provider ID: 20633 1700 S Tamiami Trl Sarasota, FL 34239 (941) 917-1000 Fax: (941) 917-6855 00 Yrs/130 Yrs Venice Regional Medical Center Provider ID: 275946 1201 Jacaranda Blvd Venice, FL 34292 (941) 497-7800 Fax: (941) 486-6068 00 Yrs/130 Yrs M-F 7:00 AM - 5:00 PM

www.wellcare.com/Florida | 558

Last update 08/14/2017

Behavioral Health De Soto Licensed Clinical Social Worker Brantley, Diane LCSW Provider ID: 1173366 Gender: Female Community Care Counseling Services 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 05 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 4:00 PM PCMH: No Faraq, Estafan LCSW Provider ID: 975573 Gender: Male Community Care Family Healthcare Center 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Reimer, Donald LCSW Provider ID: 1016737 Gender: Male Community Care Family Healthcare Center 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 4:00 PM PCMH: No Schau, Regina LCSW Provider ID: 1073501 Gender: Female Comunity Care Family Clinic Counsel 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 4:00 PM PCMH: No

Pediatric Psychiatry

Lopez, Rafael MD Provider ID: 1059660 Lopez, Rafael MD Gender: Male Provider ID: 1059660 Family Preservaton Services of Flor Gender: Male Family Preservaton Services of 925 N Mills Ave Flor Arcadia, FL 34266 925 N Mills Ave (863) 494-5082 Arcadia, FL 34266 Fax: (863) 494-5883 (863) 494-5082 05 Yrs/130 Yrs Fax: (863) 494-5883 MTWTHFSatSun 8:00 AM 5:00 PM 05 Yrs/130 Yrs PCMH: No MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

Psychiatry Dillon, Donna ARNP Provider ID: 987937 Gender: Female Community Care Family Healthcare Center 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Gallego, Manuel MD Provider ID: 458457 Gender: Male Community Care Family Healthcare Center 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Halim, Tariq MD Provider ID: 778793 Gender: Male Community Care Family Healthcare Center 725 N 12th Ave Bldg B Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 559

Last update 08/14/2017

Behavioral Health Hardee Community Mental Health Center Tri County Human Services Inc Provider ID: 958200 115 K D Revell Rd Wauchula, FL 33873 (863) 773-2226 Fax: (863) 773-2497 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Pediatric Psychiatry Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 1968 Sebring Pkwy Wauchula, FL 33873 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 213 E Orange St Wauchula, FL 33873 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Substance Abuse Tri County Human Services Inc Provider ID: 958200 115 K D Revell Rd Wauchula, FL 33873 (863) 773-2226 Fax: (863) 773-2497 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM PCMH: No

Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 213 E Orange St Wauchula, FL 33873 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Psychiatry Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 1968 Sebring Pkwy Wauchula, FL 33873 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 560

Last update 08/14/2017

Behavioral Health Highlands Behavioral Health Counseling

Psychosomatic Medicine Sadowsky, MD, William MD

Aboul-Hosn, Nawal LMHC Provider ID: 371295 Gender: Female 310 E Main St Avon Park, FL 33825 (321) 525-1556 Fax: (863) 452-4302 00 Yrs/130 Yrs Languages: French, Arabic M-F 9:00 AM - 6:00 PM PCMH: No Del Sol, Rene LMHC Provider ID: 805179 Gender: Male 2523 US Hwy 27 S Ste 130 Avon Park, FL 33825 (863) 452-1818 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Van Kleeck, Phillip LMHC Provider ID: 704338 Gender: Male The Paradigm Group Consulting, Inc 2523 US Hwy 27 Siuth Ste 130 Avon Park, FL 33825 (863) 452-0710 Fax: (863) 452-0142 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM PCMH: No

Community Mental Health Center Tri County Human Services Inc Provider ID: 958200 100 W College Dr Avon Park, FL 33825 (863) 452-0106 Fax: (863) 452-5376 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1063898 Gender: Male Peace River Center 7205 E George Blvd Sebring, FL 33875 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Substance Abuse Tri County Human Services Inc Provider ID: 958200 100 W College Dr Avon Park, FL 33825 (863) 452-0106 Fax: (863) 452-5376 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1968 Sebring Pkwy Sebring, FL 33870 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-W 7:30 AM - 6:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 7205 S George Blvd Sebring, FL 33875 (863) 386-6040 Fax: (863) 582-9251 18 Yrs/130 Yrs M 1:00 AM - 5:00 PM TW 8:00 AM - 12:00 PM THF 8:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peach River Center 106 N Main Ave Lake Placid, FL 33852 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 561

Last update 08/14/2017

Behavioral Health Hillsborough Addiction Psychiatry Fields, Jason MD Provider ID: 1069826 Gender: Male Dacco 4422 E Columbus Dr Tampa, FL 33605 (813) 384-4000 Fax: (813) 623-3730 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Advance Registered Nurse Practitioner Psychiatrist Christian III, Claiborne LMHC Provider ID: 499613 Gender: Male Waychangers Services LLC 220 W Brandon Blvd Ste 203 Brandon, FL 33511 (866) 472-7075 Fax: (766) 472-9754 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Behavioral Health Counseling Agency For Community Treatment Services Provider ID: 927325 4612 N 56th St Tampa, FL 33610 (813) 246-4899 Fax: (813) 246-5119 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Agency For Community Treatment Services Provider ID: 927325 Agency For Community Treatment Services 2214 E Henry Ave Tampa, FL 33610 (813) 246-4899 Fax: (813) 367-2312 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Averoff, Lisa LMHC Provider ID: 539594 Gender: Female 710 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 264-9955 Fax: (813) 696-4950 00 Yrs/130 Yrs Languages: French, Greek M-TH 10:00 AM - 7:00 PM F 12:00 AM - 7:00 PM Sat 10:00 AM - 3:00 PM PCMH: No Brooks, Joel LCSW Provider ID: 508717 Gender: Male Joel Brooks Counseling 3500 E Fletcher Ave Ste 129 Tampa, FL 33613 (813) 978-3960 Fax: (813) 978-0475 00 Yrs/130 Yrs M-F 10:00 AM - 8:00 PM Sat 10:00 AM - 1:00 PM PCMH: No Candis, Lavasaous LMHC Provider ID: 1160742 Gender: Male Tom Lee Community Health Center 14254 SR 574 Dover, FL 33527 (813) 349-7700 Fax: (813) 938-6422 00 Yrs/130 Yrs MWTHF 9:00 AM - 5:00 PM T 9:00 AM - 7:00 PM PCMH: No

Casanova, Anthia LMHC Provider ID: 840108 Gender: Female 2203 N Lois Ave Ste 961 Tampa, FL 33607 (813) 802-2025 18 Yrs/75 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Claudio Torres, Angela LMHC Provider ID: 903079 Gender: Female 2806 N Armenia Ave Tampa, FL 33607 (813) 264-9955 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM PCMH: No Claudio Torres, Angela LMHC Provider ID: 903079 Gender: Female 710 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 264-9955 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM PCMH: No Claudio Torres, Angela LMHC Provider ID: 903079 Gender: Female One Crisis Center Plaza Tampa, FL 33613 (813) 264-9955 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM PCMH: No

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Davidson, Wayne LMHC Provider ID: 807237 Gender: Male 14437 University Cove Pl Tampa, FL 33613 (813) 979-0535 00 Yrs/130 Yrs M 12:00 AM - 7:00 PM T 8:00 AM - 7:00 PM W 12:00 AM - 5:00 PM TH 8:00 AM - 12:00 PM PCMH: No De Armas, Odalys LMHC Provider ID: 471361 Gender: Female 6601 Memorial Hwy Ste 212 Tampa, FL 33615 (813) 884-4543 00 Yrs/65 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 1:00 PM PCMH: No Divico, Alicia LMHC Provider ID: 1066895 Gender: Female Personal Wellness Solutions PA 4511 N Himes Ave Ste 200 Tampa, FL 33614 (813) 546-0585 Fax: (813) 449-4421 05 Yrs/130 Yrs M 3:30 AM - 8:00 PM TWTHF 3:00 AM - 8:00 PM PCMH: No Divico, Alicia LMHC Provider ID: 1066895 Gender: Female Personal Wellness Solutions PA 8461 W Linebaugh Ave Tampa, FL 33625 (813) 546-0585 05 Yrs/130 Yrs MTWTHFSat 9:00 AM - 12:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Behavioral Health Counseling - cont. Dulcio, Magdala LMHC Provider ID: 1234881 Gender: Female Oasis Counseling, LLC 772 W Lumsden Rd Brandon, FL 33511 (813) 685-6700 Fax: (813) 413-7979 02 Yrs/130 Yrs Languages: Haitian Creole M-TH 9:00 AM - 6:00 PM F 9:00 AM - 3:00 PM Sat 10:00 AM - 1:00 PM PCMH: No Gerling, Tiffany LMHC Provider ID: 755426 Gender: Female Brandon Mental Health 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 417-2282 Fax: (813) 438-8973 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 10:00 AM - 2:00 PM PCMH: No Hager, Kristina LMHC Provider ID: 1238968 Gender: Female Bay Area Neuropsychology LLC 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: No

Hassan, Mahmoud LMHC

Lyublanovits, Deborah LMHC

Merritt, Casandra LMHC

Provider ID: 983016 Provider ID: 865950 Gender: Male Gender: Female Mahmoud Hassan LMHC PA One Crisis Center Plaza 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33613 Tampa, FL 33614 (813) 264-9955 (813) 389-3930 Fax: (813) 969-4950 Fax: (813) 931-4609 03 Yrs/130 Yrs 00 Yrs/130 Yrs Languages: Spanish Languages: Arabic M-TH 8:00 AM - 8:00 PM M-F 12:00 AM - 8:30 PM PCMH: No Sat 8:30 AM - 4:00 PM Marshall, Marta LMHC PCMH: No Provider ID: 387913 Lewis, Rayna LMHC Gender: Female Provider ID: 960426 13902 N Dale Mabry Hwy Ste 107 Gender: Female Tampa, FL 33618 2706 W Saint Isabel St Ste B (813) 908-2228 Tampa, FL 33607 Fax: (813) 908-5551 (888) 666-3089 00 Yrs/130 Yrs 00 Yrs/130 Yrs MTTHF 9:00 AM - 5:00 PM Languages: Spanish W 8:00 AM - 5:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 2:00 PM Sat 9:00 AM - 5:00 PM PCMH: No PCMH: No

Moir, Stephanie LMHC

Lyublanovits, Deborah LMHC

Monteleone, Joseph LMHC

Provider ID: 865950 Gender: Female 2806 N Armenia Ave Tampa, FL 33607 (813) 264-9955 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM PCMH: No Lyublanovits, Deborah LMHC Provider ID: 865950 Gender: Female 710 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 264-9955 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM PCMH: No

McGrew, Lasandra LCSW Provider ID: 793491 Gender: Female The Empowerment Group 1411 Oakfield Dr Brandon, FL 33511 (813) 395-0135 Fax: (813) 689-8100 00 Yrs/130 Yrs M-F 9:00 AM - 7:00 PM Sat 2:00 AM - 6:00 PM Sun 4:00 AM - 6:00 PM PCMH: No Mercuri, Danielle LCSW Provider ID: 903104 Gender: Female One Crisis Center of Tampa Bay Tampa, FL 33613 (813) 264-9955 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish M 9:00 AM - 12:00 PM TWTHF 11:00 AM - 7:00 PM PCMH: No

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Provider ID: 1169335 Gender: Female Start Fresh Counseling Center Inc 1463 Oakfield Dr Ste 117 Brandon, FL 33511 (813) 489-4547 Fax: (813) 381-5140 02 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No

Provider ID: 1077539 Gender: Female Serene Mind Psychology 3312 W Kennedy Blvd Tampa, FL 33609 (813) 419-3629 02 Yrs/130 Yrs M-F 10:00 AM - 9:00 PM Sat 11:00 AM - 4:00 PM PCMH: No

Provider ID: 1251690 Gender: Male Mahmoud Hassan LMHC Inc 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33614 (813) 389-3930 Fax: (813) 933-2100 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM PCMH: No Moore, Audrea LMHC Provider ID: 1251687 Gender: Female Mahmoud Hassan LMHC Inc 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33614 (813) 389-3930 Fax: (813) 933-2100 00 Yrs/130 Yrs MTWTHFSat 9:00 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Behavioral Health Counseling - cont. Odio, Francine LMHC Provider ID: 915418 Gender: Female 2706 W Saint Isabel St Ste B Tampa, FL 33607 (888) 666-3089 Fax: (888) 666-9870 03 Yrs/80 Yrs Languages: Spanish M-TH 9:30 AM - 8:00 PM F 9:30 AM - 6:00 PM Sat 10:00 AM - 4:00 PM PCMH: No Papadakis, Mary Frances LMHC Provider ID: 1229442 Gender: Female Bay Area Neuropsychology LLC 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Parker, Patricia LCSW Provider ID: 793232 Gender: Female 12108 N 56th St Ste F Tampa, FL 33617 (813) 983-8100 Fax: (813) 518-0063 00 Yrs/130 Yrs M-F 9:00 AM - 8:00 PM PCMH: No Porter, Margaret LCSW Provider ID: 550233 Gender: Female 14505 Bruce B Downs Blvd Tampa, FL 33613 (813) 971-5533 Fax: (813) 910-7828 12 Yrs/130 Yrs Languages: Spanish M-TH 12:00 AM - 8:00 PM PCMH: No

Rojas, Paola LMHC Provider ID: 840043 Gender: Female One Crisis Center Plaza Tampa, FL 33613 (813) 964-1964 Fax: (813) 969-4950 03 Yrs/130 Yrs Languages: Spanish, Russian M-TH 8:00 AM - 8:00 PM PCMH: No Roth, Justin LCSW Provider ID: 1027892 Gender: Male Pediatric Health Choice 8509 Benjamin Rd Ste D Tampa, FL 33634 (813) 872-8521 Fax: (813) 880-0321 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Rudzewicz, Marianne LCSW Provider ID: 800576 Gender: Female 14502 N Dale Mabry Hwy Ste 200 Tampa, FL 33618 (813) 960-4370 Fax: (813) 264-5458 00 Yrs/130 Yrs M-W 1:00 AM - 8:00 PM PCMH: No Sims, Susan LMHC Provider ID: 142213 Gender: Female 3601 W Azeele St Tampa, FL 33609 (813) 874-0608 Fax: (813) 350-9544 00 Yrs/130 Yrs M-TH 9:30 AM - 7:00 PM PCMH: No Spanos, Elena LCSW Provider ID: 528371 Gender: Female 407 N Parsons Ave Ste 104A Brandon, FL 33510 (813) 681-5880 Fax: (813) 681-5958 00 Yrs/130 Yrs PCMH: No

Stilson, Johnna LMHC Provider ID: 1238013 Gender: Female Bay Area Neuropsychology LLC 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Teixeira, Milton LMHC Provider ID: 271637 Gender: Male McGinn and Teixeria PA 13902 N Dale Mabry Hwy Ste 107 Tampa, FL 33618 (813) 908-2228 Fax: (813) 908-5551 05 Yrs/130 Yrs MW 10:00 AM - 9:00 PM T 3:00 AM - 9:00 PM PCMH: No Van Pelt, Teresa LMHC Provider ID: 433680 Gender: Female Counseling Kids Inc 124 W Lutz Lake Fern Rd Lutz, FL 33558 (813) 434-3468 Fax: (813) 649-6375 00 Yrs/130 Yrs MT 1:00 AM - 9:00 PM W 9:00 AM - 9:00 PM PCMH: No Williams, Kelly LCSW Provider ID: 919082 Gender: Female Kelly Williams LCSW 124 W Lutz Lake Fern Rd Lutz, FL 33548 (813) 434-3468 Fax: (813) 649-6375 00 Yrs/130 Yrs MT 5:00 AM - 8:30 PM W 3:30 AM - 8:30 PM PCMH: No

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Wilson Henton, Shaana LMHC Provider ID: 1259226 Gender: Female Mahmoud Hassan LMHC Inc 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33614 (813) 389-3930 Fax: (813) 933-2100 00 Yrs/21 Yrs MTWTHSat 9:00 AM - 6:00 PM F 9:00 AM - 5:00 PM PCMH: No

Behavioral Health Facility Bay Area Behavioral Services Inc Provider ID: 800216 Bay Area Behavioral Services 126 Lithia Pinecrest Rd Brandon, FL 33511 (813) 689-8828 Fax: (813) 689-8802 04 Yrs/64 Yrs Languages: Spanish M-F 8:00 AM - 8:00 PM PCMH: No Baycare Life Management Provider ID: 214328 2727 W Martin Luther King Blvd Ste 640 Tampa, FL 33607 (813) 872-7582 Fax: (813) 873-9591 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Camelot Community Care Inc Provider ID: 274915 1412 Tech Blvd Tampa, FL 33619 (813) 635-9765 Fax: (813) 635-9725 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Behavioral Health Facility St Josephs Hospital - cont. Provider ID: 20509 Family Preservation Service Provider ID: 295948 11428 N 53rd St Ste 100 Tampa, FL 33617 (813) 374-9416 00 Yrs/130 Yrs Languages: Spanish, Creole MTWTHFSatSun 8:00 AM 5:00 PM PCMH: No

3001 W MLK Jr Blvd Tampa, FL 33607 (813) 870-4000 Fax: (813) 870-4248 00 Yrs/130 Yrs Languages: Spanish PCMH: No

St Josephs Hospital Provider ID: 20509 3030 W MLK Jr Blvd Tampa, FL 33607 Neuropsychiatric Institute LLC (813) 879-4730 Fax: (813) 870-4048 Provider ID: 863058 00 Yrs/130 Yrs 4107 W Spruce St Ste 100 Languages: Spanish Tampa, FL 33607 PCMH: No (813) 636-8811 St Josephs Hospital Fax: (813) 636-8855 Provider ID: 20509 00 Yrs/130 Yrs 4211 Van Dyke Rd Languages: Spanish, Italian, Lutz, FL 33558 Hebrew (813) 443-7000 M-W 8:00 AM - 5:00 PM Fax: (813) 870-4048 TH 8:00 AM - 7:00 PM 00 Yrs/130 Yrs F 8:00 AM - 4:00 PM Languages: Spanish PCMH: No PCMH: No Northside Mental Health Success 4 Kids and Families Center Inc Provider ID: 28517 12512 Bruce B Downs Blvd Provider ID: 902164 Tampa, FL 33612 2902 N Armenia Ave Ste 200 (813) 977-8700 Tampa, FL 33607 Fax: (813) 971-2029 (813) 490-5490 00 Yrs/130 Yrs Fax: (813) 490-5495 MW 8:00 AM - 6:00 PM 00 Yrs/17 Yrs TTH 8:00 AM - 7:00 PM M-F 8:00 AM - 4:30 PM F 8:00 AM - 5:00 PM PCMH: No PCMH: No South Florida Baptist Hospital

Community Mental Health Center

Provider ID: 24934 Baycare Life Management 301 N Alexander St Plant City, FL 33563 Provider ID: 214328 (813) 757-1230 2727 W Martin Luther King Fax: (813) 870-4248 Blvd Ste 640 00 Yrs/130 Yrs Tampa, FL 33607 South Florida Baptist Hospital (813) 872-7582 PCMH: No Fax: (813) 873-9591 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: No

Childrens Home Society of Florida Provider ID: 274874 4520 Oak Fair Blvd Tampa, FL 33610 (813) 471-0066 Fax: (813) 471-0007 00 Yrs/130 Yrs Languages: Spanish, Creole M 8:00 AM - 5:30 PM TWTHF 8:30 AM - 5:30 PM PCMH: No Circle of Friends Services Inc Provider ID: 525649 13234 Telecom Dr Ste 114 Tampa, FL 33637 (386) 259-5413 Fax: (386) 753-9265 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Dacco Provider ID: 811648 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 413-1065 Fax: (813) 630-0082 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Dacco Provider ID: 811648 3630 N 5th St Tampa, FL 33619 (813) 984-1818 Fax: (813) 630-0082 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Dacco Provider ID: 811648 Dacco Detox 4424 E Columbus Dr Tampa, FL 33605 (813) 384-4000 Fax: (813) 630-0082 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Families First of Florida LLC Provider ID: 792132 4902 Eisenhower Blvd Ste 315 Tampa, FL 33634 (813) 290-8560 Fax: (813) 354-2416 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Healing Educational Alternatives For Des Provider ID: 1025080 Heads 1001 E Baker St Ste 202 Plant City, FL 33563 (813) 754-5555 Fax: (813) 754-5552 02 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Lifeshare Management Group LLC Provider ID: 903667 3505 E Frontage Rd Ste 250 Tampa, FL 33607 (813) 891-9474 Fax: (813) 293-7234 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Mental Health Care Inc Provider ID: 21336 Gracepoint Main Center 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 03 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Community Mental Health Center - cont. Mental Health Care Inc Provider ID: 21336 Mental Health Care Inc DBA Gracepoi 10500 Univ Center Dr Ste 215 Tampa, FL 33612 (813) 272-2244 Fax: (813) 272-3766 03 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Mental Health Care Inc Provider ID: 21336 Mental Health Care Inc DBA Gracepoi 2208 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 03 Yrs/130 Yrs PCMH: No Mental Health Care Inc Provider ID: 21336 Mental Health Care Inc DBA Gracepoi 2212 E Henry Ave Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 03 Yrs/130 Yrs PCMH: No Mental Health Care Inc Provider ID: 21336 Mental Health Care Inc DBA Gracepoi 3107 N 50th St Ste A Tampa, FL 33619 (813) 272-2244 Fax: (813) 233-2745 03 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

Mental Health Care Inc Provider ID: 21336 Mental Health Care Inc DBA Gracepoi 5800 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 272-3766 03 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Mental Health Care Inc Provider ID: 21336 Mental Health Care Inc DBA Gracepoi 6220 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 272-3766 03 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Mts Health Services LLC Provider ID: 1063734 4511 N Himes Ave Ste 200 Tampa, FL 33614 (877) 698-4681 Fax: (877) 334-9751 02 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Tampa Crossroads Inc Provider ID: 1247818 Tampa Crossroads, Inc 5109 N Nebraska Ave Tampa, FL 33603 (813) 238-8557 Fax: (813) 232-2009 18 Yrs/130 Yrs MF 9:00 AM - 5:00 PM TWTH 9:00 AM - 7:00 PM Sat 11:00 AM - 5:00 PM PCMH: No

Geriatric Psychiatry De Jesus Flynn, Myrna ARNP Provider ID: 1361972 Gender: Female USF Physicicans Group 4001 E Fletcher Ave Tampa, FL 33613 (813) 974-4355 Fax: (813) 974-4251 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Licensed Clinical Social Worker Acheson, Kimberly LCSW Provider ID: 1145215 Gender: Female Kimberly Acheson 12197 W Linebaugh Ave Tampa, FL 33626 (813) 727-0264 Fax: (813) 792-5272 02 Yrs/130 Yrs M-F 7:30 AM - 2:30 PM PCMH: No Bentivenga, Lisa LCSW Provider ID: 1234875 Gender: Female Mahmoud Hassan, LMHC PA 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33614 (800) 729-0979 Fax: (800) 429-1304 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Coons, Audra LCSW Provider ID: 1245945 Gender: Female Brandon Mental Health 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 05 Yrs/130 Yrs M-W 9:00 AM - 6:00 PM PCMH: No

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Coughlin, Jacquelyn LCSW Provider ID: 1017055 Gender: Female Brandon Mental Health 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 00 Yrs/130 Yrs Pediatric Surgery Centers LLC M 9:00 AM - 6:00 PM TWTH 9:00 AM - 7:00 PM F 9:00 AM - 5:00 PM PCMH: No Daniels, Nikki LCSW Provider ID: 1026684 Gender: Female Nikki Daniels Consulting LLC 1200 W Platt St Ste 202 Tampa, FL 33606 (813) 324-5715 Fax: (813) 867-0797 12 Yrs/130 Yrs M-F 10:00 AM - 6:00 PM PCMH: No Jordan, Cassandra LCSW Provider ID: 1422903 Gender: Female Metropolitan Charities, Inc. 1315 E 7th Ave Tampa, FL 33605 (727) 321-3854 Fax: (727) 327-7670 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat 10:00 AM - 4:00 PM PCMH: No Lamb, Cheryl LCSW Provider ID: 1161985 Gender: Female Brandon Mental Health 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 Fax: (813) 438-8973 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Licensed Clinical Social Worker - cont. Martin, Reta LCSW Provider ID: 1161986 Gender: Female Brandon Mental Health 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 Fax: (813) 438-8973 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Raymond, Shane LCSW Provider ID: 754141 Gender: Male Brandon Mental Health LLC 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 Fax: (813) 438-8973 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Small, Frankie LCSW Provider ID: 1414952 Gender: Female Frankie Small 1503 S US Hwy 301 Ste 15 Tampa, FL 33619 (813) 551-1550 Fax: (813) 712-4150 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No St Vil, Islaine LCSW Provider ID: 1359452 Gender: Female Restore U Inc 3005 Lithia Pinecrest Rd Valrico, FL 33596 (813) 495-6702 Fax: (813) 425-5739 12 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 3:00 PM PCMH: No

Sutter, Kara LCSW Provider ID: 1251369 Gender: Female Brandon Mental Health 421 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 Fax: (813) 438-8973 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Thomas, Rosalyn LCSW Provider ID: 1350626 Gender: Female The Trinity Group of Florida, Inc 400 N Ashley Dr Ste 1900 Tampa, FL 33602 (813) 712-8705 Fax: (863) 937-5973 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM PCMH: No Tobias, Penelope LCSW Provider ID: 1362029 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Walker, Amanda LCSW Provider ID: 1362033 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Waters, Robin LCSW Cimino, Cynthia PHD Provider ID: 1238955 Provider ID: 1361967 Gender: Female Gender: Female Success Steps Counseling LLC USF Physicicans Group 1016 W Hillsborough Ave 13330 USF Laurel Dr Tampa, FL 33603 Tampa, FL 33612 (813) 924-3957 (813) 396-9478 12 Yrs/130 Yrs Fax: (813) 974-7590 M-F 9:00 AM - 7:00 PM 18 Yrs/110 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No

Licensed Marriage and Family Therapist

Danser, Laura LMFT Provider ID: 1169353 Gender: Female Brandon Mental Health 423 Lithia Pinecrest Rd Brandon, FL 33511 (813) 315-8648 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM PCMH: No Monteleone, Joseph LMHC Provider ID: 1251690 Gender: Male Mahmoud Hassan LMHC Inc 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33614 (813) 389-3930 Fax: (813) 933-2100 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM PCMH: No

Neuropsychology Artreches Camacho, Tahirin PsyD Provider ID: 1011266 Gender: Female Bay Area Neuropsychology LLC 2909 W Bay To Bay Blvd Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 05 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Mehra, Rahul MD Provider ID: 1423282 Gender: Male Mehra,Rahul N;MD 400 E MLK Blvd Ste 107 Tampa, FL 33603 (813) 442-7505 05 Yrs/130 Yrs M-TH 9:00 AM - 8:00 PM F 9:00 AM - 5:00 PM Sat 10:00 AM - 3:00 PM PCMH: No Ritchie, Abigail PsyD Provider ID: 1034499 Gender: Female Bay Area Neuropsychology 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Pediatric Psychiatry Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 10500 Univ Center Dr Ste 215 Tampa, FL 33612 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Pediatric Psychiatry cont. Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 2208 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 00 Yrs/130 Yrs PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 2212 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 00 Yrs/130 Yrs PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 3107 N 50th St Ste A Tampa, FL 33619 (813) 272-2244 Fax: (813) 272-6766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 5800 N Nebraska Ave Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 6220 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Armstrong, Kathleen PHD Provider ID: 1361960 Gender: Female USF Physicicans Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2583 Fax: (813) 396-9678 02 Yrs/12 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Armstrong, Kathleen PHD Provider ID: 1361960 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 02 Yrs/12 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

De Jesus Rosario, Nilsa MD Provider ID: 1304372 Gender: Female Mental Health Care DBA Gracepoint 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM PCMH: No De Jesus Rosario, Nilsa MD Provider ID: 1304372 Gender: Female Mental Health Care DBA Gracepoint 5800 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 239-8394 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Feinstein, Harris MD Provider ID: 1052854 Gender: Male Bay Area Behavioral Services 126 Lithia Pinecrest Rd Brandon, FL 33511 (813) 689-8828 Fax: (813) 689-8802 05 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM PCMH: No Feinstein, Harris MD Provider ID: 942094 Gender: Male Gracepoint Main Center 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 12 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

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Gettes, Ruth MD Provider ID: 1186026 Gender: Female Pediatric Health Choice 8509 Benjamin Rd Ste D Tampa, FL 33634 (813) 872-8521 Fax: (813) 800-0321 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kanfer, Steven MD Provider ID: 1187279 Gender: Male Bay Area Behavioral Services 126 Lithia Pinecrest Rd Brandon, FL 33511 (813) 689-8828 Fax: (813) 689-8802 05 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM PCMH: No Lupo, Joseph MD Provider ID: 1056148 Gender: Male Camelot Community Care 1410 Tech Blvd Tampa, FL 33619 (813) 635-9765 Fax: (813) 635-9725 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Pediatrics Behavioral and Developmental Armstrong, Kathleen PHD Provider ID: 1361960 Gender: Female USF Physicicans Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2583 Fax: (813) 396-9678 02 Yrs/12 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Pediatrics Behavioral and Ali, Muhammad MD Developmental - cont. Provider ID: 1056433 Armstrong, Kathleen PHD Provider ID: 1361960 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 02 Yrs/12 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Psychiatry Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 10500 Univ Center Dr Ste 215 Tampa, FL 33612 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 2208 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 00 Yrs/130 Yrs PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 2212 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 00 Yrs/130 Yrs PCMH: No

Gender: Male Mental Health Care Inc DBA Gracepoi 3107 N 50th St Ste A Tampa, FL 33619 (813) 272-2244 Fax: (813) 272-6766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 5800 N Nebraska Ave Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Ali, Muhammad MD Provider ID: 1056433 Gender: Male Mental Health Care Inc DBA Gracepoi 6220 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No

Baker, Teresa MD Provider ID: 1361963 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Botros-Mikhail, Hany MD Provider ID: 502114 Gender: Male 106 W Windhorst Rd Brandon, FL 33510 (813) 373-9531 Fax: (813) 413-4330 00 Yrs/130 Yrs Brandon Regional Hospital Springbrook Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Buagas, Archiel ARNP Provider ID: 1361964 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 13601 N 22nd St Tampa, FL 33613 (813) 307-8058 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 865-0158 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM PCMH: No Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 2103 N Rome Ave Tampa, FL 33607 (813) 490-1426 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 3901 S W. Shore Blvd Tampa, FL 33611 (813) 712-1940 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 00 Yrs/130 Yrs MTTHF 8:00 AM - 8:00 PM WSat 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Psychiatry - cont. Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 5611 Sheldon Rd Tampa, FL 33613 (813) 397-5320 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 8213 W Waters Ave Tampa, FL 33615 (813) 490-5420 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 5:00 PM PCMH: No Chowdhury, Quamrul MD

Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1035978 Gender: Male Adult Central Intake 2212 E Henry Ave Ste A and B Tampa, FL 33610 (813) 272-2958 Fax: (813) 272-3766 00 Yrs/130 Yrs PCMH: No Chowdhury, Quamrul MD

Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 490-1426 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM PCMH: No Chandy, Joshua DO Provider ID: 1275519 Gender: Male Tampa Family Health Centers 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1035978 Gender: Male Medical Health Care Inc DBA Gracepo 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs PCMH: No Cohen-Oram, Alexis MD Provider ID: 1361968 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Currier, Glenn MD Provider ID: 1361970 Gender: Male USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Currier, Glenn MD Provider ID: 1361970 Gender: Male USF Physicicans Group 5802 N 30th St Tampa, FL 33610 (813) 844-7111 Fax: (813) 236-5300 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Daniel, Jeffrey DO Provider ID: 1361971 Gender: Male USF Physicicans Group 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No De Jesus Rosario, Nilsa MD Provider ID: 1304372 Gender: Female Mental Health Care DBA Gracepoint 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

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De Jesus Rosario, Nilsa MD Provider ID: 1304372 Gender: Female Mental Health Care DBA Gracepoint 5800 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 239-8394 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Desai, Devyani MD Provider ID: 1213642 Gender: Female Childrens Home Society of Florida 1515 Michelin Ct Lutz, FL 33549 (813) 949-8946 Fax: (813) 949-2926 00 Yrs/130 Yrs M 2:30 AM - 6:30 PM PCMH: No Feinstein, Harris MD Provider ID: 1052854 Gender: Male Bay Area Behavioral Services 126 Lithia Pinecrest Rd Brandon, FL 33511 (813) 689-8828 Fax: (813) 689-8802 05 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM PCMH: No Feinstein, Harris MD Provider ID: 942094 Gender: Male Gracepoint Main Center 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 12 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Psychiatry - cont. Feldman, Alan MD Provider ID: 207569 Gender: Male Alan D Feldman MD PA 2835 W De Leon St Tampa, FL 33609 (813) 871-1123 Fax: (727) 392-1399 18 Yrs/130 Yrs MT 12:00 AM - 7:00 PM W 10:00 AM - 6:00 PM PCMH: No Fils, Jean MD Provider ID: 1361977 Gender: Male USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Goldberg, Karen MD Provider ID: 1361978 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hartney, Kimberly MD Provider ID: 1361983 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Kanfer, Steven MD Provider ID: 1187279 Gender: Male Bay Area Behavioral Services 126 Lithia Pinecrest Rd Brandon, FL 33511 (813) 689-8828 Fax: (813) 689-8802 05 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM PCMH: No

Lupo, Joseph MD Provider ID: 1056148 Gender: Male Camelot Community Care 1410 Tech Blvd Tampa, FL 33619 (813) 635-9765 Fax: (813) 635-9725 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Lluch, Roberto MD Provider ID: 1050160 Gender: Male Mental Health Care Inc DBA Gracepoi 2212 E Henry Ave Ste A and B Tampa, FL 33610 (813) 272-2958 Fax: (813) 272-3766 00 Yrs/130 Yrs Languages: Spanish PCMH: No

Pabon, Hernan MD Provider ID: 1058131 Gender: Male Gulf Coast Jewish Family and Commun 225 W Busch Blvd Tampa, FL 33612 (727) 450-7269 Fax: (727) 479-1248 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Lluch, Roberto MD Provider ID: 1050160 Gender: Male Mental Health Care Inc DBA Gracepoi 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs Languages: Spanish PCMH: No

Patel, Pragnesh MD Provider ID: 1282662 Gender: Male Mental Health Care Inc DBA Gracepoi 2208 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 00 Yrs/130 Yrs PCMH: No

Lockett, Stephanie MD Provider ID: 1277393 Gender: Female Mental Health Care Inc 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 12 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No

Patel, Pragnesh MD Provider ID: 1282662 Gender: Male Mental Health Care Inc DBA Gracepoi 2212 E Henry Ave Tampa, FL 33610 (813) 272-2958 Fax: (813) 233-2745 00 Yrs/130 Yrs PCMH: No

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Patel, Pragnesh MD Provider ID: 1282662 Gender: Male Mental Health Care Inc DBA Gracepoi 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patel, Pragnesh MD Provider ID: 1282662 Gender: Male Mental Health Care Inc DBA Gracepoi 5800 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 272-6766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Patel, Pragnesh MD Provider ID: 1282662 Gender: Male Mental Health Care Inc DBA Gracepoi 6220 N Nebraska Ave Tampa, FL 33604 (813) 272-2244 Fax: (813) 272-6766 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM PCMH: No Patel, Pragnesh MD Provider ID: 1415126 Gender: Male Neurobehavioral Medicine LLC 613 W MLK Jr Blvd Ste 101 Tampa, FL 33603 (813) 237-1958 Fax: (813) 237-8147 18 Yrs/130 Yrs Memorial Hospital of Tampa Tampa Community Hospital Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Psychiatry - cont. Patel, Shodhan MD Provider ID: 1422901 Gender: Male Solace Behavioral Health 1211 N W. Shore Blvd Ste 100 Tampa, FL 33607 (813) 282-3382 Fax: (727) 376-3652 00 Yrs/130 Yrs Languages: Gujarati M 8:30 AM - 7:30 PM PCMH: No Patel, Shodhan MD Provider ID: 158370 Gender: Male 1211 N W. Shore Blvd Ste 100 Tampa, FL 33607 (352) 596-4562 Fax: (352) 596-8188 00 Yrs/130 Yrs Springbrook Hospital Languages: French, Gujarati MT 10:00 AM - 6:00 PM PCMH: No Rankupalli, Babu MD Provider ID: 1285350 Gender: Male Phoenix Houses of Florida 510 Vonderburg Dr Ste 301 Brandon, FL 33511 (843) 881-1000 Fax: (813) 689-4132 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Rankupalli, Babu MD Provider ID: 1285350 Gender: Male Phoenix Houses of Florida 5501 W Waters Ave Ste 404/406 Tampa, FL 33634 (813) 881-1000 Fax: (813) 886-2791 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Rudd, Melissa ARNP Provider ID: 1362014 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Seignon, Caroline ARNP Provider ID: 1312033 Gender: Female Mental Health Care DBA Gracepoint 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 12 Yrs/130 Yrs Languages: French M-F 7:30 AM - 5:00 PM PCMH: No Settle, Edmund MD Provider ID: 1286761 Gender: Male Pathways Human Services of Florida 11428 N 53rd St Temple Terrace, FL 33617 (813) 374-9416 Fax: (813) 443-5795 05 Yrs/130 Yrs Lakeland Reg Medical Center M-F 9:00 AM - 5:00 PM PCMH: No Sheehan, Mary MD Provider ID: 962670 Gender: Female Gracepoint Main Center 5707 N 22nd St Tampa, FL 33610 (813) 272-2244 Fax: (813) 272-3766 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sheneman, Debbie ARNP Provider ID: 1161007 Gender: Female Debbie C. Sheneman Np-C, LLC 1501 LA Jolla Ave Sun City Center, FL 33573 (813) 759-3385 Fax: (813) 702-9477 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Hangauer, Jason PHD Provider ID: 1361980 Gender: Male USF Physicicans Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-0602 Fax: (813) 558-1343 02 Yrs/12 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hanson, Amanda PsyD Provider ID: 1361982 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Vijapura, Ashit MD Provider ID: 28164 Gender: Male 107 N Alexander St Plant City, FL 33563 (813) 754-1496 Fax: (813) 754-2553 12 Yrs/130 Yrs Memorial Hospital of Tampa South Florida Baptist Hospital Tampa Community Hospital Hoover, Kurt PHD Languages: Gujarati Provider ID: 144311 M-F 9:00 AM - 5:00 PM Gender: Male PCMH: No 5221 Ehrlich Rd Tampa, FL 33624 Yale, Steven MD (813) 926-3170 Provider ID: 1408861 Fax: (813) 920-1270 Gender: Male 00 Yrs/130 Yrs Agency For Community MWTH 8:00 AM - 8:00 PM Treatment Services TF 8:00 AM - 2:00 PM 4612 N 56th St PCMH: No Tampa, FL 33610 (813) 246-4899 Hudkins, Emily PHD Fax: (813) 367-2579 Provider ID: 1361987 18 Yrs/130 Yrs Gender: Female M-F 9:00 AM - 5:00 PM USF Physicicans Group PCMH: No 13101 Bruce B Downs Blvd Tampa, FL 33612 Psychology (813) 974-0602 Fax: (813) 558-1343 Childres, Jillian PHD 00 Yrs/130 Yrs Provider ID: 1361966 M-F 9:00 AM - 5:00 PM Gender: Female PCMH: No USF Physicicans Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-2583 Fax: (813) 396-9678 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Last update 08/14/2017

Behavioral Health Hillsborough Psychology - cont. Ingulli, Lamar PsyD Provider ID: 658240 Gender: Male Bay Area Neuropsychology LLC 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 00 Yrs/130 Yrs Bayfront Medical Center Tampa General Hospital MT 9:30 AM - 4:00 PM W 1:00 AM - 4:00 PM PCMH: No Isaac, Isaac MD Provider ID: 1361989 Gender: Male USF Physicicans Group 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kirby, Shana MD Provider ID: 1361992 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Leach, Christi MD Provider ID: 1361997 Gender: Female USF Physicicans Group 4001 E Fletcher Ave Tampa, FL 33613 (813) 396-0728 Fax: (813) 905-9815 65 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Leibmann, Susan MD Provider ID: 1361999 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Maciver, Patrick MD Provider ID: 1362002 Gender: Male USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Lewiscroswell, Jaclyn PsyD

Marrero, Isis MD Provider ID: 1362004 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1289507 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-6956 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lewis-Croswell, Jaclyn PsyD Provider ID: 1362001 Gender: Female USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-6956 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lopez, Magda PsyD Provider ID: 1100639 Gender: Female Bay Area Neuropsychology 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Marrero, Isis MD Provider ID: 1362004 Gender: Female USF Physicicans Group 5802 N 30th St Tampa, FL 33610 (813) 236-5300 Fax: (813) 236-5332 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Mattingly, Michelle PHD Provider ID: 1362006 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Mattingly, Michelle PHD Provider ID: 1362006 Gender: Female USF Physicicans Group 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2331 Fax: (813) 974-7181 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Patz, Daniel PsyD Provider ID: 670297 Gender: Male 2706 W Isabel St Ste B Tampa, FL 33607 (888) 666-3089 Fax: (888) 666-9870 00 Yrs/130 Yrs M-F 9:00 AM - 7:00 PM PCMH: No Rosenblatt, Arthur PHD Provider ID: 1362010 Gender: Male USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Roth, Deborah DO Provider ID: 1362011 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Hillsborough Psychology - cont. Ruano, Giselle PsyD Provider ID: 1362013 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Santana, Carlos MD Provider ID: 1362016 Gender: Male USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Shaw, Kailie MD Provider ID: 1362020 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Smith, Amanda MD Provider ID: 1362022 Gender: Female USF Physicicans Group 4001 E Fletcher Ave Tampa, FL 33613 (813) 974-4355 Fax: (813) 974-4251 65 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Smith, Laura PHD Provider ID: 1362023 Gender: Female USF Physicicans Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 396-2580 Fax: (813) 974-3313 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Wagoner, Ryan MD Provider ID: 1362031 Gender: Male USF Physicicans Group 5802 N 30th St Tampa, FL 33610 (813) 844-7111 Fax: (813) 236-5300 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Stock, Saundra MD Provider ID: 1362026 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Williamson, Nicole PHD

Taormina, Rochelle PHD Provider ID: 1143580 Gender: Female Bay Area Neuropsychology LLC 2909 W Bay To Bay Blvd Ste 200 Tampa, FL 33629 (813) 381-5200 Fax: (813) 381-5200 00 Yrs/21 Yrs M-F 8:00 AM - 7:00 PM PCMH: No Wagoner, Ryan MD Provider ID: 1362031 Gender: Male USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 1259233 Gender: Female Tampa General Hospital 1 Tampa General Cir Tampa, FL 33606 (813) 844-7667 Fax: (813) 844-4283 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Willis, Richard PsyD Provider ID: 1362034 Gender: Male USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Zern, Brittany PsyD Provider ID: 1362037 Gender: Female USF Physicicans Group 3515 E Fletcher Ave Tampa, FL 33613 (813) 974-8900 Fax: (813) 974-3223 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Substance Abuse Childrens Home Society of Florida Provider ID: 274874 4520 Oak Fair Blvd Tampa, FL 33610 (813) 471-0066 Fax: (813) 471-0007 00 Yrs/130 Yrs Languages: Spanish, Creole M 8:00 AM - 5:30 PM TWTHF 8:30 AM - 5:30 PM PCMH: No

Last update 08/14/2017

Behavioral Health Manatee Advance Registered Nurse Practitioner Psychiatrist Sauter, Patricia ARNP Provider ID: 1069527 Gender: Female Centerstone of Florida, Inc 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4642 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Behavioral Health Counseling Allen, Sarah LCSW Provider ID: 933693 Gender: Female Childrens Therapy Solutions Inc 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs Languages: Spanish, Norwegian M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Gibala, Virginia LMHC Provider ID: 927098 Gender: Female Childrens Therapy Solutions Inc 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No

Kroll, Linda LCSW Provider ID: 505805 Gender: Female 5609 26th St W Bradenton, FL 34207 (941) 751-0600 Fax: (941) 761-1510 05 Yrs/130 Yrs Languages: Spanish M-TH 10:00 AM - 7:00 PM PCMH: No Martin, Linda LMHC Provider ID: 865170 Gender: Female 6012 9th Ave W Bradenton, FL 34209 (941) 755-7830 Fax: (941) 794-2570 06 Yrs/65 Yrs PCMH: No Russell, Constance LCSW Provider ID: 199361 Gender: Female 6400 Manatee Ave W Ste D Bradenton, FL 34209 (941) 795-2228 Fax: (941) 795-2228 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM T 9:00 AM - 8:00 PM WTH 9:00 AM - 7:00 PM F 9:00 AM - 3:00 PM PCMH: No White, Kathy LMHC Provider ID: 311059 Gender: Female Childrens Therapy Solutions Inc 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No

Behavioral Health Facility Palm Shores Behavioral Health Camelot Community Care Inc Provider ID: 274915 5225 Office Park Blvd Bradenton, FL 34203 (941) 254-4900 Fax: (941) 254-4903 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Centerstone of Florida Inc Provider ID: 28509 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4618 Fax: (941) 782-4642 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Centerstone of Florida Inc Provider ID: 28509 Centerstone 6th Ave 379 6th Ave W Bradenton, FL 34205 (941) 782-4150 Fax: (941) 782-4104 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Centerstone of Florida Inc Provider ID: 28509 Manatee Glens Inc 2020 26th Ave E Bradenton, FL 34208 (941) 782-4299 Fax: (941) 782-4301 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Center Provider ID: 959913 1324 37th Ave E Bradenton, FL 34208 (941) 792-2222 Fax: (941) 795-4359 05 Yrs/18 Yrs PCMH: No

Community Mental Health Center Kin-Ship Services Inc Provider ID: 991682 Kinship Services Inc 515 27th St E Ste 3 Bradenton, FL 34208 (941) 748-2697 Fax: (941) 748-2937 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Licensed Clinical Social Worker Faraq, Estafan LCSW Provider ID: 975573 Gender: Male Lawton Chiles Children and Family H 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Faraq, Estafan LCSW Provider ID: 975573 Gender: Male Southwest Healthcare Center 5325 26th St W Bradenton, FL 34207 (941) 752-7173 Fax: (941) 567-6277 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Manatee Licensed Clinical Social Worker - cont. Quinton, Cynthia LCSW Provider ID: 1176337 Gender: Female Manatee County Rural Services Inc 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 05 Yrs/130 Yrs MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM PCMH: No

Pediatric Psychiatry Halder, Ranjay MD Provider ID: 1057566 Gender: Male Centerstone of Florida 2020 26th Ave E Bradenton, FL 34208 (941) 782-4600 Fax: (941) 782-4601 00 Yrs/130 Yrs Manatee Memorial Hospital PCMH: No

Halder, Ranjay MD Provider ID: 1057566 Gender: Male Centerstone of Florida Reimer, Donald LCSW 379 6th Ave W Provider ID: 1016737 Bradenton, FL 34205 Gender: Male (941) 782-4150 Southwest Healthcare Center Fax: (941) 782-4101 5325 26th St W 00 Yrs/130 Yrs Bradenton, FL 34207 Manatee Memorial Hospital (941) 752-7173 M-F 8:30 AM - 5:00 PM Fax: (941) 567-6277 PCMH: No 00 Yrs/130 Yrs Sheshani, Shashidhar MD M-F 8:00 AM - 5:00 PM PCMH: No Provider ID: 1069533 Schau, Regina LCSW Gender: Male Provider ID: 1073501 Centerstone of Florida, Inc. Gender: Female 379 6th Ave W Southwest Healthcare Center Bradenton, FL 34205 5325 26th St W (941) 782-4150 Bradenton, FL 34207 Fax: (941) 782-4104 (941) 752-7173 00 Yrs/130 Yrs Fax: (941) 567-6277 M-F 8:30 AM - 5:00 PM 00 Yrs/130 Yrs PCMH: No M-F 8:00 AM - 5:00 PM Zaglul, Jose MD PCMH: No Provider ID: 1069620 Pediatric Behavioral Gender: Male Medicine Centerstone of Florida 379 6th Ave W Hubbard, Helene MD Bradenton, FL 34205 Provider ID: 521607 (941) 782-4150 Gender: Female Fax: (941) 782-4101 K & H Healthkare Inc 00 Yrs/130 Yrs 408 Manatee Ave E M-F 8:30 AM - 5:00 PM Bradenton, FL 34208 PCMH: No (941) 922-5366 Fax: (941) 894-3487 00 Yrs/21 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Pediatrics Behavioral and Centerstone of Florida Inc Developmental Hubbard, Helene MD Provider ID: 275813 Gender: Female K & H Healthkare Inc 408 Manatee Ave E Bradenton, FL 34208 (941) 922-5366 Fax: (941) 894-3487 00 Yrs/21 Yrs Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Hubbard, Helene MD Provider ID: 275813 Gender: Female K & H Healthkare Inc 4506 26th St W Bradenton, FL 34207 (941) 922-5366 00 Yrs/21 Yrs Manatee Memorial Hospital M 9:00 AM - 5:00 PM PCMH: No

Provider ID: 28509 Centerstone 6th Ave 379 6th Ave W Bradenton, FL 34205 (941) 782-4150 Fax: (941) 782-4104 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Centerstone of Florida Inc Provider ID: 28509 Manatee Glens Inc 2020 26th Ave E Bradenton, FL 34208 (941) 782-4299 Fax: (941) 782-4301 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Psychiatry

Hubbard, Helene MD Burcenski, Holleen ARNP Provider ID: 28801 Gender: Male Provider ID: 1069464 Southwest Healthcare Center Gender: Female 5325 26th St W Centerstone of Florida, Inc Bradenton, FL 34207 379 6th Ave W (941) 752-7173 Bradenton, FL 34205 Fax: (941) 567-6277 (941) 782-4150 18 Yrs/130 Yrs Fax: (941) 782-4104 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No

Psych Hospital

Centerstone of Florida Inc Provider ID: 28509 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4618 Fax: (941) 782-4642 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

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Burcenski, Holleen ARNP Provider ID: 1069464 Gender: Female Centerstone of Florida, Inc 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4642 18 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Manatee Psychiatry - cont. Dillon, Donna ARNP Provider ID: 987937 Gender: Female Lawton Chiles Children and Family H 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Lasebny, Deborah ARNP Provider ID: 1069495 Gender: Female Centerstone of Florida Inc 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4642 18 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Rabines Burga, Marco MD Provider ID: 1069518 Gender: Male Manatee Glens Inc 379 6th Ave W Bradenton, FL 34205 (941) 782-4150 Fax: (941) 782-4104 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Linares-Flor, Jesus MD Provider ID: 1069498 Dillon, Donna ARNP Gender: Male Provider ID: 987937 Centerstone of Florida Inc Gender: Female 5214 4th Ave Cir E Southwest Healthcare Center Bradenton, FL 34208 5325 26th St W (941) 782-4150 Bradenton, FL 34207 Fax: (941) 782-4642 (941) 752-7173 18 Yrs/130 Yrs Fax: (941) 567-6277 M-F 8:30 AM - 6:00 PM 00 Yrs/130 Yrs PCMH: No M-F 9:00 AM - 5:00 PM PCMH: No Rabines Burga, Marco MD

Rhyne, Dennis MD Provider ID: 1233461 Gender: Male Centerstone State Road 64 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4642 18 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Halim, Tariq MD Provider ID: 1069518 Provider ID: 778793 Gender: Male Gender: Male Centerstone of Florida Southwest Healthcare Center 2020 26th Ave E 5325 26th St W Bradenton, FL 34208 Bradenton, FL 34207 (941) 782-4150 (941) 752-7173 Fax: (941) 782-4601 Fax: (941) 567-6277 18 Yrs/130 Yrs 05 Yrs/130 Yrs PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Rabines Burga, Marco MD

Provider ID: 1069533 Gender: Male Centerstone of Florida, Inc. 379 6th Ave W Bradenton, FL 34205 (941) 782-4150 Fax: (941) 782-4104 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Jasa, Luis MD Provider ID: 1069489 Gender: Male Manatee Glens Inc 2020 26th Ave E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4601 18 Yrs/130 Yrs PCMH: No

Provider ID: 1069518 Gender: Male Centerstone of Florida 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4642 18 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM PCMH: No

Sheshani, Shashidhar MD

Psychology Abanishe, Dahomey PHD Provider ID: 988498 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

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Aguilu, Karla PsyD Provider ID: 988522 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bakay, Scott PsyD Provider ID: 988490 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 00 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Bishop, Bonni PsyD Provider ID: 986142 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Manatee Psychology - cont. Campbell, Elizabeth PHD Provider ID: 988508 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Clyburn, Thomas PHD Provider ID: 499584 Gender: Male 318 Old Main St Ste 21 Bradenton, FL 34205 (941) 224-3800 Fax: (941) 745-1630 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Dolgin, Daniel PHD Provider ID: 986520 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Espinal, Miguel PHD Provider ID: 988558 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Helfand, Janet PHD Provider ID: 988470 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Jones, Anne PsyD Provider ID: 988613 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Fitzsimmons, Daniel PsyD Provider ID: 986538 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Hopson, Derek PHD Provider ID: 1176410 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 12 Yrs/130 Yrs MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM PCMH: No

Lajos, Laura PHD Provider ID: 986159 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Gomez, Ana PsyD Provider ID: 988568 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Hulett Johnson, Lesley PsyD Provider ID: 986112 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Levy, Erik PsyD Provider ID: 986544 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lovell, Alice PHD Provider ID: 986153 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Manatee Psychology - cont. Mendoza, Jennifer PHD Provider ID: 986527 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Moore, Tracee PHD Provider ID: 988635 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Padronaggio, Joseph PHD Provider ID: 220037 Gender: Male 4910 14th St W Ste 301 Bradenton, FL 34207 (941) 756-7000 00 Yrs/130 Yrs M 8:00 AM - 8:00 PM TW 8:00 AM - 9:00 PM TH 9:00 AM - 8:00 PM PCMH: No Patz, Daniel PsyD Provider ID: 986147 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Pena Rosa, Karla PHD Provider ID: 986525 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Rios Ortega, Dally PsyD Provider ID: 986121 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Savill, Gary PHD Provider ID: 986473 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Schiffner, Tiffany PHD Provider ID: 986127 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Sears, Karmon PsyD Provider ID: 429483 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Stevens, Xuan PHD Provider ID: 986138 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Van Dam, Gregory PsyD Provider ID: 986531 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Vanbrackle, Cathryn PsyD Provider ID: 986553 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

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Weber, Theodore PsyD Provider ID: 988732 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Blake Medical Center Lakewood Ranch Medical Center Manatee Memorial Hospital M-F 9:00 AM - 5:00 PM PCMH: No Williams, Mark PHD Provider ID: 986090 Gender: Male Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4060 21 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pasco Behavioral Health Counseling Bielitz, Robert LMHC Provider ID: 1304386 Gender: Male Lifespan Services Inc 4800 Rowan Rd New Port Richey, FL 34653 (727) 847-0069 Fax: (727) 849-3780 00 Yrs/130 Yrs MTWTHFSatSun 9:00 AM 8:00 PM PCMH: No Bjorkman, Tara LMHC Provider ID: 286499 Gender: Female 6245 State Rd 54 New Port Richey, FL 34653 (727) 846-9496 Fax: (727) 849-8410 12 Yrs/130 Yrs Languages: Korean M-TH 8:00 AM - 7:00 PM F 8:00 AM - 12:00 PM PCMH: No Corradini, Frank LCSW Provider ID: 194543 Gender: Male 6536 Stadium Dr Ste F Zephyrhills, FL 33542 (813) 783-2135 Fax: (813) 783-2135 05 Yrs/130 Yrs MW 8:00 AM - 5:00 PM TTH 8:30 AM - 6:00 PM F 8:00 AM - 6:00 PM PCMH: No

Edwards II, Stephen LMHC Provider ID: 753957 Gender: Male Christian Counseling Center 2017 Riegler Rd Land O Lakes, FL 34639 (813) 416-0597 Fax: (813) 948-8414 00 Yrs/130 Yrs M 8:00 AM - 9:00 PM T 8:00 AM - 6:00 PM W 8:00 AM - 4:00 PM PCMH: No Erickson, Shannon LCSW Provider ID: 278890 Gender: Female 8022 Old County Rd 54 New Port Richey, FL 34653 (727) 784-8244 Fax: (727) 264-8802 00 Yrs/130 Yrs MT 9:00 AM - 8:00 PM W 8:00 AM - 5:00 PM PCMH: No Fogleman, Ruthann LMHC Provider ID: 1085149 Gender: Female Ruthann Fogleman 8022 Old County Rd 54 New Port Richey, FL 34653 (727) 784-8244 Fax: (727) 264-8802 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Gadouas, Cassandra LMHC

Dubovsky, Ladislaus LMHC Provider ID: 665147 Gender: Male 10854 Telford St New Port Richey, FL 34654 (727) 328-4335 Fax: (727) 856-9656 00 Yrs/130 Yrs Languages: German M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 1189835 Gender: Female Cassandras Counseling 7620 Congress St New Port Richey, FL 34653 (727) 505-0959 Fax: (727) 863-1343 00 Yrs/130 Yrs MW 9:00 AM - 7:00 PM T 9:00 AM - 3:00 PM TH 9:00 AM - 5:00 PM F 3:00 AM - 5:00 PM PCMH: No

Henning, Trish LCSW Provider ID: 970476 Gender: Female 8022 Old County Rd 54 New Port Richey, FL 34653 (727) 784-8244 Fax: (727) 287-9302 15 Yrs/90 Yrs M-F 9:00 AM - 7:00 PM PCMH: No Kassed, Marvin LMHC Provider ID: 28452 Gender: Male 5510 River Rd Ste 101 New Prt Rchy, FL 34652 (727) 842-3999 Fax: (727) 848-0731 05 Yrs/130 Yrs Languages: Spanish, French, German MTF 9:00 AM - 5:00 PM W 9:00 AM - 7:00 PM TH 9:00 AM - 6:00 PM PCMH: No Nikla, Richard LMHC Provider ID: 817735 Gender: Male Richard Nikla LMHC DBA West Co 5462 Grand Blvd Ste 104 New Port Richey, FL 34652 (727) 741-2457 Fax: (727) 939-0204 00 Yrs/130 Yrs M-TH 10:00 AM - 9:00 PM PCMH: No Sparrowhawk, Paloma LMHC Provider ID: 532014 Gender: Female Paloma Sparrowhawk 5328 Trouble Creek Rd New Port Richey, FL 34652 (813) 610-9815 Fax: (813) 973-8589 12 Yrs/130 Yrs M-TH 11:00 AM - 8:00 PM F 10:00 AM - 3:00 PM PCMH: No

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Stemble, Kelly LMHC Provider ID: 1138372 Gender: Female Kelly D Stemble 8022 Old County Rd 54 New Port Richey, FL 34653 (727) 784-8244 05 Yrs/130 Yrs M-W 10:00 AM - 7:00 PM TH 2:00 AM - 5:00 PM F 10:00 AM - 2:00 PM PCMH: No Tranum, Megan LMHC Provider ID: 1195317 Gender: Female Lifespan Services 4800 Rowan Rd New Port Richey, FL 34652 (727) 847-0069 00 Yrs/18 Yrs M-W 12:00 AM - 8:00 PM PCMH: No Tranum, Megan LMHC Provider ID: 1248341 Gender: Female True North Behavioral Health Servic 3848 Flatiron Loop Ste 100 Wesley Chapel, FL 33544 (813) 319-3910 Fax: (813) 498-2671 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Visalli, Alyssa LMHC Provider ID: 1136437 Gender: Female Lifespan Services Inc 4800 Rowan Rd New Port Richey, FL 34653 (727) 847-0069 Fax: (727) 849-3780 00 Yrs/18 Yrs MTWTHFSat 9:00 AM - 8:00 PM Sun 9:00 AM - 9:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pasco Behavioral Health Facility The Harbor BHCI Morton Plant North Bay Hospital Provider ID: 20138 6600 Madison St New Prt Rchy, FL 34652 (727) 843-4500 Fax: (813) 635-7970 00 Yrs/130 Yrs PCMH: No Sequelcare of Florida LLC Provider ID: 479208 9550 US Hwy 19 Ste 202 203 and 214 Port Richey, FL 34668 (727) 494-7609 Fax: (727) 494-7610 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 14527 7th St Dade City, FL 33523 (813) 872-7582 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Provider ID: 21158 7809 Massachusetts Ave New Port Richey, FL 34653 (813) 872-7582 Fax: (727) 841-4354 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 8002 King Helie Blvd New Prt Rchy, FL 34653 (813) 872-7582 Fax: (727) 841-4436 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 8132 King Helie Blvd New Port Richey, FL 34653 (813) 872-7582 Fax: (727) 834-3969 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Community Mental Health Center

The Harbor BHCI Provider ID: 21158 14541 7th St Dade City, FL 33523 (813) 872-7582 Fax: (727) 841-4436 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Impower Inc Provider ID: 270420 3848 Flatiron Loop Unit 101 Wesley Chapel, FL 33544 (407) 215-0095 Fax: (407) 261-0523 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

The Harbor BHCI Provider ID: 21158 6040 Indiana Ave New Port Richey, FL 34653 (813) 872-7582 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

The Harbor BHCI Provider ID: 21158 14527 7th St Dade City, FL 33523 (813) 872-7582 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

The Harbor BHCI Provider ID: 21158 14541 7th St Dade City, FL 33523 (813) 872-7582 Fax: (727) 841-4436 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 6040 Indiana Ave New Port Richey, FL 34653 (813) 872-7582 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 7809 Massachusetts Ave New Port Richey, FL 34653 (813) 872-7582 Fax: (727) 841-4354 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 8002 King Helie Blvd New Prt Rchy, FL 34653 (813) 872-7582 Fax: (727) 841-4436 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No The Harbor BHCI Provider ID: 21158 8132 King Helie Blvd New Port Richey, FL 34653 (813) 872-7582 Fax: (727) 834-3969 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 581

Distinct Part Unit Psych Medical Center of Trinity Provider ID: 20948 5637 Marine Pkwy New Port Richey, FL 34652 (727) 834-5700 Fax: (727) 834-5963 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Medical Center of Trinity Provider ID: 20948 9330 State Rd 54 Trinity, FL 34655 (727) 834-4000 Fax: (727) 834-4912 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Geriatric Psychiatry Vijapura, Ashit MD Provider ID: 1107301 Gender: Male Premier Community Healthcare Group 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 02 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Licensed Clinical Social Worker Acosta, Cary LCSW Provider ID: 1267533 Gender: Female Premier Community Healthcare Group 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pasco Licensed Clinical Social Worker - cont. Adami, Angela LCSW Provider ID: 1302577 Gender: Female Premier Community Healthcare Group 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM PCMH: No Cortes Ramirez, Luz LCSW Provider ID: 1196805 Gender: Female Lifespan Services, Inc. 4800 Rowan Rd New Port Richey, FL 34653 (727) 847-0069 Fax: (727) 849-3780 05 Yrs/130 Yrs M 9:00 AM - 7:00 PM T 1:00 AM - 5:00 PM W 10:00 AM - 5:00 PM PCMH: No Jordan, Cassandra LCSW Provider ID: 1422903 Gender: Female Metropolitan Charities, Inc. 4747 US Hwy 19 New Prt Rchy, FL 34652 (727) 321-3854 Fax: (727) 327-7670 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

Misiaszek-Boser, Joann LCSW Provider ID: 1028400 Gender: Female Partnership For Children and Famili 10939 Kenmore Dr New Port Richey, FL 34654 (813) 310-3295 Fax: (727) 236-6742 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM PCMH: No Vagedes, Marie LCSW Provider ID: 1126080 Gender: Female The Solution Counseling Center 8022 Old County Rd 54 New Port Richey, FL 34653 (727) 784-8244 Fax: (727) 264-8802 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Licensed Marriage and Family Therapist Jaramillo, Kate LMFT Provider ID: 1034643 Gender: Female Kate Jaramillo 13345 Hillwood Cir Hudson, FL 34667 (727) 687-8982 00 Yrs/130 Yrs M-F 9:00 AM - 9:00 PM Sat 8:00 AM - 12:00 PM PCMH: No Jaramillo, Kate LMFT Provider ID: 1034643 Gender: Female Kate Jaramillo 8022 Old County Rd 54 New Port Richey, FL 34653 (727) 687-8982 00 Yrs/130 Yrs M-F 9:00 AM - 9:00 PM PCMH: No

Licensed Professional Counselor Slickers, Albert LPC Provider ID: 1278414 Gender: Male Acas Counseling, LLC 2718 Letap Ct Ste 101 Land O Lakes, FL 34638 (813) 777-8253 Fax: (813) 475-4794 05 Yrs/130 Yrs M-TH 5:00 AM - 9:00 PM F 1:00 AM - 6:00 PM PCMH: No

Pediatric Psychiatry Williams, Vashaun MD Provider ID: 1239758 Gender: Male Impower 3848 Flatiron Loop Unit 101 Wesley Chapel, FL 33544 (321) 639-1224 Fax: (321) 639-1194 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Psychiatry Ahmad, Kazi MD Provider ID: 1239760 Gender: Male Impower 3848 Flatiron Loop Unit 101 Wesley Chapel, FL 33544 (321) 639-1224 Fax: (321) 639-1194 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cannon, Fay MD Provider ID: 957933 Gender: Male Baycare Behavioral Health DBA The H 14527 7th St Dade City, FL 33523 (813) 428-6181 Fax: (352) 521-1477 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 582

Cannon, Fay MD Provider ID: 957933 Gender: Male Baycare Behavioral Health DBA The H 8002 King Helie Blvd New Port Richey, FL 34653 (727) 841-4430 Fax: (727) 841-4443 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Dhillon, Amarjeet MD Provider ID: 28592 Gender: Male Amarjeet S Dhillon 4807 US Hwy 19 Ste 204 New Port Richey, FL 34652 (727) 847-7464 Fax: (747) 847-0692 05 Yrs/130 Yrs Florida Hospital North Pinellas Medical Center of Trinity Morton Plant North Bay Hospital Languages: Hindi M-F 9:30 AM - 5:00 PM PCMH: No Hart, Marlene MD Provider ID: 199522 Gender: Female 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 00 Yrs/130 Yrs MTTHF 8:00 AM - 5:00 PM W 10:00 AM - 7:00 PM Sat 9:00 AM - 4:00 PM PCMH: No Herron, Jessica ARNP Provider ID: 1107302 Gender: Female Premier Community Healthcare Group 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pasco Psychiatry - cont. Kirmani, Najib MD Provider ID: 1059632 Gender: Male Impower Inc 3848 Flatiron Loop Ste 101 Wesley Chapel, FL 33544 (321) 639-1224 Fax: (321) 639-1194 00 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Murray, Ingrid PA Provider ID: 1245796 Gender: Female Impower Inc 3848 Flatiron Loop Unit 101 Wesley Chapel, FL 33544 (321) 639-1224 Fax: (321) 639-1194 05 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Pabon, Hernan MD Provider ID: 1058131 Gender: Male Gulf Coast Jewish Family and Commun 2425 Chatlin Rd Holiday, FL 34691 (727) 450-7269 Fax: (727) 479-1248 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Pabon, Hernan MD Provider ID: 1058131 Gender: Male Gulf Coast Jewish Family and Commun 3142 Darlington Rd Holiday, FL 34691 (727) 450-7269 Fax: (727) 479-1248 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Parks, Alicia ARNP Provider ID: 1295838 Gender: Female Gulf Coast Jewish Family and Commun 3142 Darlington Rd Holiday, FL 34691 (727) 450-7269 Fax: (727) 479-1248 05 Yrs/130 Yrs M 9:00 AM - 5:00 PM PCMH: No Patel, Shodhan MD Provider ID: 1422901 Gender: Male Solace Behavioral Health 4800 Rowan Rd New Port Richey, FL 34653 (727) 483-5912 Fax: (352) 556-5931 00 Yrs/130 Yrs Languages: Gujarati M-F 8:30 AM - 7:00 PM PCMH: No Patel, Shodhan MD Provider ID: 158370 Gender: Male 4800 Rowan Rd New Port Richey, FL 34657 (727) 483-5912 Fax: (727) 376-3652 00 Yrs/130 Yrs Springbrook Hospital Languages: French, Gujarati M 10:00 AM - 6:00 PM PCMH: No Vijapura, Ashit MD Provider ID: 1107301 Gender: Male Premier Community Healthcare Group 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 02 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM PCMH: No

Williams, Vashaun MD Provider ID: 1239758 Gender: Male Impower 3848 Flatiron Loop Unit 101 Wesley Chapel, FL 33544 (321) 639-1224 Fax: (321) 639-1194 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Psychology Cameron, Rhonda PHD Provider ID: 273689 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-8125 00 Yrs/130 Yrs MWFSat 8:00 AM - 5:00 PM TTH 8:00 AM - 8:00 PM PCMH: No Cameron, Rhonda PHD Provider ID: 723689 Gender: Female Premier Community Healthcare Group 37944 Pasco Ave Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-0218 00 Yrs/130 Yrs MTWF 9:00 AM - 6:00 PM TH 8:00 AM - 8:00 PM PCMH: No

Substance Abuse Impower Inc Provider ID: 270420 3848 Flatiron Loop Unit 101 Wesley Chapel, FL 33544 (407) 215-0095 Fax: (407) 261-0523 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 583

North Tampa Behav Health Provider ID: 914392 29910 SR 56 Wesley Chapel, FL 33543 (813) 922-3300 Fax: (813) 994-4249 18 Yrs/130 Yrs PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Advance Registered Nurse Practitioner Psychiatrist Lotito, Jillian ARNP Provider ID: 1029479 Gender: Female Directions For Mental Health Inc Db 1437 S Belcher Rd Clearwater, FL 33764 (727) 524-4464 Fax: (727) 524-4491 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Behavioral Health Counseling Agency For Community Treatment Services Provider ID: 927325 Agency For Community Treatment Services 3575 Keystone Rd Tarpon Springs, FL 34688 (813) 522-0489 Fax: (727) 942-4181 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Arredondo, Andra LCSW Provider ID: 949933 Gender: Female St Pete Behavioral Health Center 433 4th St N Saint Petersburg, FL 33701 (727) 895-8499 Fax: (727) 895-8497 16 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 10:00 AM - 2:00 PM PCMH: No

Bajor, Jane LMHC Provider ID: 1212535 Gender: Female 7229 Central Ave Saint Petersburg, FL 33710 (727) 270-9920 02 Yrs/130 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Bajor, Jane LMHC Provider ID: 1212535 Gender: Female Jane Bajor, LMHC 7850 Ulmerton Rd Ste 4 Largo, FL 33771 (727) 698-2941 Fax: (727) 213-9035 02 Yrs/130 Yrs MTWF 8:00 AM - 7:00 PM TH 8:00 AM - 12:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Barnes, Wanda LMHC Provider ID: 930121 Gender: Female 3840 5th Ave N Saint Petersburg, FL 33713 (727) 367-2273 Fax: (727) 800-6929 00 Yrs/130 Yrs M-F 10:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM PCMH: No Bishop, Harold LCSW Provider ID: 28107 Gender: Male 1905 Tyrone Blvd N Saint Petersburg, FL 33710 (727) 347-3284 Fax: (747) 347-4472 18 Yrs/130 Yrs M-TH 9:00 AM - 6:00 PM PCMH: No

Bulla, Angela LCSW Provider ID: 803118 Gender: Female Angela Brown Bulla LCSW 51 S Main Ave Ste 304 Clearwater, FL 33765 (727) 328-4672 Fax: (727) 287-9302 00 Yrs/130 Yrs MW 8:00 AM - 7:00 PM T 8:00 AM - 2:00 PM TH 8:00 AM - 5:00 PM F 1:00 AM - 5:00 PM PCMH: No Bunton, Miriam LCSW Provider ID: 751512 Gender: Female 8601 4th St N Ste 312 Saint Petersburg, FL 33702 (727) 744-4489 Fax: (813) 854-1472 05 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 4:00 PM PCMH: No Carini, Andrew LCSW Provider ID: 937746 Gender: Male Suncoast Counseling LLC 51 S Main Ave Ste 304 Clearwater, FL 33765 (727) 784-8244 Fax: (727) 287-9302 00 Yrs/130 Yrs MTWF 8:00 AM - 9:00 PM TH 9:00 AM - 9:00 PM PCMH: No Childers, Eleanor LCSW Provider ID: 805553 Gender: Female 1301 Seminole Blvd Ste 111B Largo, FL 33770 (727) 754-4936 Fax: (866) 496-4382 00 Yrs/130 Yrs MTWTHFSat 9:00 AM - 6:00 PM PCMH: No

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Christova, Albena LMHC Provider ID: 950069 Gender: Female St Pete Behavioral Health Center In 433 4th St N Saint Petersburg, FL 33701 (727) 895-8499 Fax: (727) 895-8497 16 Yrs/130 Yrs Languages: Russian, German, Polish, Bulgarian M-F 8:30 AM - 5:00 PM Sat 10:00 AM - 2:00 PM PCMH: No Clare, John LMHC Provider ID: 1217571 Gender: Male John J. Clare, LMHC, Cap, Ceap 12360 66th St Ste H5 Largo, FL 33773 (727) 282-2883 Fax: (727) 240-1047 12 Yrs/130 Yrs MT 4:00 AM - 9:00 PM W 9:00 AM - 6:00 PM PCMH: No Clark, Louisa LMHC Provider ID: 540858 Gender: Female 430 Athens St Tarpon Springs, FL 34689 (727) 709-8964 Fax: (727) 937-7330 00 Yrs/130 Yrs M-F 8:00 AM - 7:00 PM PCMH: No Cooney, Patricia LCSW Provider ID: 948905 Gender: Female St Pete Behavioral Health Center In 1232 N Pinellas Ave Tarpon Springs, FL 34689 (727) 944-5171 Fax: (727) 944-5171 16 Yrs/130 Yrs Languages: Spanish, Russian, German, Polish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Behavioral Health Counseling - cont. Cooney, Patricia LCSW Provider ID: 948905 Gender: Female St Pete Behavioral Health Center In 433 4th St N Saint Petersburg, FL 33701 (727) 895-8499 Fax: (727) 895-8497 16 Yrs/130 Yrs Languages: Spanish, Russian, German, Polish M-TH 10:30 AM - 3:00 PM PCMH: No Dann, Kelly LCSW Provider ID: 922185 Gender: Female 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 581-2678 18 Yrs/100 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Davenport, Glenda LCSW Provider ID: 359531 Gender: Female Glenda Davenport LCSW 430 Athens St Tarpon Springs, FL 34689 (727) 560-8225 Fax: (727) 787-2384 00 Yrs/130 Yrs M 11:00 AM - 8:00 PM TW 1:00 AM - 9:00 PM PCMH: No Davidson, Wayne LMHC Provider ID: 807237 Gender: Male 40347 US Hwy 19 N Ste 103 Tarpon Springs, FL 34689 (813) 979-0535 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Erickson, Shannon LCSW Provider ID: 278890 Gender: Female 2270 Drew St Ste C Clearwater, FL 33765 (727) 784-8244 Fax: (727) 287-9302 00 Yrs/130 Yrs M 9:00 AM - 8:00 PM T 8:00 AM - 5:00 PM PCMH: No Feiler, Angela LMHC Provider ID: 28111 Gender: Female 32196 US Hwy 19 N Palm Harbor, FL 34684 (727) 372-8660 07 Yrs/100 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Fine, Frank LMHC Provider ID: 783620 Gender: Male Orlando Counseling Center 737 Main St Safety Harbor, FL 34695 (407) 588-6235 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Fogleman, Ruthann LMHC Provider ID: 1085149 Gender: Female Ruthann Fogleman 2270 Drew St Ste C Clearwater, FL 33765 (727) 784-8244 Fax: (727) 287-9302 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No

Fuller, Mary LMHC Provider ID: 965256 Gender: Female 40347 US Hwy 19 N Ste 103 Tarpon Springs, FL 34689 (727) 330-8932 Fax: (727) 772-8212 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Gibson, Angela LCSW Provider ID: 788721 Gender: Female 10225 Ulmerton Rd Ste 8B Largo, FL 33771 (727) 586-0636 Fax: (727) 585-6287 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM PCMH: No Graff, Sara LCSW Provider ID: 318176 Gender: Female 1301 Seminole Blvd Ste 111B Largo, FL 33770 (727) 754-4936 Fax: (727) 496-4382 00 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Hall, Sandra LMHC Provider ID: 282772 Gender: Female Sandra S Hall LMHC Cap Crc PA 10825 Seminole Blvd Unit 2A Largo, FL 33778 (727) 623-0974 Fax: (727) 623-0975 05 Yrs/130 Yrs M-F 10:00 AM - 6:00 PM PCMH: No Henning, Trish LCSW Provider ID: 970476 Gender: Female 2270 Drew St Ste C Clearwater, FL 33765 (727) 784-8244 Fax: (727) 287-9302 15 Yrs/90 Yrs M-F 9:00 AM - 7:00 PM PCMH: No

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Holland, Cynthia LCSW Provider ID: 176767 Gender: Female 10875 Park Blvd Ste A Seminole, FL 33772 (727) 391-4050 Fax: (727) 391-2522 13 Yrs/100 Yrs M 12:00 AM - 7:00 PM TTH 9:00 AM - 8:00 PM W 12:00 AM - 7:30 PM F 12:00 AM - 6:00 PM PCMH: No Ingram, Jennifer LMHC Provider ID: 499629 Gender: Female 1301 Seminole Blvd Ste 103 Largo, FL 33770 (727) 213-5379 Fax: (727) 213-5370 00 Yrs/130 Yrs M 9:00 AM - 7:00 PM TWTH 9:00 AM - 2:00 PM F 9:00 AM - 4:00 PM PCMH: No Ingram, Jennifer LMHC Provider ID: 499629 Gender: Female Richard D Morris LLC DBA Famil 2555 Enterprise Rd Ste 111 Clearwater, FL 33763 (727) 213-5379 Fax: (727) 213-5370 00 Yrs/130 Yrs M 9:00 AM - 1:00 PM T 9:00 AM - 2:00 PM PCMH: No Kerwin, Joan LMHC Provider ID: 789621 Gender: Female 275 4th St N Saint Petersburg, FL 33701 (727) 271-1783 Fax: (727) 245-8938 05 Yrs/130 Yrs M-TH 9:00 AM - 8:00 PM F 9:00 AM - 8:30 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Behavioral Health Counseling - cont. Knop, Karen LCSW Provider ID: 929780 Gender: Female 1210 66th St N Saint Petersburg, FL 33710 (727) 518-6444 Fax: (727) 581-2678 17 Yrs/100 Yrs MT 9:00 AM - 7:00 PM PCMH: No Lambert, John LCSW Provider ID: 801620 Gender: Male John F Lambert 820 Jasmine Way Larkin Center Clearwater, FL 33756 (727) 492-4926 Fax: (727) 442-4810 00 Yrs/130 Yrs M-F 7:30 AM - 9:00 PM Sat-Sun 9:00 AM - 7:00 PM PCMH: No Leanes, Mary LMHC Provider ID: 330205 Gender: Female 2706 Alt 19 Ste 221 Palm Harbor, FL 34683 (727) 480-3148 Fax: (727) 772-5569 00 Yrs/130 Yrs M-F 3:00 AM - 9:00 PM Sat 9:00 AM - 3:00 PM PCMH: No Lenz, Kristen LMHC Provider ID: 958209 Gender: Female 1301 Seminole Blvd Ste 103 Largo, FL 33770 (727) 213-5379 Fax: (727) 213-5370 00 Yrs/130 Yrs M-TH 9:00 AM - 8:00 PM FSat 9:00 AM - 5:00 PM PCMH: No

Lewis, Deborah LMHC Provider ID: 27995 Gender: Female 5100 78th Ave N Ste 7 Pinellas Park, FL 33781 (727) 586-0636 Fax: (727) 585-6287 00 Yrs/130 Yrs M 12:30 AM - 6:30 PM T 8:30 AM - 2:30 PM W 8:30 AM - 3:30 PM TH 8:30 AM - 6:30 PM PCMH: No Mack, Teresa LMHC Provider ID: 1091324 Gender: Female Building Blocks Therapy PLLC 801 W. Bay Dr Ste 413 Largo, FL 33770 (727) 709-7751 00 Yrs/130 Yrs M-F 9:00 AM - 7:00 PM PCMH: No Mason, Andrea LMHC Provider ID: 787655 Gender: Female 7850 Ulmerton Rd Ste 4 Largo, FL 33771 (727) 542-3635 Fax: (727) 213-9035 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mayorca, June LMHC Provider ID: 966166 Gender: Female 950 Broadway Dunedin, FL 34698 (850) 324-2634 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 4:30 PM Sat 11:00 AM - 4:00 PM PCMH: No

Moore, Victoria LCSW Provider ID: 805556 Gender: Female 1853 S Belcher Rd Ste A Clearwater, FL 33764 (727) 754-4936 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM PCMH: No Morel, Mary LCSW Provider ID: 789698 Gender: Female 10225 Ulmerton Rd Ste 8B Largo, FL 33771 (727) 586-0636 Fax: (727) 585-6287 00 Yrs/130 Yrs M 9:30 AM - 7:30 PM TW 9:30 AM - 8:30 PM PCMH: No Morel, Mary LCSW Provider ID: 789698 Gender: Female 5100 78th Ave N Ste 7 Pinellas Park, FL 33781 (727) 586-0636 Fax: (727) 585-6287 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Morris, Richard LMHC Provider ID: 454186 Gender: Male 1301 Seminole Blvd Ste 103 Largo, FL 33770 (727) 213-5379 Fax: (727) 213-5370 00 Yrs/130 Yrs M-TH 9:00 AM - 8:00 PM F 9:00 AM - 5:00 PM Sat 8:00 AM - 5:00 PM PCMH: No

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Oneil, Susan LMHC Provider ID: 1041422 Gender: Female Susan J Oneil 5771 Roosevelt Blvd Ste 300 Clearwater, FL 33760 (727) 687-7452 Fax: (727) 507-8822 00 Yrs/18 Yrs M-TH 9:00 AM - 7:00 PM F 9:00 AM - 4:00 PM Sat 9:00 AM - 12:00 PM PCMH: No Pierce, Tyne LMHC Provider ID: 950243 Gender: Female Tyne Pierce 51 S Main Ave Ste 304 Clearwater, FL 33765 (727) 784-8244 Fax: (727) 287-9302 05 Yrs/130 Yrs MSat 8:00 AM - 5:00 PM TWTHF 8:00 AM - 8:00 PM PCMH: No Santiago, Karmivis LMHC Provider ID: 461212 Gender: Female Karmivis Santiago LMHC 3900 Belle Oak Blvd Ste 105 Largo, FL 33771 (727) 480-0107 Fax: (727) 499-7555 00 Yrs/130 Yrs Languages: Spanish M-TH 9:00 AM - 6:00 PM F 8:00 AM - 5:00 PM PCMH: No Schmidt, Patricia LMHC Provider ID: 27996 Gender: Female 5100 78th Ave N Ste 7 Pinellas Park, FL 33781 (727) 586-0636 Fax: (727) 546-9586 03 Yrs/130 Yrs MW 8:30 AM - 4:30 PM T 8:30 AM - 11:30 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Behavioral Health Counseling - cont. Sisco, Kelly LCSW Provider ID: 806500 Gender: Female 1301 Seminole Blvd Ste A-103 Largo, FL 33770 (727) 213-5379 Fax: (727) 213-5370 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Stemble, Kelly LMHC Provider ID: 1138372 Gender: Female Kelly Stemble 2270 Drew St Ste C Clearwater, FL 33765 (727) 784-8244 Fax: (727) 264-8802 05 Yrs/130 Yrs M-F 8:00 AM - 10:00 PM PCMH: No Williamson, Blake LMHC Provider ID: 1130687 Gender: Male Blake Healing For You, PLLC 3530 1st Ave N Ste 217 Saint Petersburg, FL 33713 (760) 641-4408 Fax: (727) 954-7190 05 Yrs/130 Yrs M-TH 4:30 AM - 9:00 PM F 12:00 AM - 4:00 PM PCMH: No Wingert, Frank LCSW Provider ID: 948360 Gender: Male St Pete Behavioral Health Center In 1232 N Pinellas Ave Tarpon Springs, FL 34689 (727) 944-5171 Fax: (727) 944-5171 16 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 10:00 PM PCMH: No

Wingert, Frank LCSW Provider ID: 948360 Gender: Male St Pete Behavioral Health Center In 433 4th St N Saint Petersburg, FL 33701 (727) 895-8499 Fax: (727) 895-8497 16 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Sat 10:00 AM - 2:00 PM PCMH: No

Behavioral Health Facility Adoption Related SVS Pinellas, Inc Provider ID: 469754 3941 68th Ave N Pinellas Park, FL 33781 (727) 657-7761 Fax: (727) 786-5517 00 Yrs/130 Yrs Languages: Spanish, German, Vietnamese M-F 9:00 AM - 5:00 PM PCMH: No Boley Centers Inc Provider ID: 781494 445 31st St N Saint Petersburg, FL 33713 (727) 821-4819 Fax: (727) 490-0538 00 Yrs/130 Yrs PCMH: No Boley Centers Inc Provider ID: 781494 647 34th Ave S Saint Petersburg, FL 33705 (727) 821-4819 Fax: (727) 895-7225 00 Yrs/130 Yrs PCMH: No Camelot Community Care Inc Provider ID: 274915 4910 Creekside Dr Clearwater, FL 33760 (727) 593-0003 Fax: (727) 596-1713 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No

Directions For Living Provider ID: 271921 1437 S Belcher Rd Ste 200 Clearwater, FL 33764 (727) 524-4464 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 7:00 PM PCMH: No Directions For Living Provider ID: 271921 8823 115th Ave Largo, FL 33773 (727) 547-4566 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Gulf Coast Jewish Family and Community S Provider ID: 348545 14041 Icot Blvd Clearwater, FL 33760 (727) 479-1800 Fax: (727) 479-1248 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Gulf Coast Jewish Family and Community S Provider ID: 348545 3180 66th St N Saint Petersburg, FL 33710 (727) 843-1661 Fax: (727) 893-1663 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Mease Countryside Hospital Provider ID: 20917 3231 McMullen Booth Rd Safety Harbor, FL 34695 (727) 725-6111 Fax: (813) 635-7970 00 Yrs/130 Yrs PCMH: No

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Morton Plant Hospital Provider ID: 21478 300 Pinellas St Clearwater, FL 33756 (727) 462-7000 Fax: (813) 635-7970 00 Yrs/130 Yrs PCMH: No Sequelcare of Florida LLC Provider ID: 479208 3491 Gandy Blvd N Ste 201 Pinellas Park, FL 33781 (727) 547-0607 Fax: (727) 456-6127 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Community Mental Health Center Carlton Manor Inc Provider ID: 801129 45 Westwood Ter N Saint Petersburg, FL 33710 (727) 343-3662 Fax: (727) 347-1649 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Operation Par Inc Provider ID: 28534 Operation Par Inc Detox 6150 150th Ave N Clearwater, FL 33760 (727) 538-7243 Fax: (727) 507-4023 00 Yrs/130 Yrs Languages: Spanish PCMH: No Operation Par Inc Provider ID: 28534 Operation Par Inc Enhanced Outpatie 2000 4th St S Saint Petersburg, FL 33705 (727) 893-5444 00 Yrs/130 Yrs Languages: Spanish PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Community Mental Health Center - cont. Personal Enrichment Through Mental Healt Provider ID: 20823 1614 Palm Way Largo, FL 33771 (727) 545-6477 Fax: (727) 507-4722 05 Yrs/64 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM PCMH: No Personal Enrichment Through Mental Healt Provider ID: 20823 400 15th St N Saint Petersburg, FL 33705 (727) 552-1053 Fax: (727) 552-1174 05 Yrs/64 Yrs Languages: Spanish MTWTHFSatSun 10:00 AM 6:00 PM PCMH: No Personal Enrichment Through Mental Healt Provider ID: 20823 Personal Enrichment Through Mental 11254 58th St N Pinellas Park, FL 33782 (727) 545-6477 Fax: (727) 545-6464 05 Yrs/64 Yrs Languages: Spanish PCMH: No Suncoast Center Inc Provider ID: 275293 1001 16th St S Saint Petersburg, FL 33705 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Suncoast Center Inc Provider ID: 275293 2188 58th St N Clearwater, FL 33760 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Suncoast Center Inc Provider ID: 275293 940 22nd Ave S Saint Petersburg, FL 33705 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Suncoast Center Inc Provider ID: 275293 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu MF 8:00 AM - 5:00 PM TWTH 8:00 AM - 8:00 PM PCMH: No

The Chrysalis Center Inc

Suncoast Center Inc Provider ID: 275293 4010 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu MF 8:00 AM - 5:00 PM TWTH 8:00 AM - 8:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Suncoast Center Inc Provider ID: 275293 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu M-F 8:00 AM - 5:00 PM PCMH: No Suncoast Center Inc Provider ID: 275293 928 22nd Ave S Saint Petersburg, FL 33705 (727) 327-7656 00 Yrs/100 Yrs Languages: Spanish, French, Russian, Urdu M-F 8:00 AM - 5:00 PM PCMH: No

Provider ID: 303776 970 Lake Carillon Dr Ste 300 Saint Petersburg, FL 33716 (813) 443-4827 Fax: (954) 587-0080 00 Yrs/130 Yrs M-F 9:00 AM - 5:30 PM PCMH: No

Licensed Clinical Social Worker Acheson, Kimberly LCSW Provider ID: 1145215 Gender: Female Kimberly Acheson 8950 Dr. MLK Jr. St. N Ste 102 Saint Petersburg, FL 33702 (813) 727-0264 Fax: (813) 792-5272 02 Yrs/130 Yrs M-F 8:00 AM - 7:00 PM PCMH: No Jordan, Cassandra LCSW Provider ID: 1422903 Gender: Female Metropolitan Charities, Inc. 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 321-3854 Fax: (727) 327-7670 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

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Vagedes, Marie LCSW Provider ID: 1126080 Gender: Female The Solution Counseling Center 2270 Drew St Ste C Clearwater, FL 33765 (727) 784-8244 Fax: (727) 287-9302 12 Yrs/130 Yrs M 1:30 AM - 5:30 PM T 9:00 AM - 5:00 PM PCMH: No Wheeler, Cynthia LCSW Provider ID: 1195278 Gender: Female Good Caws LLC 7130 Seminole Blvd Ste 100 Seminole, FL 33772 (727) 240-7488 Fax: (727) 800-6137 00 Yrs/130 Yrs M 3:00 AM - 7:00 PM TW 5:00 AM - 7:00 PM THF 9:30 AM - 7:30 PM PCMH: No

Licensed Marriage and Family Therapist Grimm, Mariann LMFT Provider ID: 1130754 Gender: Female Mariann Grimm 312 10th St Ste 301 D Safety Harbor, FL 34695 (727) 504-4126 Fax: (727) 216-3998 00 Yrs/130 Yrs MT 8:00 AM - 8:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Neuropsychology Clement, Veronica PHD Provider ID: 968627 Gender: Female Suncoast Medical Clinic LLC 1201 5th Ave N Ste 204 Saint Petersburg, FL 33705 (727) 824-3189 Fax: (727) 824-7101 18 Yrs/130 Yrs St Anthonys Hospital M-F 8:00 AM - 5:00 PM PCMH: No

Pediatric Psychiatry Agazzi, Heather PHD Provider ID: 1361959 Gender: Female USF Physicicans Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Ali, Muhammad MD Provider ID: 1061698 Gender: Male Directions For Living 88550 Ulmerton Rd Ste 145 Largo, FL 33771 (727) 524-4464 Fax: (727) 524-4491 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Draeger, John MD Provider ID: 1189756 Gender: Male John H Draeger MD 10225 Ulmerton Rd Ste 8B Saint Petersburg, FL 33771 (727) 586-0636 Fax: (727) 585-6287 00 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Kunins, Craig MD Provider ID: 1075874 Gender: Male Sequelcare of Florida LLC 3491 Gandy Blvd N Ste 201 Pinellas Park, FL 33781 (727) 547-0607 Fax: (727) 547-6752 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Shah, Meena MD Provider ID: 1282852 Gender: Female Suncoast Center Inc 4010 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/18 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Pediatrics Behavioral and Developmental Howie, Flora MD Provider ID: 341506 Gender: Female 501 6th Ave S Saint Petersburg, FL 33701 (727) 898-7451 00 Yrs/19 Yrs Johns Hopkins All Childrens Hospital Inc M-F 9:00 AM - 5:00 PM PCMH: No Howie, Flora MD Provider ID: 341506 Gender: Female PPS Developmental/ Behavioral Ped 880 6th St S Ste 490 Saint Petersburg, FL 33701 (727) 767-8035 Fax: (727) 767-4765 00 Yrs/19 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM PCMH: No

Psych Hospital Windmoor Healthcare Inc Provider ID: 1427 11300 US 19 N Clearwater, FL 33764 (727) 541-2646 Fax: (727) 541-4402 18 Yrs/130 Yrs PCMH: No

Psychiatry Adams, Sherry ARNP Provider ID: 1321413 Gender: Female Suncoast Center Inc 2188 58th St N Clearwater, FL 33760 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Adams, Sherry ARNP Provider ID: 1321413 Gender: Female Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Agustines, Rachel MD Provider ID: 222757 Gender: Female Florida Behavioral Medicine 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 581-2678 03 Yrs/130 Yrs Mease Hospital Dunedin Languages: Spanish M-TH 9:00 AM - 4:30 PM PCMH: No

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Agustines, Rachel MD Provider ID: 222757 Gender: Female Florida Behavioral Medicine 1210 66th St N Saint Petersburg, FL 33710 (727) 518-6444 Fax: (727) 581-2678 03 Yrs/130 Yrs Mease Hospital Dunedin Languages: Spanish M-TH 8:30 AM - 5:00 PM PCMH: No Ali, Muhammad MD Provider ID: 1061698 Gender: Male Directions For Living 88550 Ulmerton Rd Ste 145 Largo, FL 33771 (727) 524-4464 Fax: (727) 524-4491 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Bedi, Bharminder MD Provider ID: 1053272 Gender: Male Hector Corzo MD PA 7955 66th St N Ste D Pinellas Park, FL 33781 (727) 541-3362 Fax: (727) 544-4015 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Brooks, Aaron ARNP Provider ID: 1094867 Gender: Male Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Psychiatry - cont. Chamberlain, Andrea MD Provider ID: 1056033 Gender: Female Camelot Community Care 4910 Creekside Dr Ste D Clearwater, FL 33760 (727) 595-0003 Fax: (727) 596-1713 00 Yrs/21 Yrs M 3:00 AM - 6:00 PM PCMH: No Chamberlain, Andrea MD Provider ID: 922188 Gender: Female 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 518-1267 00 Yrs/130 Yrs M 9:00 AM - 1:00 PM PCMH: No Chamberlain, Andrea MD Provider ID: 922188 Gender: Female 1210 66th St N Saint Petersburg, FL 33710 (727) 518-6444 Fax: (727) 581-2678 00 Yrs/130 Yrs M 2:00 AM - 5:00 PM PCMH: No Corwin, Lois C ARNP Provider ID: 1329617 Gender: Female Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 18 Yrs/110 Yrs MT 8:00 AM - 5:00 PM PCMH: No

Corzo, Hector MD Provider ID: 164669 Gender: Male Hector Corzo MD PA 7955 66th St N Ste D Pinellas Park, FL 33781 (727) 541-3362 Fax: (727) 544-4015 00 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital Languages: Spanish M-TH 9:00 AM - 5:00 PM F 8:00 AM - 12:00 PM PCMH: No Dempsey, Donna ARNP Provider ID: 958604 Gender: Female St Pete Behavioral Health Center In 433 4th St N Saint Petersburg, FL 33701 (727) 895-8499 Fax: (727) 895-8497 18 Yrs/130 Yrs Languages: Spanish, American Sign Language M-F 9:00 AM - 5:00 PM PCMH: No Desai, Sangita MD Provider ID: 301679 Gender: Female Directions For Mental Health Inc Db 1437 S Belcher Rd Clearwater, FL 33764 (727) 524-4464 Fax: (727) 524-4491 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Dougherty, Phyllis ARNP Provider ID: 1352401 Gender: Female Family Enrichment Services 3941 68th Ave N Pinellas Park, FL 33781 (727) 657-7761 Fax: (727) 213-9054 02 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 8:00 PM PCMH: No Draeger, John MD Provider ID: 1189756 Gender: Male John H Draeger MD 10225 Ulmerton Rd Ste 8B Saint Petersburg, FL 33771 (727) 586-0636 Fax: (727) 585-6287 00 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM PCMH: No Jeffery, Thomas ARNP Provider ID: 1277377 Gender: Male Directions For Living 1437 S Belcher Rd Clearwater, FL 33764 (727) 524-4464 Fax: (727) 524-4491 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Jones, Karl MD Provider ID: 793328 Gender: Male 5800 49th St N Ste 206 S Saint Petersburg, FL 33709 (727) 525-1134 Fax: (727) 525-2964 00 Yrs/130 Yrs Largo Medical Center Languages: Spanish M-W 10:00 AM - 6:00 PM TH 10:00 AM - 4:00 PM PCMH: No

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Kunins, Craig MD Provider ID: 1075874 Gender: Male Sequelcare of Florida LLC 3491 Gandy Blvd N Ste 201 Pinellas Park, FL 33781 (727) 547-0607 Fax: (727) 547-6752 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Lefler, Linda MD Provider ID: 1095018 Gender: Female Suncoast Center Inc 3800 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Lemus, Carmen MD Provider ID: 1095023 Gender: Female Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 18 Yrs/130 Yrs M-W 8:00 AM - 4:00 PM PCMH: No Martin, Andres MD Provider ID: 1056461 Gender: Male Directions For Mental Health Inc Db 1437 S Belcher Rd Clearwater, FL 33764 (727) 524-4464 Fax: (727) 524-4491 18 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Psychiatry - cont. Mayer, Robert MD Provider ID: 1339538 Gender: Male Adoption Related Services of Pinell 3941 68th Ave N Pinellas Park, FL 33781 (727) 657-7761 Fax: (727) 865-5178 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Mayer, Robert MD Provider ID: 28454 Gender: Male 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 581-2678 03 Yrs/130 Yrs Morton Plant Hospital M-TH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No McLaughlin, Darlene ARNP Provider ID: 1169319 Gender: Female Darlene McLaughlin ARNP LLC 1452 Durling Dr S Saint Petersburg, FL 33707 (727) 777-3390 Fax: (727) 489-2400 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Newby, David ARNP Provider ID: 1324812 Gender: Male Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Newman, Jaclyn MD Provider ID: 1169568 Gender: Female Florida Behavioral Institute 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 518-2675 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Onderko, Gregory DO Provider ID: 1320274 Gender: Male Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 18 Yrs/130 Yrs Manatee Memorial Hospital M-F 8:00 AM - 5:00 PM PCMH: No Pabon, Hernan MD Provider ID: 1058131 Gender: Male Gulf Coast Jewish Family and Commun 14041 Icot Blvd Clearwater, FL 33760 (727) 479-1897 Fax: (727) 479-1248 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Pabon, Hernan MD Provider ID: 1058131 Gender: Male Gulf Coast Jewish Family and Commun 3180 66th St N Saint Petersburg, FL 33710 (727) 450-7269 Fax: (727) 479-1248 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Parks, Alicia ARNP Provider ID: 1295838 Gender: Female Gulf Coast Jewish Family and Commun 14041 Icot Blvd Clearwater, FL 33760 (727) 450-7269 Fax: (727) 479-1248 05 Yrs/130 Yrs M 9:00 AM - 5:00 PM PCMH: No Patel, Ashok MD Provider ID: 28895 Gender: Male Florida Behavioral Medicine 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 581-2678 16 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin St Anthonys Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Patel, Ashok MD Provider ID: 28895 Gender: Male Florida Behavioral Medicine 1210 66th St N Saint Petersburg, FL 33710 (727) 518-6444 Fax: (727) 581-2678 16 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin St Anthonys Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Reynolds, Emily ARNP Provider ID: 1095053 Gender: Female Suncoast Center Inc 4024 Central Ave Saint Petersburg, FL 33733 (727) 327-7656 Fax: (727) 322-2110 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

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Rodriguez, Mauro MD Provider ID: 201327 Gender: Male 611 Druid Rd E Ste 506 Clearwater, FL 33756 (727) 600-8090 Fax: (727) 600-8088 00 Yrs/130 Yrs Morton Plant Hospital Languages: Spanish M 8:00 AM - 5:30 PM TW 8:00 AM - 5:00 PM PCMH: No Sanderbeck, Tracey ARNP Provider ID: 1331297 Gender: Female Suncoast Center Inc 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/130 Yrs MTWF 8:00 AM - 5:00 PM TH 0:80 AM - 5:00 PM PCMH: No Shah, Meena MD Provider ID: 1282852 Gender: Female Suncoast Center Inc 4010 Central Ave Saint Petersburg, FL 33711 (727) 327-7656 Fax: (727) 322-2110 00 Yrs/18 Yrs M-F 8:00 AM - 4:00 PM PCMH: No Shah, Nihal MD Provider ID: 224636 Gender: Male 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 581-2678 18 Yrs/130 Yrs Largo Medical Center Mease Hospital Dunedin Languages: Hindi, Gujarati M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Psychiatry - cont. Smith, Richard DO Provider ID: 1169561 Gender: Male Florida Behavioral Medicine 1100 Clearwater Largo Rd N Largo, FL 33770 (727) 518-6444 Fax: (727) 581-2675 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Smith, Richard DO Provider ID: 1169561 Gender: Male Florida Behavioral Medicine 1210 66th St N Saint Petersburg, FL 33710 (727) 518-6444 Fax: (727) 581-2675 00 Yrs/130 Yrs M 12:00 AM - 5:00 PM T 10:00 AM - 5:00 PM WTH 9:00 AM - 5:00 PM F 9:00 AM - 3:00 PM PCMH: No Weller, Conrad MD Provider ID: 1056497 Gender: Male Directions For Mental Health Inc Db 1437 S Belcher Rd Clearwater, FL 33764 (727) 524-4464 Fax: (727) 524-4491 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Wojas, Justyna MD Provider ID: 1362036 Gender: Female USF Physicicans Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Zaidi, Syed MD Provider ID: 510940 Gender: Male Syed K Zaidi MD PA 2831 4th St N Saint Petersburg, FL 33704 (941) 206-5200 Fax: (941) 206-6416 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Psychology Childres, Jillian PHD Provider ID: 1361966 Gender: Female USF Physicicans Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Cohen, Benjamin PHD Provider ID: 328173 Gender: Male Benjamin N Cohen PHD PA 905 E M L King Dr Ste 211 Tarpon Springs, FL 34689 (727) 271-3112 Fax: (727) 942-3073 00 Yrs/130 Yrs M-F 8:00 AM - 7:00 PM PCMH: No Futch, Emily PHD Provider ID: 161129 Gender: Female 5046 73rd Ave N Pinellas Park, FL 33781 (727) 541-5436 Fax: (727) 541-5484 00 Yrs/130 Yrs Bayfront Medical Center St Anthonys Hospital MWTH 9:00 AM - 7:00 PM T 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM PCMH: No

Gimon, Alexander PHD Provider ID: 900515 Gender: Male 10225 Ulmerton Rd Ste 12B Largo, FL 33771 (727) 584-1551 Fax: (727) 581-5107 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 2:00 PM PCMH: No Hemsath, Randolph PsyD Provider ID: 684382 Gender: Male Boley Centers Inc 645 34th Ave S Saint Petersburg, FL 33705 (727) 824-5745 Fax: (727) 823-5795 12 Yrs/130 Yrs Languages: German PCMH: No Horng, Betty PHD Provider ID: 1361985 Gender: Female USF Physicicans Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Lunden, Judy PsyD Provider ID: 1148683 Gender: Female Lunden Psychological Services Inc 9160 Oakhurst Rd Ste 3B Seminole, FL 33776 (727) 240-1922 Fax: (727) 240-1928 18 Yrs/130 Yrs M-TH 9:00 AM - 8:00 PM F 9:00 AM - 3:00 PM PCMH: No

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Rahman, Omar PHD Provider ID: 1362008 Gender: Male USF Physicicans Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Smith, Jeffrey PHD Provider ID: 28115 Gender: Male 1905 Tyrone Blvd N Saint Petersburg, FL 33710 (727) 347-3284 Fax: (727) 347-4472 18 Yrs/130 Yrs St Anthonys Hospital M-F 9:00 AM - 6:00 PM PCMH: No Stokes, Melvin PHD Provider ID: 28121 Gender: Male 1250 10th St N Saint Petersburg, FL 33705 (727) 823-7955 Fax: (866) 575-0034 12 Yrs/130 Yrs M-TH 11:00 AM - 5:00 PM F 11:00 AM - 2:00 PM PCMH: No

Substance Abuse Operation Par Inc Provider ID: 28534 Operation Par Inc Detox 6150 150th Ave N Clearwater, FL 33760 (727) 538-7243 Fax: (727) 507-4023 00 Yrs/130 Yrs Languages: Spanish PCMH: No

Last update 08/14/2017

Behavioral Health Pinellas Substance Abuse - cont. Operation Par Inc Provider ID: 28534 Operation Par Inc Enhanced Outpatie 2000 4th St S Saint Petersburg, FL 33705 (727) 893-5444 00 Yrs/130 Yrs Languages: Spanish PCMH: No

www.wellcare.com/Florida | 593

Last update 08/14/2017

Behavioral Health Polk Advance Registered Nurse Practitioner Psychiatrist Burton, Debbie ARNP Provider ID: 1021454 Gender: Female Center For Behavioral Health 1201 1st St S Winter Haven, FL 33880 (863) 294-7062 Fax: (863) 294-7064 05 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Robinson, Marcus ARNP Provider ID: 1356307 Gender: Male Center For Behavioral Health 1201 1st St S Winter Haven, FL 33880 (863) 294-7062 Fax: (863) 291-6784 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 4:00 PM PCMH: No

Behavioral Health Counseling Agency For Community Treatment Services Provider ID: 927325 Agency For Community Treatment Services 6980 State Rd 37 S Mulberry, FL 33860 (941) 428-1520 Fax: (941) 428-2204 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Chila, J Patricia LMHC Kent, David LCSW Provider ID: 454999 Provider ID: 684237 Gender: Female Gender: Male C Family Focus and Solutions I 925 S Floral Ave 2504 Sand Mine Rd Bartow, FL 33830 Davenport, FL 33897 (863) 221-7788 (407) 654-0914 Fax: (863) 534-8211 Fax: (407) 362-7095 00 Yrs/130 Yrs 02 Yrs/130 Yrs M-F 11:00 AM - 8:00 PM Languages: Spanish PCMH: No M 1:00 AM - 6:00 PM Kent, David LCSW PCMH: No Provider ID: 684237 Cohen-Posey, Kate LMHC Gender: Male David W Kent 317 W Highland Dr Provider ID: 28596 Lakeland, FL 33813 Gender: Female (863) 221-7788 930 Alicia Rd Fax: (863) 534-8211 Lakeland, FL 33801 00 Yrs/130 Yrs (863) 680-1950 M-TH 11:00 AM - 8:00 PM Fax: (863) 683-4654 F 9:00 AM - 12:00 PM 16 Yrs/130 Yrs PCMH: No MT 9:00 AM - 5:00 PM W 11:00 AM - 7:00 PM Olivares, Alicia LMHC PCMH: No Provider ID: 1181677 Dowding, Daryl LMHC Gender: Female Professional Counseling Provider ID: 317292 Associates Gender: Female 280 Patterson Rd Ste 6 930 Alicia Rd Haines City, FL 33844 Lakeland, FL 33801 (321) 442-6665 (863) 680-1950 Fax: (800) 883-7015 Fax: (863) 683-4654 05 Yrs/130 Yrs 18 Yrs/85 Yrs Languages: Spanish M-W 9:00 AM - 7:00 PM M 8:00 AM - 3:00 PM PCMH: No T 8:00 AM - 6:00 PM Ghent, Cathy LMHC W 3:00 AM - 8:00 PM THF 8:00 AM - 8:00 PM Provider ID: 1178611 Sat 9:30 AM - 3:00 PM Gender: Female PCMH: No Creative Community Counseling, Inc Behavioral Health Facility 202 Lake Miriam Dr Ste W6 Lakeland, FL 33813 Resilience Counseling Center (863) 226-5081 Inc Fax: (888) 502-7187 Provider ID: 1043719 02 Yrs/130 Yrs 7512 Cypress Gardens Blvd M-F 8:00 AM - 7:00 PM Winter Haven, FL 33884 PCMH: No (407) 977-4335 Fax: (407) 977-4370 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 8:00 PM F 8:00 AM - 4:00 PM PCMH: No

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Community Mental Health Center Childrens Home Society of Florida Provider ID: 274874 1260 Golfview Ave Bartow, FL 33830 (352) 754-1111 Fax: (352) 796-9657 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:30 AM - 5:30 PM PCMH: No Families First of Florida LLC Provider ID: 792132 3020 S Florida Ave Ste 201 Lakeland, FL 33803 (813) 290-8560 Fax: (863) 583-0392 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Impower Inc Provider ID: 270420 1239 E Main St Bartow, FL 33830 (407) 215-0095 Fax: (407) 261-0523 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Lifeshare Management Group LLC Provider ID: 903667 20 Lake Wire Dr Ste 250 Lakeland, FL 33815 (863) 868-1600 Fax: (844) 293-7234 00 Yrs/18 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Polk Community Mental Health Center - cont. Mgm Case Management Services Inc Provider ID: 993460 Mgm Case Management Services 1975 E Sunrise Blvd Ste 800A Lakeland, FL 33804 (954) 507-3414 Fax: (305) 827-2819 50 Yrs/110 Yrs Languages: Spanish M-F 9:00 AM - 4:00 PM PCMH: No Peace River Center For Personal Developm Provider ID: 920970 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-TH 7:30 AM - 5:00 PM PCMH: No Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 1255 Golfriels Ave Lakeland, FL 33805 (863) 519-3744 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French PCMH: No Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 1825 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 1835 Gilmore Ave Lakeland, FL 33805 (863) 248-3311 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-F 7:30 AM - 5:00 PM PCMH: No Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 715 N Lake Ave Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Tri County Human Services Inc Provider ID: 958200 1201 1st St S Winter Haven, FL 33880 (863) 797-6680 Fax: (863) 709-8923 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tri County Human Services Inc Provider ID: 958200 1409 Meadowbrook Ave Lakeland, FL 33803 (863) 709-8543 Fax: (863) 688-2520 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Tri County Human Services Inc Provider ID: 958200 5421 US Hwy 98 S Highland City, FL 33846 (863) 709-9392 Fax: (863) 709-8923 00 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:30 PM T 8:00 AM - 5:00 PM PCMH: No Tri County Human Services Inc Provider ID: 958200 650 Ave K NW Winter Haven, FL 33881 (863) 299-5286 Fax: (863) 299-8760 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Winter Haven Hospital Inc Center For Beh Provider ID: 906977 Center For Behavioral Health 1201 1st St S Winter Haven, FL 33880 (863) 294-7062 Fax: (863) 294-7064 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No

Licensed Clinical Social Worker Chinlund, Heidi LCSW Provider ID: 1207705 Gender: Female MC Messam Inc 301 3rd St NW Ste 201 Winter Haven, FL 33881 (863) 229-5219 Fax: (407) 530-4795 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Sat-Sun 9:00 AM - 12:00 PM PCMH: No

www.wellcare.com/Florida | 595

Pediatric Psychiatry Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 1255 Golfview Ave Bartow, FL 33830 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 1825 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 600 El Paseo Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 621 N Lake Parker Ave Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Polk Pediatric Psychiatry cont. Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 722 E Myrtle St Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Forszpaniak, Margaret MD Provider ID: 1418037 Gender: Female Lifeshare Management 20 Lake Wire Dr Ste 200 Lakeland, FL 33815 (863) 937-9650 Fax: (844) 293-7234 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Morales, Miguel MD Provider ID: 1026851 Gender: Male Resilience Counseling Center Inc 7502 Cypress Gardens Blvd Winter Haven, FL 33884 (407) 977-4335 Fax: (407) 977-4370 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Psychiatry Ahmad, Kazi MD Provider ID: 1239760 Gender: Male Impower 1239 E Main St Bartow, FL 33830 (407) 931-2911 Fax: (407) 931-2711 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 1255 Golfview Ave Bartow, FL 33830 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 722 E Myrtle St Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 1825 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Forszpaniak, Margaret MD Provider ID: 1418037 Gender: Female Lifeshare Management 20 Lake Wire Dr Ste 200 Lakeland, FL 33815 (863) 937-9650 Fax: (844) 293-7234 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 600 El Paseo Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Ali, Muhammad MD Provider ID: 1256848 Gender: Male Peace River Center 621 N Lake Parker Ave Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

Giovanetti, Austin PA Provider ID: 1059551 Gender: Male Impower Inc 1239 E Main St Bartow, FL 33830 (407) 931-2911 Fax: (407) 931-2711 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kirmani, Najib MD Provider ID: 1059632 Gender: Male Impower Inc 1239 E Main St Bartow, FL 33830 (407) 931-2911 Fax: (407) 931-2711 00 Yrs/130 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 596

Morales, Miguel MD Provider ID: 1026851 Gender: Male Resilience Counseling Center Inc 7502 Cypress Gardens Blvd Winter Haven, FL 33884 (407) 977-4335 Fax: (407) 977-4370 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Patel, Shodhan MD Provider ID: 1422901 Gender: Male Solace Behavioral Health 930 Alicia Rd Lakeland, FL 33801 (863) 680-1950 Fax: (863) 683-4654 00 Yrs/130 Yrs Languages: Gujarati M 8:30 AM - 7:30 PM PCMH: No Paul, Sean MD Provider ID: 1352224 Gender: Male Center For Behavioral Health 1201 1st St S Winter Haven, FL 33880 (863) 294-7062 Fax: (863) 294-7064 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Polur, Marina MD Provider ID: 1353823 Gender: Female Center For Behavioral Health 1201 1st St S Winter Haven, FL 33880 (863) 294-7062 Fax: (863) 294-7064 05 Yrs/130 Yrs Languages: Russian M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Polk Psychiatry - cont. Rao, Takkallapelli MD Provider ID: 418838 Gender: Male Center For Behavioral Health 1201 1st St S Winter Haven, FL 33880 (863) 294-7062 Fax: (863) 294-7064 18 Yrs/130 Yrs Languages: Indian M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM PCMH: No Restrepo, Alvaro MD Provider ID: 1063885 Gender: Male Peace River Center For Personal Dev 722 E Myrtle St Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs PCMH: No Vangala, Vidyasagar MD Provider ID: 274873 Gender: Male 2504 Sand Mine Rd Davenport, FL 33897 (863) 419-7645 Fax: (863) 419-7655 18 Yrs/130 Yrs Florida Hospital Orlando Languages: Hindi, Telugu M-F 8:00 AM - 4:30 PM PCMH: No

Psychology Hangauer, Jason PHD Provider ID: 1361980 Gender: Male USF Physicicans Group 200 N Kentucky Ave Ste 106 Lakeland, FL 33801 (813) 974-0602 Fax: (813) 558-1343 02 Yrs/12 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Hudkins, Emily PHD Provider ID: 1361987 Gender: Female USF Physicicans Group 200 N Kentucky Ave Lakeland, FL 33801 (863) 413-3484 Fax: (863) 413-3468 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Kirkpatrick Justice, Kimberly PsyD Provider ID: 443341 Gender: Female Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No Robinson-Kyles, Jeanene PHD Provider ID: 1245677 Gender: Female Robinson-Kyles Counseling & Testing 505 Martin L King Jr Ave Ste 1 Lakeland, FL 33815 (863) 398-6748 Fax: (863) 688-3159 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM PCMH: No

Psychosomatic Medicine Kear, Mavra ARNP Provider ID: 1130692 Gender: Female Peace River Center For Personal Dev 1831 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center 300 Parkview Pl Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center 4435 US Hwy 98th North Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center 600 El Paseo Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center 621 N Lake Parker Ave Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 597

Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1239 E Main St Bartow, FL 33830 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1255 Golfview Ave Bartow, FL 33830 (863) 519-3747 Fax: (863) 582-9251 18 Yrs/130 Yrs PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1825 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1831 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Polk Psychosomatic Medicine - Sadowsky, MD, William MD cont. Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1831 N Crystal Lake Dr Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 1835 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 213 W Orange St Lakeland, FL 33815 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-W 8:00 AM - 6:00 PM TH 8:00 AM - 12:00 PM PCMH: No

Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2620 Fax: (863) 582-9251 18 Yrs/130 Yrs M-TH 7:30 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 715 N Lake Ave Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Sadowsky, MD, William MD Provider ID: 1063898 Gender: Male Peace River Center For Personal Dev 722 E Myrtle St Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 18 Yrs/130 Yrs PCMH: No

Substance Abuse Childrens Home Society of Florida Provider ID: 274874 1260 Golfview Ave Bartow, FL 33830 (352) 754-1111 Fax: (352) 796-9657 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:30 AM - 5:30 PM PCMH: No

Impower Inc Provider ID: 270420 1239 E Main St Bartow, FL 33830 (407) 215-0095 Fax: (407) 261-0523 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Peace River Center For Personal Developm Provider ID: 920970 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-TH 7:30 AM - 5:00 PM PCMH: No Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 1255 Golfriels Ave Lakeland, FL 33805 (863) 519-3744 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French PCMH: No Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 1825 Gilmore Ave Lakeland, FL 33805 (863) 519-0575 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 598

Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 1835 Gilmore Ave Lakeland, FL 33805 (863) 248-3311 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-F 7:30 AM - 5:00 PM PCMH: No Peace River Center For Personal Developm Provider ID: 920970 Peace River Center For Personal Dev 715 N Lake Ave Lakeland, FL 33801 (863) 519-0575 Fax: (863) 582-9251 08 Yrs/65 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No Tri County Human Services Inc Provider ID: 958200 1201 1st St S Winter Haven, FL 33880 (863) 797-6680 Fax: (863) 709-8923 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Tri County Human Services Inc Provider ID: 958200 1409 Meadowbrook Ave Lakeland, FL 33803 (863) 709-8543 Fax: (863) 688-2520 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Polk Substance Abuse - cont. Tri County Human Services Inc Provider ID: 958200 5421 US Hwy 98 S Highland City, FL 33846 (863) 709-9392 Fax: (863) 709-8923 00 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:30 PM T 8:00 AM - 5:00 PM PCMH: No Tri County Human Services Inc Provider ID: 958200 650 Ave K NW Winter Haven, FL 33881 (863) 299-5286 Fax: (863) 299-8760 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 599

Last update 08/14/2017

Behavioral Health Sarasota Behavioral Health Counseling Alvarez, Carmen LMHC Provider ID: 993591 Gender: Female 3333 Clark Rd Ste 170 Sarasota, FL 34231 (941) 888-2081 Fax: (888) 700-6760 02 Yrs/130 Yrs M-F 8:30 AM - 7:00 PM Sat 10:00 AM - 2:00 PM PCMH: No Audeh, Alisha LMHC Provider ID: 1050237 Gender: Female Mangrove Wellness Center 1515 Tamiami Trl S Ste 2 Venice, FL 34285 (941) 822-5620 Fax: (855) 239-0365 05 Yrs/130 Yrs M-F 10:00 AM - 7:00 PM Sat 10:00 AM - 4:00 PM PCMH: No Baker, Joanna LMHC Provider ID: 793235 Gender: Female 4370 S Tamiami Trl Ste 241 Sarasota, FL 34231 (941) 926-2474 Fax: (941) 926-2440 00 Yrs/130 Yrs Languages: Danish M-TH 10:00 AM - 5:00 PM F 10:00 AM - 1:00 PM PCMH: No Burkard, Megan LMHC Provider ID: 1189384 Gender: Female Mangrove Wellness Center Inc 1515 Tamiami Trl S Ste 2 Venice, FL 34285 (941) 483-6616 Fax: (855) 239-0365 00 Yrs/130 Yrs M-F 10:00 AM - 7:00 PM Sat 10:00 AM - 4:00 PM PCMH: No

Cauffield and Associates Inc Provider ID: 981577 1693 Main St Ste A Sarasota, FL 34236 (941) 225-2374 Fax: (941) 366-0033 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Dunn, Dolores LMHC Provider ID: 499172 Gender: Female Dolores T Dunn 3205 Southgate Cir Sarasota, FL 34239 (941) 685-1444 Fax: (941) 351-1650 18 Yrs/130 Yrs M-F 9:00 AM - 7:00 PM PCMH: No Emens, Christine LMHC Provider ID: 1121145 Gender: Female Mangrove Wellness Center 1515 Tamiami Trl S Ste 2 Venice, FL 34285 (941) 822-5620 Fax: (855) 239-0365 05 Yrs/130 Yrs M-F 10:00 AM - 7:00 PM Sat 12:00 AM - 4:00 PM PCMH: No Kaufman, Deborah LCSW Provider ID: 394866 Gender: Female 7727A Holiday Dr Sarasota, FL 34231 (941) 927-9334 Fax: (941) 927-2144 00 Yrs/130 Yrs M-F 10:00 AM - 7:00 PM PCMH: No

Levine, Robert LCSW Provider ID: 199932 Gender: Male 4474 Oak View Dr Sarasota, FL 34232 (941) 921-0527 Fax: (941) 342-3405 03 Yrs/100 Yrs M 1:00 AM - 8:00 PM TTH 9:00 AM - 8:00 PM W 8:30 AM - 5:00 PM F 9:00 AM - 8:30 PM Sat 9:00 AM - 4:30 PM PCMH: No Marshall, Michelle LMHC Provider ID: 1126078 Gender: Female Venice Counseling LLC 2190 Tamiami Trl S Venice, FL 34293 (941) 202-8252 12 Yrs/130 Yrs M-F 10:00 AM - 8:00 PM PCMH: No Marshall, Michelle LMHC Provider ID: 1126078 Gender: Female Venice Counseling LLC 333 Tamiami Trl S Ste 260 Venice, FL 34285 (941) 237-7174 12 Yrs/130 Yrs M-F 10:00 AM - 8:00 PM PCMH: No Musselwhite-Weaver, Patricia LMHC Provider ID: 1026114 Gender: Female Patricia J Musselwhite Weaver LMHC 7021 S Tamiami Trl Ste C Sarasota, FL 34231 (941) 922-6404 Fax: (941) 926-8724 00 Yrs/130 Yrs Languages: Spanish MWTHF 9:00 AM - 8:00 PM T 8:00 AM - 8:00 PM Sat 9:00 AM - 2:00 PM Sun 12:00 AM - 4:00 PM PCMH: No

www.wellcare.com/Florida | 600

Nikla, Richard LMHC Provider ID: 817735 Gender: Male Richard Nikla LMHC DBA West Co 2100 Constitution Blvd Unit 125 Sarasota, FL 34231 (727) 741-2457 Fax: (727) 939-0204 00 Yrs/130 Yrs M 10:00 AM - 9:00 PM PCMH: No Olivere, Mark LMHC Provider ID: 711421 Gender: Male 3205 Southgate Cir Sarasota, FL 34239 (941) 400-7702 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 7:00 PM PCMH: No Osgood, Bonnie LMHC Provider ID: 1202392 Gender: Female Suncoast Therapy LLC 411 Commercial Ct Ste F Venice, FL 34292 (941) 485-0121 00 Yrs/21 Yrs MWTH 8:00 AM - 5:00 PM TF 8:00 AM - 7:00 PM PCMH: No Reidsema, Lisa LMHC Provider ID: 1050240 Gender: Female Mangrove Wellness Center 1515 Tamiami Trl S Ste 2 Venice, FL 34285 (941) 822-5620 Fax: (855) 239-0365 05 Yrs/130 Yrs M-F 10:00 AM - 7:00 PM Sat 10:00 AM - 4:00 PM Sun 12:00 AM - 4:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Sarasota Behavioral Health Counseling - cont. Richardson, Lisa LMHC Provider ID: 1185517 Gender: Female Spirited Away Art Therapy, LLC 1505 S Tamiami Trl Ste 402 Venice, FL 34285 (941) 882-0590 Fax: (941) 444-0602 02 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM PCMH: No Snyder, Todd LMHC Provider ID: 217343 Gender: Male 2477 Stickney PT Rd Ste 115B Sarasota, FL 34231 (941) 506-1674 Fax: (941) 922-3875 05 Yrs/65 Yrs M-TH 4:00 AM - 8:00 PM F 9:00 AM - 2:00 PM PCMH: No St Aubin, Mary LMHC Provider ID: 215854 Gender: Female 1524 Stickney Point Rd Ste A Sarasota, FL 34231 (941) 356-2744 Fax: (941) 752-3193 05 Yrs/130 Yrs M 9:00 AM - 7:00 PM T 2:00 AM - 7:00 PM PCMH: No St Aubin, Mary LMHC Provider ID: 215854 Gender: Female 3205 Southgate Cir Sarasota, FL 34239 (941) 356-2744 Fax: (941) 752-3193 05 Yrs/130 Yrs MT 9:00 AM - 7:00 PM PCMH: No

Steiner, Judith LMHC Provider ID: 214477 Gender: Female Center For Family and Personal Grow 417 Commercial Ct Ste E Venice, FL 34292 (941) 485-8896 Fax: (866) 594-5970 00 Yrs/130 Yrs M 12:00 AM - 8:00 PM T 11:00 AM - 6:00 PM W 12:00 AM - 8:30 PM TH 11:00 AM - 8:30 PM F 12:00 AM - 7:00 PM PCMH: No Thatcher-Janowski, Amy LCSW Provider ID: 790352 Gender: Female Amy Thatcher, LCSW 5971 Cattlemen Ln Sarasota, FL 34232 (941) 587-2055 Fax: (941) 371-3549 00 Yrs/130 Yrs M-TH 8:00 AM - 7:30 PM F 9:00 AM - 5:00 PM PCMH: No Thorpe, Rachel LCSW Provider ID: 839593 Gender: Female 4167 Clark Rd Sarasota, FL 34233 (941) 219-3111 Fax: (941) 894-1322 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No

Behavioral Health Facility Centerstone of Florida Inc Provider ID: 28509 4010 Sawyer Rd Sarasota, FL 34233 (941) 782-4898 Fax: (941) 782-4899 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

The Florida Center For Early Childhood Provider ID: 288970 6929 Outreach Way North Port, FL 34287 (941) 371-8820 00 Yrs/130 Yrs Languages: Spanish, French M-F 8:00 AM - 5:00 PM PCMH: No

Community Mental Health Center

Jewish Family and Childrens Svcs Provider ID: 286344 2688 Fruitville Rd Sarasota, FL 34237 (941) 366-2224 Fax: (941) 366-2982 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No

Geriatric Psychiatry

Coastal Behavioral Healthcare Monosiet, Frederic MD Inc Provider ID: 298 Provider ID: 1069636 Coastal Behavioral Healthcare Gender: Male Inc C Coastal Recovery Centers Inc 12497 Tamiami Trl S Ste 4 12497 Tamiami Trl S Ste 4 North Port, FL 34287 North Port, FL 34287 (941) 492-4300 (941) 492-4300 Fax: (941) 492-2170 Fax: (941) 492-2170 05 Yrs/130 Yrs 05 Yrs/130 Yrs Languages: Spanish Languages: Spanish, French, M-F 8:00 AM - 5:00 PM Creole PCMH: No M-F 8:00 AM - 5:00 PM PCMH: No Coastal Behavioral Healthcare Inc Monosiet, Frederic MD Provider ID: 298 Coastal Behavioral Healthcare Provider ID: 1069636 Inc C Gender: Male 1451 10th St Coastal Recovery Centers Inc Sarasota, FL 34236 1451 10th St (941) 331-2530 Sarasota, FL 34236 Fax: (941) 331-2536 (941) 331-2530 05 Yrs/130 Yrs Fax: (941) 331-2536 Languages: Spanish 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish, French, PCMH: No Creole Coastal Behavioral Healthcare M-F 8:00 AM - 5:00 PM PCMH: No Inc Provider ID: 298 Monosiet, Frederic MD Coastal Behavioral Healthcare Provider ID: 1069636 Inc C Gender: Male 1750 17th St Coastal Recovery Centers Inc Sarasota, FL 34234 1750 17th St (941) 953-0000 Sarasota, FL 34234 Fax: (941) 954-0918 (941) 953-0000 05 Yrs/130 Yrs Fax: (941) 954-0918 Languages: Spanish 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish, French, PCMH: No Creole M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 601

Last update 08/14/2017

Behavioral Health Sarasota Licensed Clinical Social Worker

Lopez, Rafael MD Sheshani, Shashidhar MD Brasington, Steve MD Provider ID: 1059660 Provider ID: 1424773 Gender: Male Gender: Male Provider ID: 1069533 Gallagher, Cassandra LCSW Family Preservaton Services of Gender: Male Coastal Behavioral Healthcare Flor 1451 10th St Centerstone of Florida, Inc. 1500 Independence Blvd Ste Sarasota, FL 34236 4010 Sawyer Rd Provider ID: 1408914 100 (941) 927-8900 Sarasota, FL 34233 Gender: Female Sarasota, FL 34234 Fax: (941) 927-6315 (941) 782-4150 Comprehensive Care Center (941) 359-1927 00 Yrs/18 Yrs Inc DBA C Fax: (941) 782-4898 Fax: (941) 359-1929 M-F 8:00 AM - 5:00 PM 1231 N Tuttle Ave 00 Yrs/130 Yrs 05 Yrs/130 Yrs PCMH: No Sarasota, FL 34237 M-F 8:30 AM - 5:00 PM MTWTHFSatSun 8:00 AM (941) 366-0134 PCMH: No 5:00 PM Brasington, Steve MD Fax: (941) 210-3702 PCMH: No Pediatrics Behavioral and Provider ID: 1424773 18 Yrs/130 Yrs Gender: Male Developmental M-TH 9:00 AM - 5:00 PM Nesternko, Marina MD Coastal Behavioral Healthcare F 9:00 AM - 12:00 PM Provider ID: 1296978 Inc Hubbard, Helene MD PCMH: No Gender: Female 1750 17th St Provider ID: 275813 Coastal Behavioral Healthcare Gender: Female Sarasota, FL 34234 Pediatric Psychiatry 12497 Tamiami Trl S Ste 4 (941) 927-8900 K & H Healthkare Inc North Port, FL 34287 Fax: (941) 927-6315 Halder, Ranjay MD 5989 Approach Rd (941) 492-4300 00 Yrs/18 Yrs Provider ID: 1057566 Sarasota, FL 34238 Fax: (941) 492-2170 M-F 8:00 AM - 5:00 PM Gender: Male (941) 922-5366 05 Yrs/130 Yrs PCMH: No Centerstone of Florida Fax: (941) 894-3487 M-F 8:00 AM 5:00 PM 4010 Sawyer Rd 00 Yrs/21 Yrs PCMH: No Calleja, Joseph MD Sarasota, FL 34233 Manatee Memorial Hospital Provider ID: 1254489 (941) 782-4150 M-F 9:00 AM - 5:00 PM Nesternko, Marina MD Gender: Male Fax: (941) 782-4898 PCMH: No Provider ID: 1296978 Coastal Behavioral Healthcare 00 Yrs/130 Yrs Gender: Female Inc Psych Hospital Manatee Memorial Hospital Coastal Behavioral Healthcare 1451 10th St M-F 8:30 AM - 8:30 PM 1451 10th St Sarasota, FL 34236 Centerstone of Florida Inc PCMH: No Sarasota, FL 34236 (941) 331-2530 (941) 331-2530 Fax: (941) 331-2536 Lidge, Alecia PA Provider ID: 28509 Fax: (941) 331-2536 05 Yrs/130 Yrs Provider ID: 1272040 4010 Sawyer Rd 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Gender: Female Sarasota, FL 34233 PCMH: No Florida Department of Health M-F 8:00 AM - 5:00 PM (941) 782-4898 PCMH: No In Sar Fax: (941) 782-4899 Damayo, Mizyl MD 2200 Ringling Blvd 00 Yrs/130 Yrs Nesternko, Marina MD Sarasota, FL 34237 Languages: Spanish Provider ID: 1296978 Provider ID: 1255042 (941) 861-2900 M-F 9:00 AM - 5:00 PM Gender: Female Gender: Female Fax: (941) 861-2719 PCMH: No Coastal Behavioral Healthcare Coastal Behavioral Healthcare 00 Yrs/130 Yrs 1750 17th St Inc M-F 9:00 AM - 5:00 PM Psychiatry Sarasota, FL 34234 12497 Tamiami Trl S Ste 4 PCMH: No (941) 953-0000 North Port, FL 34287 Brasington, Steve MD Fax: (941) 954-0918 (941) 492-4300 Provider ID: 1424773 05 Yrs/130 Yrs Fax: (941) 492-2170 Gender: Male M-F 8:00 AM - 5:00 PM Coastal Behavioral Healthcare 05 Yrs/130 Yrs PCMH: No M-F 8:00 AM - 5:00 PM 12497 Tamiami Trail Ste 4 PCMH: No North Port, FL 34287 (941) 927-8900 Fax: (941) 927-6315 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 602

Last update 08/14/2017

Behavioral Health Sarasota Psychiatry - cont.

Greenwood, Kenneth MD Lopez, Rafael MD Provider ID: 1254012 Provider ID: 1059660 Damayo, Mizyl MD Gender: Male Gender: Male Provider ID: 1255042 Coastal Behavioral Healthcare Family Preservaton Services of Inc Flor Gender: Female 1500 Independence Blvd Ste Coastal Behavioral Healthcare 1451 10th St 100 Inc Sarasota, FL 34236 Sarasota, FL 34234 1451 10th St (941) 331-2530 (941) 359-1927 Sarasota, FL 34236 Fax: (941) 331-2536 Fax: (941) 359-1929 (941) 331-2530 05 Yrs/130 Yrs 05 Yrs/130 Yrs Fax: (941) 331-2536 M-F 8:00 AM - 5:00 PM MTWTHFSatSun 8:00 AM 05 Yrs/130 Yrs PCMH: No 5:00 PM M-F 8:00 AM - 5:00 PM Kamnik, Ronald MD PCMH: No PCMH: No Provider ID: 1367611 Monosiet, Frederic MD Damayo, Mizyl MD Gender: Male Indigo Healthcare LLC Provider ID: 1069636 1693 Main St Ste A Provider ID: 1255042 Gender: Male Sarasota, FL 34236 Gender: Female Coastal Recovery Centers Inc (941) 225-2373 Coastal Behavioral Healthcare 12497 Tamiami Trl S Ste 4 Inc Fax: (941) 366-0033 North Port, FL 34287 1750 17th St 05 Yrs/130 Yrs (941) 492-4300 Sarasota, FL 34234 M-F 9:00 AM - 5:00 PM Fax: (941) 492-2170 (941) 953-0000 PCMH: No 05 Yrs/130 Yrs Fax: (941) 954-0918 Linares-Flor, Jesus MD Languages: Spanish, French, 05 Yrs/130 Yrs Creole Provider ID: 1069498 M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No PCMH: No Centerstone of Florida Inc Deicke, Adair ARNP 4010 Sawyer Rd Monosiet, Frederic MD Provider ID: 1362315 Sarasota, FL 34233 Gender: Female (941) 782-4150 Provider ID: 1069636 Pathways Human Services Fax: (941) 782-4898 Gender: Male Select Focustable Ste 100 18 Yrs/130 Yrs Coastal Recovery Centers Inc Sarasota, FL 34234 M-F 8:30 AM - 5:00 PM 1451 10th St (941) 359-1927 PCMH: No Sarasota, FL 34236 05 Yrs/130 Yrs Lirio, Stephanie MD (941) 331-2530 M-F 8:30 AM - 5:00 PM Provider ID: 1358708 Fax: (941) 331-2536 PCMH: No Gender: Female 05 Yrs/130 Yrs Greenwood, Kenneth MD Pathways Human Services of Languages: Spanish, French, Florida Creole Provider ID: 1254012 1500 Independence Blvd Ste M-F 8:00 AM - 5:00 PM Gender: Male PCMH: No Coastal Behavioral Healthcare 100 Sarasota, FL 34234 12497 Tamiami Trl S Ste 4 (941) 359-1927 North Port, FL 34287 00 Yrs/130 Yrs (941) 492-4300 M-F 8:30 AM - 5:00 PM Fax: (941) 492-2170 PCMH: No 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 603

Monosiet, Frederic MD Provider ID: 1069636 Gender: Male Coastal Recovery Centers Inc 1750 17th St Sarasota, FL 34234 (941) 953-0000 Fax: (941) 954-0918 05 Yrs/130 Yrs Languages: Spanish, French, Creole M-F 8:00 AM - 5:00 PM PCMH: No Nadeem, Abdul MD Provider ID: 1317620 Gender: Male Pathways Human Services of Florida 1500 Independence Blvd Ste 100 Sarasota, FL 34234 (941) 359-1927 Fax: (941) 359-1929 12 Yrs/130 Yrs Sarasota Memorial Hospital Languages: Hindi M-F 9:00 AM - 5:00 PM PCMH: No Nesternko, Marina MD Provider ID: 1296978 Gender: Female Coastal Behavioral Healthcare 12497 Tamiami Trl S Ste 4 North Port, FL 34287 (941) 492-4300 Fax: (941) 492-2170 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Nesternko, Marina MD Provider ID: 1296978 Gender: Female Coastal Behavioral Healthcare 1451 10th St Sarasota, FL 34236 (941) 331-2530 Fax: (941) 331-2536 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Sarasota Psychiatry - cont. Nesternko, Marina MD Provider ID: 1296978 Gender: Female Coastal Behavioral Healthcare 1750 17th St Sarasota, FL 34234 (941) 953-0000 Fax: (941) 954-0918 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Oliva, Mario MD Provider ID: 1069639 Gender: Male Coastal Recovery Centers Inc 12497 Tamiami Trl S Ste 4 North Port, FL 34287 (941) 492-4300 Fax: (941) 492-2170 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Oliva, Mario MD Provider ID: 1069639 Gender: Male Coastal Recovery Centers Inc 1451 10th St Sarasota, FL 34236 (941) 331-2530 Fax: (941) 331-2536 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No Oliva, Mario MD Provider ID: 1069639 Gender: Male Coastal Recovery Centers Inc 1750 17th St Sarasota, FL 34234 (941) 953-0000 Fax: (941) 954-0918 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM PCMH: No

Sheshani, Shashidhar MD Provider ID: 1069533 Gender: Male Centerstone of Florida, Inc. 4010 Sawyer Rd Sarasota, FL 34233 (941) 782-4150 Fax: (941) 782-4898 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No St Laurent, Renee ARNP Provider ID: 1069535 Gender: Female Centerstone of Florida Inc 4010 Sawyer Rd Sarasota, FL 34233 (941) 782-4150 Fax: (941) 782-4898 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM PCMH: No Thomas, Matthew MD Provider ID: 1310181 Gender: Male Comprehensive Care Center Inc 1231 N Tuttle Ave Sarasota, FL 34237 (941) 366-0134 Fax: (941) 951-1795 00 Yrs/130 Yrs Sarasota Memorial Hospital M-TH 9:00 AM - 6:00 PM F 9:00 AM - 1:00 PM PCMH: No

Psychology Baird, Nancy PsyD Provider ID: 335593 Gender: Female Nancy Baird 2831 Ringling Blvd Ste 207C Sarasota, FL 34237 (941) 362-9972 Fax: (941) 362-1999 00 Yrs/130 Yrs M-W 8:00 AM - 8:00 PM TH 9:00 AM - 1:00 PM PCMH: No

Baker, William PsyD Provider ID: 796763 Gender: Male 4370 S Tamiami Trl Ste 241 Sarasota, FL 34231 (941) 926-2474 Fax: (941) 926-2440 18 Yrs/130 Yrs Sarasota Memorial Hospital MTTHF 10:00 AM - 7:00 PM W 9:30 AM - 7:00 PM PCMH: No Boxley, Robert PHD Provider ID: 783502 Gender: Male 7727A Holiday Dr Sarasota, FL 34231 (941) 685-4358 Fax: (941) 926-3946 00 Yrs/130 Yrs MWTH 4:00 AM - 7:00 PM T 4:00 AM - 7:30 PM PCMH: No Clyburn, Thomas PHD Provider ID: 499584 Gender: Male 1345 Main St Ste E Sarasota, FL 34236 (941) 224-3800 Fax: (941) 745-1630 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM PCMH: No Hendon, Marvin PHD Provider ID: 1131637 Gender: Male Marvin K Hendon PHD 240 N Washington Blvd Sarasota, FL 34236 (941) 316-0230 Fax: (941) 366-5675 00 Yrs/130 Yrs M 9:00 AM - 6:00 PM T 1:00 AM - 8:00 PM W 9:00 AM - 2:00 PM TH 10:00 AM - 7:00 PM F 9:00 AM - 5:00 PM PCMH: No

www.wellcare.com/Florida | 604

Trancik, Anika PHD Provider ID: 791078 Gender: Female 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/130 Yrs Languages: Swedish M-F 8:00 AM - 6:00 PM PCMH: No

Substance Abuse Coastal Behavioral Healthcare Inc Provider ID: 298 Coastal Behavioral Healthcare Inc C 12497 Tamiami Trl S Ste 4 North Port, FL 34287 (941) 492-4300 Fax: (941) 492-2170 05 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Coastal Behavioral Healthcare Inc Provider ID: 298 Coastal Behavioral Healthcare Inc C 1451 10th St Sarasota, FL 34236 (941) 331-2530 Fax: (941) 331-2536 05 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM PCMH: No Coastal Behavioral Healthcare Inc Provider ID: 298 Coastal Behavioral Healthcare Inc C 1750 17th St Sarasota, FL 34234 (941) 953-0000 Fax: (941) 954-0918 05 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PCMH: No

Last update 08/14/2017

Behavioral Health Sarasota Substance Abuse - cont. First Step of Sarasota Inc Provider ID: 372182 4613 N Washington Blvd Sarasota, FL 34234 (941) 366-5333 Fax: (941) 351-5161 18 Yrs/65 Yrs PCMH: No

www.wellcare.com/Florida | 605

Last update 08/14/2017

Ancillary Providers All Art Therapy Staywell Customer Service For Providers and Locations Please Call: (866) 334-7927 TTY/TDD 1-877-247-6272

Durable Medical Equipment Durable Medical Equipment For Additional Providers and Locations Please Call: (866) 334-7927

Equine Therapy Staywell Customer Service For Providers and Locations Please Call: (866) 334-7927 TTY/TDD 1-877-247-6272

Food and Lodging Staywell Customer Service For Providers and Locations Please Call: (866) 334-7927 TTY/TDD 1-877-247-6272

Non-Emergency Transportation Medical Transportation Management To Schedule A Ride To An Appointment, Please Call: (866) 591-4066 TTY 800-855-2880 For English and 800-855-2884 For Spanish

Nutritional Counseling Staywell Customer Service For Providers and Locations Please Call: (866) 334-7927 TTY/TDD 1-877-247-6272

PET Therapy Staywell Customer Service For Providers and Locations Please Call: (866) 334-7927 TTY/TDD 1-877-247-6272

Home Health Care Home Health Care For Additional Providers and Locations Please Call: (866) 334-7927

Laboratory Pathology Testing Quest Diagnostics For Additional Providers and Locations Please Call: (866) 697-8378

Meals Staywell Customer Service For Providers and Locations Please Call: (866) 334-7927 TTY/TDD 1-877-247-6272

www.wellcare.com/Florida | 606

Last update 08/14/2017

Ancillary Providers De Soto Dialysis Arcadia Dialysis Center Provider ID: 186502 1341 E Oak St Arcadia, FL 34266 (863) 491-8550 Fax: (863) 491-8553 18 Yrs/130 Yrs M-W 5:00 AM - 6:00 PM

Hearing Aid Supplier Foster, Linda Had Provider ID: TPV08162-01 Gender: Female Arcadia Hearing Center 110 W Oak St Arcadia, FL 34266 (863) 494-2342 Fax: (863) 993-3600 02 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Hospice Tidewell Hospice Inc Provider ID: 400833 917 N Arcadia Ave Arcadia, FL 34266 (863) 231-3300 Fax: (941) 926-4883 00 Yrs/130 Yrs Tidewell Hospice Inc Provider ID: 400833 919 N Arcadia Ave Arcadia, FL 34266 (863) 231-3350 Fax: (941) 926-4883 00 Yrs/130 Yrs

www.wellcare.com/Florida | 607

Last update 08/14/2017

Ancillary Providers Hardee Dialysis Fresenius Medical Care Wauchula Provider ID: 1019731 457 Carlton St Wauchula, FL 33873 (863) 767-0016 Fax: (863) 767-0525 18 Yrs/130 Yrs M-W 6:00 AM - 6:00 PM

www.wellcare.com/Florida | 608

Last update 08/14/2017

Ancillary Providers Highlands Diagnostic Imaging

Hearing Aid Supplier

Central Florida Imaging Center Inc Provider ID: 318918 6801 US Hwy 27 N Ste E3 Sebring, FL 33870 (863) 386-1144 Fax: (863) 386-1142 00 Yrs/130 Yrs Languages: Hindi M-F 8:00 AM - 5:00 PM

Arthur, Jayson Had Provider ID: TPV17295-01 Gender: Male Hearing Life 263 US Hwy 27 North Sebring, FL 33870 (863) 385-5656 Fax: (863) 385-5856 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Khurana Radiology MD PA Provider ID: 615235 Advanced MRI and Imaging 2821 US Hwy 27 N Sebring, FL 33870 (863) 385-8000 Fax: (863) 385-8002 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Arthur, Jayson Had Provider ID: TPV17295-02 Gender: Male Hearing Life 263 US Hwy 27 North Sebring, FL 33870 (863) 385-5656 Fax: (863) 385-5856 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Dialysis BMA Avon Park Provider ID: 164542 BMA of Florida Inc 4833 Sun N Lake Blvd Sebring, FL 33872 (863) 385-1850 Fax: (863) 385-1255 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Rcc Sebring Provider ID: 164541 40 Medical Center Ave Sebring, FL 33870 (863) 395-7351 Fax: (863) 385-8962 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Durable Medical Equipment Encore Respiratory Provider ID: 1131215 3672 US Hwy 27 N Sebring, FL 33870 (863) 382-8464 Fax: (863) 382-8979 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Conlon, Sharon Had Provider ID: TPV07877-01 Gender: Female Beltone Hearing Aid Center 1253 US 27 South Sebring, FL 33870 (863) 471-0016 Fax: (863) 471-0083 02 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Reichmann, David Had Provider ID: TPV09075-01 Gender: Male Hearing Life 263 US Hwy 27 North Sebring, FL 33870 (863) 385-5656 Fax: (863) 385-5856 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Home Health Care

Arthur, Jayson Had Provider ID: TPV17369-01 Gender: Male Hearing Life 263 US Hwy 27 North Sebring, FL 33870 (863) 385-5656 Fax: (863) 385-5856 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Fusion Healthcare Provider ID: 1263675 155 US 27 Ste 4 Sebring, FL 33870 (863) 471-9421 Fax: (863) 471-9467 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM

Conlon, Kelly Had Provider ID: TPV08593-01 Gender: Female Beltone Hearing Aid Center 1253 US 27 South Sebring, FL 33870 (863) 471-0016 Fax: (863) 471-0083 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Compassionate Care Hospice of Central Florida Provider ID: 1365333 Compassionate Care Hospice of Centr 2153 US 27 S Sebring, FL 33870 (863) 314-0166 Fax: (863) 314-0168 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:30 AM - 5:00 PM

Conlon, Patrick Had Provider ID: TPV07878-01 Gender: Male Beltone Hearing Aid Center 1253 US 27 South Sebring, FL 33870 (863) 471-0016 Fax: (863) 471-0083 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Hospice

Good Shepherd Hospice Inc Provider ID: 996424 1110 Hammock Rd Sebring, FL 33870 (863) 402-1066 Fax: (863) 402-0230 00 Yrs/130 Yrs Languages: Spanish

www.wellcare.com/Florida | 609

Orthotics & Prosthetics Hanger Clinic Provider ID: 134894 4227 Sun N Lake Blvd Sebring, FL 33872 (863) 471-0300 Fax: (863) 471-1388 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Rehabilitation Facility Cora Health Services Inc Provider ID: 1051793 Cora Rehabilitation Clinics 6120 US 27 North Sebring, FL 33870 (863) 471-1223 Fax: (863) 471-2015 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Systems Provider ID: 1047717 Cora Rehabilitation Clinics 346 E Royal Palm St Lake Placid, FL 33852 (863) 465-9500 Fax: (863) 465-9542 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sundance Therapy Inc Provider ID: 1220917 147 Tower St Lake Placid, FL 33852 (863) 465-9992 Fax: (863) 465-9906 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Skilled Nursing Facility Avon Park Royal Holdings Lld DBA Royal C Provider ID: 1126155 Royal Care of Avon Park 1213 W Stratford Rd Avon Park, FL 33825 (863) 453-6674 Fax: (863) 453-0769 00 Yrs/130 Yrs Languages: Spanish M 2:00 AM - 5:00 PM TWTH 4:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Highlands Skilled Nursing Facility cont. Kenilworth Care and Rehabilitation Center Provider ID: 627682 3011 Kenilworth Blvd Sebring, FL 33870 (863) 382-2153 Fax: (863) 382-2039 18 Yrs/130 Yrs Languages: Spanish Lake Placid Health and Rehabilitation C Provider ID: 688297 125 Tomoka Blvd S Lake Placid, FL 33852 (863) 465-7200 Fax: (863) 465-2054 00 Yrs/130 Yrs Languages: Spanish The Oaks At Avon Park Provider ID: 636092 1010 US 27 N Avon Park, FL 33825 (863) 453-5200 Fax: (863) 453-5308 00 Yrs/130 Yrs

Urgent Care Center First Help Urgent Care Clinic Provider ID: 60430 First Help Urgent Care 1023 US 27 S Avon Park, FL 33825 (863) 452-2980 Fax: (863) 452-2587 00 Yrs/130 Yrs MTWTHFSatSun 8:30 AM 6:30 PM

www.wellcare.com/Florida | 610

Last update 08/14/2017

Ancillary Providers Hillsborough Ambulatory Surgery Center Ambulatory Surgery Center Provider ID: 21009 Ambulatory Surgery Center Group 4500 E Fletcher Ave Tampa, FL 33613 (813) 977-8550 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Armenia Ambulatory Surgery Center Inc Provider ID: 160046 Armenia Ambulatory Surgery Center 4703 N Armenia Ave Tampa, FL 33603 (813) 871-9032 Fax: (813) 875-9543 18 Yrs/130 Yrs Languages: Spanish M-F 6:00 AM - 5:00 PM Brandon Ambulatory Surgery Center Provider ID: 293132 514 Eichenfeld Dr Brandon, FL 33511 (813) 571-7088 Fax: (813) 571-7099 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 5:00 PM Brandon Outpatient Surgery Center Provider ID: 290429 Outpatient Surgery Center Inc 201 Noland Dr Brandon, FL 33511 (352) 688-6393 Fax: (352) 688-1113 18 Yrs/130 Yrs Brandon Outpatient Surgery Center Languages: Spanish, Arabic M-F 8:30 AM - 5:00 PM

Brandon Surgery Center Provider ID: 6872 Brandon Surgi Center LTD 711 S Parsons Ave Brandon, FL 33511 (813) 654-7771 Fax: (813) 654-3347 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Columbia Eye & Specialty Surgery Center Provider ID: 6883 Columbia Eye & Specialty Sergery 4302 N Gomez Ave Tampa, FL 33607 (813) 870-6330 Fax: (813) 871-3956 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Pediatric Surgery Centers LLC Provider ID: 272838 10080 Balaye Run Dr Tampa, FL 33619 (813) 490-6100 Fax: (813) 490-6105 00 Yrs/18 Yrs Citrus Surgical Center M-F 8:00 AM - 5:00 PM Tampa Bay Surgery Center Provider ID: 20966 11811 N Dale Mabry Hwy Tampa, FL 33618 (813) 961-8500 Fax: (813) 968-6818 00 Yrs/130 Yrs Tampa Bay Surgery Center Languages: Spanish M-F 8:00 AM - 5:00 PM

Tampa Bay Surgery Center Provider ID: 20966 2727 Martin Luther King Jr Blvd Tampa, FL 33607 (813) 357-5905 Fax: (813) 874-2509 00 Yrs/130 Yrs Tampa Bay Surgery Center Languages: Spanish M-F 6:30 AM - 5:00 PM USF Endoscopy & Surgery Center Provider ID: 28762 12901 Bruce B Downs Blvd Tampa, FL 33612 (816) 974-2870 Fax: (813) 975-5448 00 Yrs/130 Yrs M-F 7:30 AM - 4:30 PM Westchase Surgery Center LTD Provider ID: 619854 Westchase Surgery Center 10901 Sheldon Rd Tampa, FL 33626 (813) 343-3101 Fax: (813) 920-5963 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Birthing Center Sweet Child O Mine LLC Provider ID: 1048863 Sweet Child Omine LLC 215 Lithia Pinecrest Rd Brandon, FL 33511 (813) 685-8404 Fax: (813) 298-0620 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM

www.wellcare.com/Florida | 611

Convenient Care Clinic Minuteclinic LLC Provider ID: 1129577 5905 US Hwy 301 S Riverview, FL 33578 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 2322 Land O Lakes Blvd Lutz, FL 33549 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 4120 Henderson Blvd Tampa, FL 33629 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 5357 Ehrlich Rd Tampa, FL 33625 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Convenient Care Clinic - Take Care Health cont. Provider ID: 705179 Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 611 S Howard Ave Tampa, FL 33606 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 6206 Commerce Palms Dr Tampa, FL 33647 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 704 W MLK Blvd Seffner, FL 33584 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 8801 W Linebaugh Ave Tampa, FL 33626 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM

15602 N Dale Mabry Hwy Tampa, FL 33618 (866) 825-3227 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 128 E Brandon Blvd Brandon, FL 33511 (866) 825-3227 00 Yrs/130 Yrs MF 8:00 AM - 6:00 PM TWTH 8:00 AM - 8:00 PM Sat-Sun 9:30 AM - 5:30 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 17511 Bruce B Downs Blvd Tampa, FL 33647 (866) 825-3227 00 Yrs/130 Yrs M-W 9:00 AM - 8:00 PM THF 9:00 AM - 6:00 PM Sat-Sun 9:30 AM - 5:30 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 2115 E Hillsborough Ave Tampa, FL 33610 (866) 825-3227 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM Sat-Sun 9:30 AM - 5:30 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 8706 W Hillsborough Ave Tampa, FL 33615 (866) 825-3227 00 Yrs/130 Yrs MWF 8:00 AM - 8:00 PM TTH 8:00 AM - 6:00 PM Sat-Sun 9:30 AM - 5:30 PM

Diagnostic Imaging Advanced Diagnostic Group Provider ID: 276574 1111 Oakfield Dr Ste 103 Brandon, FL 33511 (813) 238-3833 Fax: (813) 655-6747 03 Yrs/130 Yrs Languages: Spanish MTTH 8:00 AM - 9:00 PM WF 8:00 AM - 6:00 PM Advanced Diagnostic Group Provider ID: 276574 3104 W Waters Ave Ste 106 Tampa, FL 33614 (813) 935-5332 Fax: (813) 933-5849 03 Yrs/130 Yrs Languages: Spanish MTTH 8:00 AM - 9:00 PM WF 8:00 AM - 6:00 PM Advanced Diagnostic Group Provider ID: 276574 607 W MLK Blvd Ste 103 Tampa, FL 33603 (813) 874-3260 Fax: (813) 847-3250 03 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 8:00 PM Baycare Outpatient Imaging Provider ID: 1054955 2222 W Swann Ave Tampa, FL 33606 (813) 259-1900 Fax: (813) 259-1999 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 5:00 PM Baycare Outpatient Imaging Provider ID: 141487 10141 Big Bend Rd Ste 102 Riverview, FL 33578 (813) 302-8925 Fax: (813) 302-8929 00 Yrs/130 Yrs M-F 7:00 AM - 5:00 PM

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Baycare Outpatient Imaging Provider ID: 15579 4091 Van Dyke Rd Lutz, FL 33558 (813) 265-6300 Fax: (813) 265-6319 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:30 PM Sat 8:00 AM - 12:00 PM Baycare Outpatient Imaging Provider ID: 15579 St Josephs Diagnostic Center LTD 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4826 Fax: (813) 554-8396 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Bayview Radiology Provider ID: 285261 10010 N Dale Mabry Hwy Tampa, FL 33618 (813) 964-8439 Fax: (813) 964-0908 00 Yrs/130 Yrs MWF 8:00 AM - 5:00 PM TTH 8:00 AM - 8:00 PM Global Mobile Diagnostics of Florida Inc Provider ID: 923685 Global Mobile Diagnostics of Florid 4023 N Armenia Ave Ste 102 Tampa, FL 33607 (813) 443-4837 Fax: (813) 443-4858 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Diagnostic Imaging - cont. Stand Up MRI of Tampa Rose Radiology Centers Inc Provider ID: 210006 Rose Radilogy Brandon 1220 Oakfield Dr Brandon, FL 33511 (813) 655-1144 Fax: (813) 655-1511 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology On Kennedy 2605 W Kennedy Blvd Tampa, FL 33609 (813) 876-7200 Fax: (813) 876-7300 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology Riverview 7239 Hwy 301 South Riverview, FL 33578 (813) 876-7200 Fax: (813) 876-7300 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology Tampa 5107 N Armenia Ave Bldg B Tampa, FL 33603 (813) 874-2999 Fax: (813) 874-7673 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM

Provider ID: 302338 2605 W Kennedy Blvd Tampa, FL 33609 (813) 876-7200 Fax: (813) 876-7300 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM

Stjosephs Diag Cntr Provider ID: 464359 St Josephs Diag Cntr 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4826 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Bloomingdale Radiology Center 3350 Bell Shoals Rd Brandon, FL 33511 (813) 654-4883 Fax: (813) 676-0339 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Community Diagnostic Center of Bran 500 Vonderburg Dr Ste 111 Brandon, FL 33511 (813) 654-5400 Fax: (813) 436-2882 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:30 PM Tower Imaging Inc Provider ID: 2000 Tower Breast Diagnostic Center Nort 17503 N Dale Mabry Hwy Lutz, FL 33548 (813) 968-4540 Fax: (813) 968-4502 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Tower Imaging Inc Provider ID: 2000 Tower Breast Diagnostic Center Nort 2716 University Square Dr Tampa, FL 33612 (813) 971-2050 Fax: (813) 972-4888 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 4:30 PM Tower Imaging Inc Provider ID: 2000 Tower Diagnostic Center Bruce B Dow 3069 Grand Pavilion Dr Tampa, FL 33613 (813) 977-9777 Fax: (813) 977-8222 00 Yrs/130 Yrs Languages: Spanish MF 7:00 AM - 6:00 PM TW 7:00 AM - 8:00 PM TH 7:30 AM - 5:00 PM Sat 8:00 AM - 12:00 PM Tower Imaging Inc Provider ID: 2000 Tower Diagnostic Center South Tampa 2106 S Lois Ave Tampa, FL 33629 (813) 288-8839 Fax: (813) 288-8849 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Carrolwood 14499 N Dale Mabry Hwy Ste 150 Tampa, FL 33618 (813) 968-6998 Fax: (813) 265-1035 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:30 PM

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Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Habana 4719 N Habana Ave Tampa, FL 33614 (813) 875-3787 Fax: (813) 872-0378 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM Sat 7:30 AM - 2:00 PM Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Riverview 10689 Big Bend Rd Ste 102 Riverview, FL 33579 (813) 672-0608 Fax: (813) 672-0612 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Robertson 414 W Robertson St Brandon, FL 33511 (813) 657-6767 Fax: (813) 879-1809 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM University Diagnostic Provider ID: 179740 University Diagnostic Institute 3301 USF Alumni Dr Tampa, FL 33612 (813) 972-3351 Fax: (813) 971-6892 00 Yrs/130 Yrs M 7:30 AM - 6:00 PM TWTHF 7:30 AM - 8:00 PM Sat 8:00 AM - 4:00 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Diagnostic Imaging - cont. Brandon East Dialysis Vymed Diagnostic Imaging Tampa LLC Provider ID: 288001 10010 N Dale Mabry Hwy Ste 160 Tampa, FL 33618 (813) 264-7176 Fax: (813) 264-7161 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 357544 Dva Renal Healthcare Inc 114 E Brandon Blvd Brandon, FL 33511 (813) 657-2783 Fax: (813) 657-2521 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Carrollwood Dialysis Provider ID: 795035 14358 N Dale Mabry Hwy West Florida PET Services LLC Tampa, FL 33618 (813) 960-3751 Provider ID: 480101 Fax: (813) 961-7312 427 S Parsons Ave Ste 101 18 Yrs/130 Yrs Brandon, FL 33511 M-W 6:00 AM - 5:00 PM (813) 657-4914 Central Tampa Dialysis Fax: (813) 657-4916 00 Yrs/130 Yrs Provider ID: 357212 M-F 8:00 AM - 5:00 PM Dva Renal Healthcare Inc 4204 N Macdill Ave S Bldg Dialysis Tampa, FL 33607 (813) 871-3202 BMA of Carrollwood Fax: (813) 871-3903 Provider ID: 164547 00 Yrs/130 Yrs BMA of Florida Inc M-F 9:00 AM - 5:00 PM 4553 Gunn Hwy Tampa, FL 33624 Dialysis Newco Inc (813) 265-9733 Provider ID: 1309275 Fax: (813) 265-3188 US Renal Care Tampa Central 18 Yrs/130 Yrs Dialysi M-F 9:00 AM - 5:00 PM 4705 N Armenia Ave Tampa, FL 33603 BMA of Ybor City (813) 353-8100 Provider ID: 164550 Fax: (813) 353-1440 BMA of Florida Inc 00 Yrs/130 Yrs 1602 N 21st St M-F 9:00 AM - 5:00 PM Tampa, FL 33605 (813) 247-5720 Dsi Lutz LLC 18 Yrs/130 Yrs Provider ID: 1309181 M-F 9:00 AM - 5:00 PM US Renal Care Lutz Dialysis 3421 N Lakeview Dr Brandon Artificial Kidney Tampa, FL 33618 Center (813) 261-1864 Provider ID: 164546 Fax: (813) 962-1861 514 Medical Oaks Ave 00 Yrs/130 Yrs Brandon, FL 33511 M-F 9:00 AM - 5:00 PM (813) 661-3815 Fax: (813) 661-3858 18 Yrs/130 Yrs MTWTHFSat 6:30 AM - 4:00 PM

Dsi South Tampa LLC Provider ID: 1309268 US Renal Care South Tampa Dialysis 731 W Lumsden Rd Brandon, FL 33511 (813) 661-7474 Fax: (813) 643-3451 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Gambro Healthcare-Town & Country Hospital Provider ID: 4678 Gambro Healthcare Renal Care 6001 Webb Rd Tampa, FL 33615 (813) 881-9711 Fax: (813) 881-1499 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Greater Tampa At Home Pd Provider ID: 552203 Reater Tampa At Home Pd 4204 N Macdill Ave Ste 1B North Bldg Tampa, FL 33607 (813) 872-8216 Fax: (813) 872-8469 18 Yrs/130 Yrs M-F 8:30 AM - 5:30 PM Plant City Dialysis Provider ID: 342478 Dva Renal Healthcare Inc 1211 W Reynolds St Plant City, FL 33563 (813) 752-2136 Fax: (813) 757-6729 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM RCG Tampa North LLC Provider ID: 277182 4450 E Fletcher Ave Ste D Tampa, FL 33613 (813) 979-9081 Fax: (813) 979-6259 18 Yrs/130 Yrs M-F 5:30 AM - 4:30 PM

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Sun City Center Dialysis Provider ID: 357264 Dva Renal Healthcare Inc 783 Cortaro Dr Sun City Center, FL 33573 (816) 633-2847 Fax: (813) 633-2972 00 Yrs/130 Yrs MTWTHFSat 6:00 AM - 5:00 PM Temple Terrace Dialysis Provider ID: 329980 Dva Renal Healthcare Inc 11306 N 53rd St Temple Terrace, FL 33617 (813) 989-2062 Fax: (813) 989-3658 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM USF Dialysis Center Provider ID: 25427 USF Physicicans Group 10770 N 46th St Ste A100 Temple Ter, FL 33617 (253) 382-1872 Fax: (866) 620-5562 00 Yrs/130 Yrs MWF 6:30 AM - 8:30 PM TTHSat 6:30 AM - 4:30 PM USF Dialysis Center Provider ID: 25427 USF Physicicans Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 975-1811 00 Yrs/130 Yrs MWF 6:30 AM - 8:30 PM TTHSat 6:30 AM - 4:30 PM West Tampa Dialysis Provider ID: 354075 4515 George Rd Ste 300 Tampa, FL 33634 (813) 884-4008 Fax: (813) 884-1465 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Durable Medical Equipment Activstyle Inc Provider ID: 296247 1202 Tech Blvd Tampa, FL 33619 (385) 218-6607 Fax: (877) 426-7329 00 Yrs/130 Yrs Languages: Spanish, German M-F 8:30 AM - 5:00 PM Affordable Medical LLC Provider ID: 1157126 24638 State Rd 54 Lutz, FL 33559 (888) 991-9945 Fax: (888) 993-9951 00 Yrs/130 Yrs M-F 10:00 AM - 5:00 PM Ally Medical Services LLC Provider ID: 1159471 4951B E Adamo Dr Ste 220 Tampa, FL 33605 (866) 684-2507 Fax: (866) 645-2183 00 Yrs/130 Yrs Languages: Spanish, French, German M-F 9:00 AM - 5:00 PM American Homepatient Inc Provider ID: 886611 American Homepatient 1911 N US Hwy 301 Ste B180 Tampa, FL 33619 (813) 626-4513 Fax: (813) 626-5504 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Bioscrip Infusion Services LLC Provider ID: 675752 5505 Johns Rd Ste 700 Tampa, FL 33634 (813) 549-5499 Fax: (813) 549-5490 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Bioscrip Infusion Services LLC Provider ID: 785558 5505 Johns Rd Ste 700 Tampa, FL 33634 (813) 514-1676 Fax: (813) 514-1677 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clinicare Medical Resources Inc Provider ID: 1131631 9245 Lazy Ln Tampa, FL 33614 (813) 935-1341 Fax: (813) 935-8770 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Encore Respiratory Provider ID: 1131201 5909 Breckenridge Pkwy Ste A Tampa, FL 33610 (863) 401-3762 Fax: (863) 956-0715 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Express Orthotics and Prosthetics Inc Provider ID: 1254545 Express Orthotics and Prosthetics 3603 W Flora St Ste 102 Tampa, FL 33614 (813) 605-4610 Fax: (813) 605-4612 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM KCI USA Inc Provider ID: 373083 1911 N USA Hwy 301 Ste 460 Tampa, FL 33619 (800) 275-4524 Fax: (888) 245-2295 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

KCI USA Inc Provider ID: 373083 4444 E Adamo Dr Ste 403 Tampa, FL 33605 (888) 275-4524 Fax: (888) 245-2295 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Matrix Medical LLC Provider ID: 1001435 408 N Alexander St Plant City, FL 33563 (407) 674-8977 Fax: (407) 674-8980 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Medicor Homecare Inc Provider ID: 292578 3403 W Waters Ave Tampa, FL 33614 (813) 930-8000 Fax: (813) 930-8026 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM MS Supply and Home Health Co Provider ID: 1126311 618 S Ware Blvd Tampa, FL 33619 (813) 621-2001 Fax: (800) 680-3722 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM National DME LLC Provider ID: 1138385 National DME 7010 E Adamo Dr Bldg C Unit 3 Tampa, FL 33619 (800) 644-1968 Fax: (801) 566-3491 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM

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Numotion Provider ID: 173278 6903 Hampton Oaks Pkwy Ste B Tampa, FL 33610 (813) 626-8476 Fax: (813) 626-8450 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Solarus Enterprises LLC Provider ID: 1135788 Solarus Enterprises, LLC D/B/ A Sola 10347 Cross Creek Blvd Ste H Tampa, FL 33647 (813) 994-6688 Fax: (866) 643-9605 00 Yrs/130 Yrs Languages: Spanish, German, Bosnian M-F 8:00 AM - 5:00 PM

Hearing Aid Supplier Davis, Luke Had Provider ID: TPV07776-01 Gender: Male HearUSA 3669 W. Waters Ave. Tampa, FL 33614 (813) 931-2307 Fax: (813) 931-8664 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Ferrone, Damian Had Provider ID: TPV08799-01 Gender: Male HearUSA 729 Cortaro Dr Ste 15 Ruskin, FL 33573 (813) 633-8517 Fax: (813) 633-0922 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Ferrone, Dimitri Had Provider ID: TPV08949-01 Gender: Male HearUSA 729 Cortaro Dr Ste 15 Ruskin, FL 33573 (813) 633-8517 Fax: (813) 633-0922 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Hearing Aid Supplier cont. Ferrone, Dimitri Had Provider ID: TPV08949-03 Gender: Male HearUSA 807 E Bloomingdale Ave. Brandon, FL 33511 (813) 685-2462 Fax: (813) 685-8162 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Kaleky, Benjamin Had Provider ID: TPV16665-01 Gender: Male HearUSA 729 Cortaro Dr Ste 15 Ruskin, FL 33573 (813) 633-8517 Fax: (813) 633-0922 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Smith, Michael Had Provider ID: TPV08642-03 Gender: Male HearUSA 3669 W. Waters Ave. Tampa, FL 33614 (813) 931-2307 Fax: (813) 931-8664 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Home Health Care Accurate Health Services Corp Provider ID: 1336554 8316 Hanley Rd Ste 3 4 Tampa, FL 33634 (813) 887-1919 Fax: (813) 887-1988 00 Yrs/130 Yrs MTWTHFSatSun 9:00 AM 5:00 PM

Aclaris Home Health LLC Provider ID: 1223187 3430 W Lambright St Ste 103 Tampa, FL 33614 (813) 935-4790 Fax: (813) 217-9671 02 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM

Best Care Providers Inc Provider ID: 1123734 204 N Howard Ave Tampa, FL 33606 (813) 251-5300 Fax: (813) 253-5301 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Best Care Providers Inc Allure Home Health Corp Provider ID: 1123734 Provider ID: 1370476 8910 N Dale Mabry Hwy Ste 17 Allure Home Health Tampa, FL 33614 8910 N Dale Mabry Hwy Ste 9 (813) 251-5300 Tampa, FL 33614 Fax: (813) 253-5301 (813) 398-7607 00 Yrs/130 Yrs Fax: (813) 280-4826 Languages: Spanish 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish Better At Home LLC M-F 9:00 AM - 5:00 PM Provider ID: 1157459 Apollo Advanced Home 7520 W Waters Ave Ste 19 Health Corp Tampa, FL 33615 Provider ID: 1135392 (813) 374-0309 Apollo Advance HHC Fax: (813) 902-7196 4019 W Waters Ave Ste E 18 Yrs/130 Yrs Tampa, FL 33614 Languages: Spanish, Creole (813) 935-5555 M-F 9:00 AM - 5:00 PM Fax: (813) 933-6417 Esperanza Home Health 00 Yrs/130 Yrs Services Inc Languages: Spanish, Creole Provider ID: 1133000 M-F 9:00 AM - 5:00 PM 2700 N Macdill Ave Ste 211 Assisting Hands Gulf Coast Tampa, FL 33607 Provider ID: 1418068 (813) 298-5692 2203 N Lois Ave G450 Fax: (813) 374-0299 Tampa, FL 33607 18 Yrs/130 Yrs (813) 868-6782 Languages: Spanish Fax: (813) 867-4544 M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs Exceptional Health Care Inc Languages: Spanish, French, Creole Provider ID: 1162313 Avian Home Health Corp 4809 E Busch Blvd Ste 106 Provider ID: 1126292 Tampa, FL 33617 8910 N Dale Mabry Hwy Ste (813) 444-9524 27 Fax: (813) 944-4530 Tampa, FL 33614 18 Yrs/130 Yrs (813) 935-4666 M-F 9:00 AM - 5:00 PM Fax: (813) 935-4777 00 Yrs/130 Yrs Languages: Spanish

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Family First Homecare LLC Provider ID: 1159479 Family First Homecare 6336 US Hwy 301 S Unit B5 Riverview, FL 33578 (813) 993-0040 Fax: (813) 993-0041 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Fusion Healthcare Provider ID: 1263675 550 N Reo St Ste 109 Tampa, FL 33609 (813) 636-5017 Fax: (813) 282-1166 18 Yrs/110 Yrs MTWTHFSatSun 8:00 AM 5:00 PM Genesis Healthcare DBA Origin Home Healt Provider ID: 1359456 Origin Home Health Care 441 Apollo Beach Blvd Apollo Beach, FL 33572 (813) 672-3949 Fax: (813) 672-3973 60 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Gentle Touch Home Care Inc Provider ID: 1405584 202 Beverly Blvd Ste 210 Brandon, FL 33511 (813) 661-9453 Fax: (813) 654-9897 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Harmony Home Health LLC Provider ID: 1371543 2301 W Palm Dr Tampa, FL 33629 (727) 723-7532 Fax: (727) 797-4733 40 Yrs/130 Yrs

Last update 08/14/2017

Ancillary Providers Hillsborough Home Health Care - cont. MS Supply and Home Health Visiting Nurse Association of Healthy Services of Tampa Inc Provider ID: 1131696 Healthy Services of Tampa, Inc 3104 W Waters Ave Ste 204 Tampa, FL 33614 (813) 932-9922 Fax: (813) 932-9911 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:30 PM Integrity Health Services Provider ID: 1189123 4023 N Armenia Ave Ste 230 Tampa, FL 33607 (813) 658-3380 Fax: (813) 864-6330 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Maxim Healthcare Services Inc Provider ID: 1218060 3109 W Dr MLK Blvd Tampa, FL 33607 (813) 289-0760 Fax: (813) 398-1730 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Medical Personnels Services Inc Provider ID: 1133461 4507 N Habana Ave Tampa, FL 33614 (813) 598-7268 Fax: (813) 872-2616 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM Medicor Healthcare Inc Provider ID: 1123280 3403 W Waters Ave Tampa, FL 33614 (813) 930-8000 Fax: (813) 930-8026 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Co Provider ID: 1126311 618 S Ware Blvd Tampa, FL 33619 (813) 621-2001 Fax: (800) 680-3722 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM

Oracle Home Health Care Provider ID: 1129158 2806 James L Redman Pkwy Ste 203 Plant City, FL 33566 (813) 747-7499 Fax: (813) 757-6081 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Preferred Touch Home Care Inc Provider ID: 1123391 510 Vonderburg Dr Ste 308 Brandon, FL 33511 (813) 702-1100 Fax: (813) 685-8973 00 Yrs/130 Yrs Pro Med Healthcare Services LLC Provider ID: 1344508 719 N Parsons Ave Brandon, FL 33510 (813) 654-3604 Fax: (813) 654-3604 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Senior Helpers Provider ID: 1403808 6152 Delancey Sta St Ste 206 Riverview, FL 33578 (813) 677-1400 Fax: (813) 864-7678 00 Yrs/130 Yrs Languages: Spanish

Florida In Provider ID: 1349606 Visiting Nurse Association of Flori 8875 Hidden River Pkwy Tampa, FL 33637 (800) 318-0399 Fax: (866) 227-6562 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat-Sun 8:00 AM - 4:30 PM Yodalys Home Health Corp Provider ID: 1124288 233 W Waters Ave Tampa, FL 33604 (813) 886-8985 Fax: (813) 886-8497 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Hospice Lifepath Hospice Inc Provider ID: 996605 3010 W Azeele St Tampa, FL 33609 (813) 877-2200 Fax: (813) 872-7037 00 Yrs/130 Yrs Languages: Spanish, French, Chinese, Vietnamese Lifepath Hospice Inc Provider ID: 996605 3725 Upper Creek Dr Ruskin, FL 33573 (813) 634-7621 Fax: (813) 633-3861 00 Yrs/130 Yrs Languages: Spanish, French, Chinese, Vietnamese

Infusion Therapy Bioscrip Infusion Services LLC Provider ID: 675752 5505 Johns Rd Ste 700 Tampa, FL 33634 (813) 549-5499 Fax: (813) 549-5490 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

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Bioscrip Infusion Services LLC Provider ID: 785558 5505 Johns Rd Ste 700 Tampa, FL 33634 (813) 514-1676 Fax: (813) 514-1677 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Caremark Therapeutic Svcs Provider ID: 14286 8010 Woodland Center Blvd Tampa, FL 33614 (800) 225-5967 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Laboratory Pathology Testing Tampa Pathology Lab Provider ID: 6245 3110 Cherry Palm Dr Ste 340 Tampa, FL 33619 (813) 932-0374 Fax: (813) 931-0658 00 Yrs/130 Yrs Languages: Spanish M-TH 9:00 AM - 6:00 PM Tampa Pathology Lab Provider ID: 6245 5515 N Armenia Ave Tampa, FL 33603 (813) 932-0374 Fax: (813) 931-0658 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM

Magnetic Resonance Imaging Brandon Open MRI Provider ID: 199094 Sapphire Brandon LTD 615 Vonderburg Dr Brandon, FL 33511 (813) 657-5579 Fax: (813) 657-6130 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Mammography Tower Imaging Inc Provider ID: 2000 Bloomingdale Radiology Center 3350 Bell Shoals Rd Brandon, FL 33511 (813) 654-4883 Fax: (813) 676-0339 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Community Diagnostic Center of Bran 500 Vonderburg Dr Ste 111 Brandon, FL 33511 (813) 654-5400 Fax: (813) 436-2882 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:30 PM Tower Imaging Inc Provider ID: 2000 Tower Breast Diagnostic Center Nort 17503 N Dale Mabry Hwy Lutz, FL 33548 (813) 968-4540 Fax: (813) 968-4502 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Tower Breast Diagnostic Center Nort 2716 University Square Dr Tampa, FL 33612 (813) 971-2050 Fax: (813) 972-4888 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 4:30 PM

Tower Imaging Inc Provider ID: 2000 Tower Diagnostic Center Bruce B Dow 3069 Grand Pavilion Dr Tampa, FL 33613 (813) 977-9777 Fax: (813) 977-8222 00 Yrs/130 Yrs Languages: Spanish MF 7:00 AM - 6:00 PM TW 7:00 AM - 8:00 PM TH 7:30 AM - 5:00 PM Sat 8:00 AM - 12:00 PM Tower Imaging Inc Provider ID: 2000 Tower Diagnostic Center South Tampa 2106 S Lois Ave Tampa, FL 33629 (813) 288-8839 Fax: (813) 288-8849 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:00 PM Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Carrolwood 14499 N Dale Mabry Hwy Ste 150 Tampa, FL 33618 (813) 968-6998 Fax: (813) 265-1035 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 5:30 PM Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Habana 4719 N Habana Ave Tampa, FL 33614 (813) 875-3787 Fax: (813) 872-0378 00 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 6:00 PM Sat 7:30 AM - 2:00 PM

Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Riverview 10689 Big Bend Rd Ste 102 Riverview, FL 33579 (813) 672-0608 Fax: (813) 672-0612 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Vascular Ultrasound Services

Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Robertson 414 W Robertson St Brandon, FL 33511 (813) 657-6767 Fax: (813) 879-1809 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

Occupational Therapy

Mobile Diagnostic Cardiovascular Mobile Ultrasound Inc Provider ID: 325061 2605 W Swann Ave Ste 100 Tampa, FL 33609 (813) 962-8350 Fax: (866) 215-7823 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Provider ID: 220015 7109 N Armenia Ave Tampa, FL 33604 (813) 990-8500 Fax: (813) 990-8600 18 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM

Independent Living Inc Provider ID: 150499 6508 Gunn Hwy Tampa, FL 33625 (813) 963-6923 Fax: (813) 264-0768 00 Yrs/21 Yrs MTWTHFSat 8:00 AM - 5:00 PM

Orthotics & Prosthetics Bader Prosthetics Orthotics Provider ID: 222241 Bader Prosthetics Orthotics 125 E Chapman Rd Lutz, FL 33549 (813) 962-6100 Fax: (888) 484-5927 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Mobile Ultrasound Services of Florida Copeland Prosthetics & Provider ID: 1530 Orthotics Mobile Ultrasound Services Provider ID: 304574 Inc Copeland Prosthetics And 720 E Fletcher Ave Ste 101 Research Tampa, FL 33612 8001 N Dale Mabry Hwy Ste (813) 977-3200 101 Fax: (813) 972-5395 Tampa, FL 33614 00 Yrs/130 Yrs (813) 875-3216 M-F 8:00 AM - 0:00 PM Fax: (813) 875-1426 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

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Last update 08/14/2017

Ancillary Providers Hillsborough Orthotics & Prosthetics - Hanger Clinic cont. Provider ID: 134894 Cranial Technologies Inc Provider ID: 980682 14497 N Dale Mabry Hwy Ste 125N Tampa, FL 33618 (305) 596-2744 Fax: (305) 596-7688 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM Express Orthotics and Prosthetics Inc Provider ID: 1254545 Express Orthotics and Prosthetics 3603 W Flora St Ste 102 Tampa, FL 33614 (813) 605-4610 Fax: (813) 605-4612 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Hanger Clinic Provider ID: 134894 1119 Professional Park Dr Brandon, FL 33511 (813) 689-8881 Fax: (813) 689-6434 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Hanger Prosthetics & Orthotics Inc 15043 Bruce B Downs Blvd Tampa, FL 33647 (813) 631-9400 Fax: (813) 931-9445 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Pediatric Orthotic and Prosthetic Servic Provider ID: 1142570 Pediatric Orthotic and Prosthetic S 12502 USF Pine Dr Ste 100 Tampa, FL 33612 (813) 975-7139 Fax: (813) 631-7160 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Tampa Bay Orthopaedic Designs Inc Provider ID: 289990 601 W Robertson St Brandon, FL 33511 (813) 661-9162 Fax: (813) 662-9347 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM

Hanger Clinic Provider ID: 134894 115 S Macdill Ave Tampa, FL 33609 (813) 251-1590 Fax: (813) 251-0642 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Tampa Bay Orthopaedic Designs Inc Provider ID: 289990 812 W MLK Blvd Tampa, FL 33603 (813) 224-0525 Fax: (813) 224-0622 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM

Hanger Clinic Provider ID: 134894 224 S Moon Ave Brandon, FL 33511 (877) 754-6542 Fax: (813) 689-6434 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Westcoast Brace & Limb Provider ID: 550 2727 W Dr MLK Blvd Ste 690 Tampa, FL 33607 (813) 354-0100 Fax: (813) 348-0629 00 Yrs/130 Yrs

Westcoast Brace & Limb Provider ID: 550 5311 E Fletcher Ave Tampa, FL 33617 (813) 985-5000 Fax: (813) 985-4499 00 Yrs/130 Yrs Westcoast Brace & Limb Provider ID: 550 620 Oakfield Dr Brandon, FL 33511 (813) 684-5525 Fax: (813) 653-3730 00 Yrs/130 Yrs World Wide Medical Services Inc Provider ID: 680705 8508 Benjamin Rd Ste D Tampa, FL 33634 (866) 961-0606 Fax: (800) 862-7022 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Physical Therapy Independent Living Inc Provider ID: 150499 6508 Gunn Hwy Tampa, FL 33625 (813) 963-6923 Fax: (813) 264-0768 00 Yrs/21 Yrs MTWTHFSat 8:00 AM - 5:00 PM

Rehabilitation Facility Beth Ingram and Associates Inc Provider ID: 1355 Beth Ingram Therapy Services Inc 1344 W Fletcher Ave Tampa, FL 33612 (813) 961-1666 Fax: (813) 961-1107 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

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Beth Ingram and Associates Inc Provider ID: 1355 Beth Ingram Therapy Services Inc 2111 W Swann Ave A1 Tampa, FL 33606 (813) 251-1618 Fax: (813) 254-1097 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM Beth Ingram and Associates Inc Provider ID: 1355 Beth Ingram Therapy Services Inc 602 Vonderburg Dr Ste 201 Brandon, FL 33511 (813) 653-1149 Fax: (813) 654-6644 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM Cora Health Services Inc Provider ID: 1049894 Cora Rehabilitation Clinics 3248 Lithia Pnecrst Rd Ste 102 Valrico, FL 33596 (813) 662-1366 Fax: (813) 662-1159 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1049894 Cora Rehabilitation Clinics 3633 W Waters Ave Ste 700 Tampa, FL 33614 (813) 932-5119 Fax: (813) 932-5319 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1050613 Cora Rehabilitation Clinics 11754 MLK Blvd E Seffner, FL 33584 (813) 661-8267 Fax: (813) 661-8715 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Hillsborough Rehabilitation Facility cont. Cora Health Services Inc Provider ID: 1050618 Cora Rehabilitation Clinics 3416 S Dale Mabry Hwy Tampa, FL 33629 (813) 837-3060 Fax: (813) 837-3080 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1053446 Cora Health Services Inc DBA Cora R 1513 Sun City Center Plz Ste C Sun City Center, FL 33573 (813) 634-6022 Fax: (813) 634-6053 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1054474 Cora Rehabilitation Clinics 10610 N 56th St Tampa, FL 33617 (813) 983-0440 Fax: (813) 983-8110 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1084467 Cora Rehabilitation Clinics 14460 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-5255 Fax: (813) 977-5205 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Total Therapy Provider ID: 582857 7243 US Hwy 301 S Ste A Riverview, FL 33578 (813) 663-9828 Fax: (813) 677-5029 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM

True Blue Therapy LLC Provider ID: 1063082 1097 E Brandon Blvd Brandon, FL 33511 (813) 404-4878 Fax: (813) 655-2622 00 Yrs/21 Yrs Languages: Spanish, Portuguese M-F 8:00 AM - 5:00 PM True Blue Therapy LLC Provider ID: 1063082 2530 Ridgetop Way Valrico, FL 33594 (813) 684-9985 Fax: (813) 655-2622 00 Yrs/21 Yrs Languages: Spanish, Portuguese M-F 8:00 AM - 5:00 PM

Skilled Nursing Facility Accentia Health and Rehab Center of Tamp Provider ID: 684782 1818 E Fletcher Ave Tampa, FL 33612 (813) 971-2383 Fax: (813) 971-7708 18 Yrs/130 Yrs Languages: Spanish Brandon Health Rehabilitatio Provider ID: 720195 1465 Oakfield Dr Brandon, FL 33511 (813) 655-0404 00 Yrs/130 Yrs Carrollwood Care Center Provider ID: 21007 15002 Hutchison Rd Tampa, FL 33625 (813) 960-1969 Fax: (813) 960-8510 18 Yrs/130 Yrs Languages: Spanish Central Park Healthcare and Rehabilitati Provider ID: 720227 702 S Kings Ave Brandon, FL 33511 (813) 651-1818 Fax: (813) 654-4252 00 Yrs/130 Yrs

CHC of Brandon Provider ID: 388190 701 Victoria St Brandon, FL 33510 (813) 681-4220 00 Yrs/130 Yrs Languages: Spanish Community Convalescent Center Provider ID: 4644 2202 W Oak Ave Plant City, FL 33563 (813) 754-3761 Fax: (813) 754-5301 18 Yrs/130 Yrs Languages: Spanish Excel Care Center Provider ID: 349288 2811 Campus Hill Dr Tampa, FL 33612 (813) 972-9700 Fax: (813) 979-2494 50 Yrs/110 Yrs Fletcher Health and Rehabilitation Center Provider ID: 720420 518 W Fletcher Ave Tampa, FL 33612 (813) 265-1600 Fax: (813) 964-0505 00 Yrs/130 Yrs Languages: Spanish, Creole Habana Health Care Center

John Knox Med Center Provider ID: 178515 Baycare Health Systems 4100 E Fletcher Ave Tampa, FL 33613 (813) 632-2455 Fax: (813) 632-2456 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Manor Care of Carrollwood #443 Provider ID: 171249 Manor Care Health Services 3030 W Bearss Ave Tampa, FL 33618 (813) 968-8777 Fax: (813) 961-5189 00 Yrs/130 Yrs Palm Garden of Sun City Center Provider ID: 700909 3850 Upper Creek Dr Sun City Center, FL 33573 (813) 633-2875 Fax: (813) 633-8402 18 Yrs/130 Yrs Palm Garden of Tampa Provider ID: 199550 3612 E 138th Ave Tampa, FL 33613 (813) 972-8775 Fax: (813) 978-0680 18 Yrs/130 Yrs Languages: Spanish

Rehabilitation & Healthcare Center of Tampa Provider ID: 4381 4411 N Habana Ave Tampa, FL 33614 (813) 872-2771 Fax: (813) 871-2831 Hawthorne Health And Rehab 18 Yrs/130 Yrs of Brandon Solaris Healthcare Plant City Provider ID: 704168 851 W Lumsden Rd Brandon, FL 33511 Provider ID: 163477 (813) 661-8998 Managed Care Consultants LLC Fax: (813) 661-3725 701 N Wilder Rd 40 Yrs/130 Yrs Plant City, FL 33566 Languages: Spanish (813) 752-3611 Fax: (813) 659-3119 18 Yrs/130 Yrs Languages: Spanish Provider ID: 193366 2916 Habana Way Tampa, FL 33614 (813) 876-5141 Fax: (813) 876-5233 00 Yrs/130 Yrs

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Last update 08/14/2017

Ancillary Providers Hillsborough Skilled Nursing Facility cont. South Tampa Health and Rehab Center Provider ID: 521934 4610 S Manhattan Ave Tampa, FL 33611 (813) 839-5311 Fax: (813) 839-4728 00 Yrs/130 Yrs Languages: Spanish Sovereign Healthcare of Tampa LLC DBA Ba Provider ID: 167873 Bayshore Pointe Nursing and Rehab C 3117 W Gandy Blvd Tampa, FL 33611 (813) 261-5500 Fax: (813) 261-5555 21 Yrs/130 Yrs The Home Association Provider ID: 294628 1203 E 22nd Ave Tampa, FL 33605 (813) 229-6901 Fax: (813) 229-6944 00 Yrs/130 Yrs The Nursing Center At University Village Provider ID: 413047 12250 N 22nd St Tampa, FL 33612 (813) 972-8001 Fax: (813) 972-8081 00 Yrs/130 Yrs Whispering Oaks Provider ID: 655692 1514 E Chelsea St Tampa, FL 33610 (813) 238-6406 Fax: (813) 238-8232 18 Yrs/130 Yrs Woodbridge Rehab & Health Center Provider ID: 146899 8720 Jackson Springs Rd Tampa, FL 33615 (813) 885-6053 Fax: (813) 882-0111 16 Yrs/130 Yrs

Urgent Care Center 1st Care Medical Provider ID: 814356 799 W Lumsden Rd Brandon, FL 33511 (813) 684-1199 Fax: (813) 685-2687 00 Yrs/130 Yrs Languages: Spanish M-F 10:00 AM - 10:00 PM A Plus Family Urgent Care, LLC Provider ID: 1271468 Aplus Family Urgent Care 3345 S Dale Mabry Hwy Tampa, FL 33629 (813) 234-0100 Fax: (813) 234-0115 00 Yrs/130 Yrs Languages: Spanish MTWTHFSatSun 10:00 AM 10:00 PM After Hours Pediatrics Practices Inc Provider ID: 216599 After Hours Pediatrics Practices In 131 W Robertson St Brandon, FL 33511 (813) 655-8880 Fax: (813) 643-8222 00 Yrs/00 Yrs M-F 5:00 AM - 11:00 PM Sat-Sun 1:00 AM - 11:00 PM After Hours Pediatrics Practices Inc Provider ID: 216599 After Hours Pediatrics Practices In 3294 Cove Bend Dr Tampa, FL 33613 (813) 910-8888 Fax: (813) 971-9514 00 Yrs/00 Yrs M-F 5:00 AM - 11:00 PM Sat-Sun 1:00 AM - 11:00 PM

After Hours Pediatrics Practices Inc Provider ID: 216599 After Hours Pediatrics Practices In 3838 W Neptune St Ste D6 Tampa, FL 33629 (813) 254-4209 Fax: (813) 254-4239 00 Yrs/00 Yrs M-F 5:00 AM - 11:00 PM Sat-Sun 1:00 AM - 11:00 PM

Doctors Walk-In Clinics Provider ID: 324 Med Express Urgent Care 206 E Brandon Blvd Brandon, FL 33511 (813) 681-5571 Fax: (813) 689-8128 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 8:00 AM - 5:30 PM

Doctors Walk-In Clinics Provider ID: 324 Avant Garde Urgent Care LLC Med Express Urgent Care 20677 Bruce B Downs Blvd Tampa, FL 33647 Provider ID: 1201962 Avant Garde Urgent Care, LLC (813) 973-9731 Fax: (813) 973-7886 5112 N Habana Ave 00 Yrs/130 Yrs Tampa, FL 33614 M-F 8:00 AM - 8:00 PM (813) 801-9111 Sat-Sun 8:00 AM - 5:30 PM Fax: (813) 801-9113 00 Yrs/130 Yrs Doctors Walk-In Clinics MTWTHFSatSun 8:00 AM Provider ID: 324 8:00 PM Med Express Urgent Care Boyette Walk In Clinic 22945 State Rd 54 Provider ID: 471931 Lutz, FL 33549 10508 Gibsonton Dr (813) 909-9099 Riverview, FL 33578 Fax: (813) 909-1822 (813) 741-2100 00 Yrs/130 Yrs Fax: (813) 741-2003 M-F 8:00 AM - 8:00 PM 00 Yrs/130 Yrs Sat-Sun 8:00 AM - 5:30 PM M-F 8:00 AM - 8:00 PM Sat-Sun 8:00 AM - 3:00 PM Doctors Walk-In Clinics Provider ID: 324 Doctors Express Med Express Urgent Care Provider ID: 709310 2810 W MLK Blvd 6182 Gunn Hwy Tampa, FL 33607 Tampa, FL 33625 (813) 877-8450 (813) 960-1100 Fax: (813) 877-6513 Fax: (813) 960-1101 00 Yrs/130 Yrs 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Languages: Spanish, Arabic Sat-Sun 8:00 AM - 4:00 PM MTWTHFSatSun 8:00 AM 8:00 PM Doctors Walk-In Clinics Provider ID: 324 Doctors Walk-In Clinics Med Express Urgent Care Provider ID: 324 801 W MLK Blvd Med Express Urgent Care Seffner, FL 33584 13856 N Dale Mabry Hwy (813) 684-4424 Tampa, FL 33618 Fax: (813) 684-0797 (813) 264-1885 00 Yrs/130 Yrs Fax: (813) 968-6438 M-F 8:00 AM - 8:00 PM 00 Yrs/130 Yrs Sat-Sun 8:00 AM - 5:30 PM M-F 8:00 AM - 8:00 PM Sat-Sun 8:00 AM - 5:30 PM

www.wellcare.com/Florida | 621

Last update 08/14/2017

Ancillary Providers Hillsborough Urgent Care Center cont. Doctors Walk-In Clinics Provider ID: 324 Medexpress Urgent Care 13610 Bruce B Downs Blvd Tampa, FL 33613 (813) 977-2777 Fax: (813) 977-3488 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 8:00 AM - 5:30 PM Evening Pediatrics Inc Provider ID: 714238 2550 W. MLK Jr Blvd Ste B Tampa, FL 33607 (813) 876-6483 Fax: (727) 525-1015 00 Yrs/21 Yrs M-F 6:00 AM - 11:00 PM Sat-Sun 11:00 AM - 11:00 PM Express Care of Tampa Bay Provider ID: 285718 6015 Rex Hall Ln Apollo Beach, FL 33572 (813) 641-0068 Fax: (813) 645-3816 00 Yrs/130 Yrs M-F 9:00 AM - 9:00 PM First Care Walk In Clinic LLC Provider ID: 552414 2912 W Waters Ave Tampa, FL 33614 (813) 443-4611 Fax: (813) 443-4754 00 Yrs/130 Yrs Languages: Amharic MTWTHFSat 10:00 AM - 8:00 PM

Late Hours Urgent Care Center Provider ID: 230503 13162 US Hwy 301 S Riverview, FL 33578 (813) 643-9393 Fax: (813) 643-8465 00 Yrs/130 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 10:00 PM Sun 8:00 AM - 6:00 PM Late Hours Urgent Care Center Provider ID: 230503 3444 Lithia Pinecrest Rd Valrico, FL 33596 (813) 643-9393 Fax: (813) 643-8465 00 Yrs/130 Yrs Languages: Spanish MTWTHFSatSun 8:00 AM 10:00 PM

Tampa Urgent Care Provider ID: 1308820 12950 Race Track Rd Ste 106 Tampa, FL 33626 (813) 616-8810 Fax: (813) 616-8809 00 Yrs/130 Yrs Languages: Urdu M-F 8:00 AM - 8:00 PM Sat-Sun 11:00 AM - 5:00 PM Urgent Care USA LLC Provider ID: 343723 413 N Alexander St Plant City, FL 33563 (813) 752-7222 Fax: (813) 752-7255 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Urgent Care USA LLC Provider ID: 343723 5464 Lithia Pinecrest Rd Lithia, FL 33547 (813) 681-2111 Night Owl Pediatrics, PA Fax: (813) 681-2611 Provider ID: 316182 00 Yrs/130 Yrs 10359 Cross Creek Blvd Ste Cd M-F 8:00 AM - 5:00 PM Tampa Palms, FL 33647 Sat-Sun 9:00 AM - 9:00 PM (813) 994-0044 Fax: (813) 994-0055 00 Yrs/130 Yrs M-F 4:00 AM - 11:00 PM Sat-Sun 10:00 AM - 11:00 PM Now Care Walk In Clinic Inc Provider ID: 289361 1009 W Baker St Plant City, FL 33563 (813) 759-1232 Fax: (813) 754-0430 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 5:00 PM Premium Health Services of Tampa Bay Provider ID: 731706 11752 E MLK Blvd Seffner, FL 33584 (813) 641-0068 Fax: (813) 677-5243 00 Yrs/130 Yrs Languages: Spanish MTWTHFSatSun 9:00 AM 9:00 PM

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Last update 08/14/2017

Ancillary Providers Manatee Ambulatory Surgery Center

West Florida Surgery Center Inc Provider ID: 523550 Bradenton Surgery Center Inc West Florida Surgery Center 5817 21st St W Bradenton, FL 34207 Provider ID: 1119645 (941) 794-0379 Bradenton Surgery Center Fax: (941) 798-9905 2902 59th St W Ste F G 21 Yrs/130 Yrs Bradenton, FL 34209 M-F 7:00 AM - 3:00 PM (941) 792-9685 Fax: (941) 757-1377 Diagnostic Imaging 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Bowes Imaging Center LLC Gulf Coast Surgery Center-HCA Columbia Provider ID: 6873 Manatee Surgicare LTD 411 2nd St E Bradenton, FL 34208 (941) 746-1121 Fax: (941) 746-7816 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Healthsouth Surg Center of Braden Provider ID: 149741 Healthsouth 5817 21st Ave W Bradenton, FL 34209 (941) 794-0379 Fax: (941) 798-9905 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Manatee Surgical Center Inc Provider ID: 187360 Manatee Surgical Center LLC 601 Manatee Ave W Bradenton, FL 34205 (941) 745-2727 Fax: (941) 745-2112 00 Yrs/130 Yrs M-F 6:30 AM - 5:00 PM

Provider ID: 880187 6207 Cortez Rd W Bradenton, FL 34210 (941) 782-0490 Fax: (941) 782-0496 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Bowes Imaging Center LLC Provider ID: 880187 62078 Cortez Rd W Bradenton, FL 34210 (941) 782-0490 Fax: (941) 782-0496 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Manatee Diagnostic Center Provider ID: 19756 2211 60th St W Bradenton, FL 34209 (941) 749-1212 Fax: (941) 761-0057 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Manatee Diagnostic Center Provider ID: 19756 300 Riverside Dr E Ste 4300 Bradenton, FL 34208 (941) 747-3034 Fax: (941) 745-5974 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Manatee Diagnostic Center Provider ID: 19756 Manatee Diagnostic 702 Manatee Ave W Bradenton, FL 34205 (941) 749-0660 Fax: (941) 708-3969 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Park South Imaging Center Provider ID: 14468 6215 21st Ave W Ste A Bradenton, FL 34209 (941) 795-4449 Fax: (941) 792-0267 00 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM Partners Imaging Center of Bradenton Provider ID: 549219 Partners Imaging Center of Bradento 5101 4th Ave Cir E Ste 100 Bradenton, FL 34208 (941) 782-0414 Fax: (941) 782-0418 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology Lakewood Ranch 10910 E State Rd 70 Bradenton, FL 34202 (941) 755-5257 Fax: (941) 755-4856 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM

Dialysis BMA of Bradenton Provider ID: 164557 BMA of Florida Inc 5902 Pointe W. Blvd Bradenton, FL 34209 (941) 792-3290 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Bradenton Dialysis Provider ID: 357346 3501 Cortez Rd W Ste 104 Bradenton, FL 34210 (941) 727-4209 Fax: (941) 753-8386 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM FMC North Sarasota Dialysis Center Provider ID: 653602 8037 Cooper Creek Blvd Bradenton, FL 34201 (941) 792-3290 Fax: (941) 794-6798 00 Yrs/130 Yrs M-W 6:00 AM - 4:30 PM FMC Southwest Florida Dialysis Center Provider ID: 432159 Bio-Medical Applications of Florida Inc 520 Manatee Ave E Bradenton, FL 34208 (941) 747-5500 Fax: (941) 748-7879 18 Yrs/130 Yrs MTWTHFSat 6:00 AM - 4:00 PM Gambro Healthcare Provider ID: 148410 520 Manatee Ave E Bradenton, FL 34208 (941) 747-5500 Fax: (941) 748-4849 00 Yrs/130 Yrs

Durable Medical Equipment Hoveround Corporation Provider ID: 1189273 2151 Whitfield Industrial Way Sarasota, FL 34243 (941) 739-6200 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Manatee Durable Medical Equipment - cont.

Home Health Care

A Life At Home Manatee County Rural Health Provider ID: 1414954 Services,Inc A Life At Home Home Health Care Provider ID: 301386 3934 E State Rd 64 1312 Manatee Ave S East Manatee Healthcare Center Bradenton, FL 34208 Bradenton, FL 34208 (941) 747-9922 (941) 708-8700 Fax: (941) 747-9944 Fax: (941) 708-8738 21 Yrs/130 Yrs 00 Yrs/130 Yrs Assisting Hands Gulf Coast MTWTHFSat 8:00 AM - 8:00 Provider ID: 1418068 PM 4916 26th St W Ste 105 Sun 12:00 AM - 8:00 PM Bradenton, FL 34207 Manatee County Rural Health (941) 444-2709 Services,Inc Fax: (813) 867-4544 Provider ID: 301386 18 Yrs/130 Yrs 1515 26th Ave E Lawton Chiles Languages: Spanish, French, Children & Family Hlthcare Creole Bradenton, FL 34208 M-F 9:00 AM - 5:00 PM (941) 708-8700 Fusion Healthcare Fax: (941) 708-7645 Provider ID: 1263675 00 Yrs/130 Yrs 324 8th Ave W Ste 103 M-F 8:00 AM - 8:00 PM Palmetto, FL 34221 Hearing Aid Supplier (941) 721-0003 Fax: (941) 721-0023 Perry, Elizabeth Had 18 Yrs/110 Yrs Provider ID: TPV09098-04 M-F 8:00 AM - 5:00 PM Gender: Female Hospice HearUSA 5602 Cortez Rd W Tidewell Hospice Inc Bradenton, FL 34210 Provider ID: 400833 (941) 761-3044 2504 34th Ave W Fax: (941) 761-8554 Bradenton, FL 34205 21 Yrs/99 Yrs (941) 782-4900 M-F 9:00 AM - 5:00 PM Fax: (941) 926-4883 Perry, Elizabeth Had 00 Yrs/130 Yrs Provider ID: TPV09098-05 Tidewell Hospice Inc Gender: Female Provider ID: 400833 HearUSA 3355 26th St W 5602 Cortez Rd W Bradenton, FL 34205 Bradenton, FL 34210 (941) 782-4900 (941) 761-3044 Fax: (941) 926-4883 Fax: (941) 761-8554 00 Yrs/130 Yrs 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Tidewell Hospice Inc Provider ID: 400833 4151 37th St E Palmetto, FL 34221 (941) 845-3033 Fax: (941) 926-4883 00 Yrs/130 Yrs

Tidewell Hospice Inc Provider ID: 400833 6310 Capital Dr Ste 100 Bradenton, FL 34202 (941) 894-1777 Fax: (941) 926-4883 00 Yrs/130 Yrs Tidewell Hospice Inc Provider ID: 400833 8330 Lakewood Ranch Blvd Lakewood Ranch, FL 34202 (941) 552-5947 Fax: (941) 926-4883 00 Yrs/130 Yrs

Mammography Blake Imaging LLC Provider ID: 319092 2010 59th St W Ste 1500 Bradenton, FL 34209 (941) 792-6611 Fax: (941) 798-6209 00 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM Bradenton Card Mngt Services Provider ID: 166084 Manatee Memorial Hospital 206 2nd St E Bradenton, FL 34208 (941) 745-7391 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Partners Imaging Center of Bradenton Provider ID: 549219 Partners Imaging Center of Bradento 5101 4th Ave Cir E Ste 100 Bradenton, FL 34208 (941) 782-0414 Fax: (941) 782-0418 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Orthotics & Prosthetics Bradenton Prosthetics Orthotic Provider ID: 197965 Manatee Prosthetics & Orthotics 535 8th St W Bradenton, FL 34205 (941) 747-5407 Fax: (941) 747-4914 00 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM Hanger Clinic Provider ID: 134894 Hanger Prosthetics and Orthotics 2717 Manatee Ave W Bradenton, FL 34205 (941) 748-2521 Fax: (941) 749-0864 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM

Rehabilitation Facility Childrens Therapy Solutions Inc Provider ID: 240261 3823 SR 64 E Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs Languages: Spanish, Norwegian M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM

Skilled Nursing Facility Braden River Rehabilitation Center LLC Provider ID: 792458 Braden River Rehabilitation Center 2010 Manatee Ave E Bradenton, FL 34208 (941) 747-3706 Fax: (941) 746-6553 18 Yrs/130 Yrs

Last update 08/14/2017

Ancillary Providers Manatee Skilled Nursing Facility cont. Bradenton Health Care Provider ID: 167648 6305 Cortez Rd W Bradenton, FL 34210 (941) 761-3499 00 Yrs/130 Yrs

Surrey Pl Convalescent Center of Bradenton Provider ID: 303143 5525 21st Ave W Bradenton, FL 34209 (941) 795-0448 Fax: (941) 795-3964 18 Yrs/130 Yrs Languages: Spanish

Casa Mora Rehabilitation Extended Care Provider ID: 654376 1902 59th St W Bradenton, FL 34209 (941) 761-1000 Fax: (941) 761-1009 00 Yrs/130 Yrs Greenbriar Nursing & Rehab Provider ID: 201232 210 21st Ave W Bradenton, FL 34205 (941) 747-3786 Fax: (941) 747-3926 00 Yrs/130 Yrs Languages: Spanish, German Heritage Park Care & Rehabilitation Cent Provider ID: 222130 2302 59th St W Bradenton, FL 34209 (941) 792-8480 Fax: (727) 347-6151 18 Yrs/130 Yrs IHS- At Riverfront Provider ID: 26758 IHS 105 15th St E Bradenton, FL 34208 (941) 747-8681 Fax: (941) 747-7091 21 Yrs/130 Yrs LLC of Sarasota Provider ID: 1277651 Life Care Center of Sarasota 8104 Tuttle Ave Sarasota, FL 34243 (941) 360-6411 Fax: (941) 360-6499 50 Yrs/110 Yrs

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Last update 08/14/2017

Ancillary Providers Pasco Ambulatory Surgery Center Bayonet Point Surgery & Endoscopy Center Provider ID: 271463 HCA 14104 Yosemite Dr Port Richey, FL 34667 (727) 869-5040 Fax: (727) 869-5041 00 Yrs/130 Yrs M-F 6:30 AM - 5:00 PM New Port Richey Surgical Center Provider ID: 20082 New Port Richey Surgery Center LTD 9332 SR 54 Ste 100 New Port Richey, FL 34655 (727) 848-0446 M-F 8:00 AM - 5:00 PM New Tampa Surgery Center Provider ID: 361481 2407 Cypress Ridge Blvd Wesley Chapel, FL 33543 (813) 991-7575 Fax: (813) 991-0161 00 Yrs/130 Yrs New Tampa Surgery Center M-F 8:00 AM - 5:00 PM Pediatric Surgery Center LLC Odessa Provider ID: 451091 14111 State Rd 54 Odessa, FL 33556 (813) 343-5690 Fax: (813) 792-1845 00 Yrs/130 Yrs Pediatric Surgery Center LLC Odessa M 7:30 AM - 4:30 PM TWTHF 7:30 AM - 6:00 PM

Suncoast Specialty Surgery Center Provider ID: 409634 4519 US Hwy 19 New Port Richey, FL 34652 (727) 853-1851 Fax: (727) 853-1855 00 Yrs/130 Yrs Suncoast Specialty Surgery Center M-F 9:00 AM - 5:00 PM

Convenient Care Clinic Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 10925 State Rd 54 New Port Richey, FL 34655 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 1929 Bruce B Downs Blvd Wesley Chapel, FL 33544 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 22829 State Rd 54 Land O Lakes, FL 34639 (866) 825-3227 00 Yrs/130 Yrs MTH 9:00 AM - 6:00 PM TWF 9:00 AM - 8:00 PM Sat-Sun 9:30 AM - 5:30 PM

Take Care Health Provider ID: 705179 Take Care Health Services PA 7420 State Rd 54 New Port Richey, FL 34653 (866) 825-3227 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 9:30 AM - 5:30 PM

Diagnostic Imaging Baycare Outpatient Imaging Center Provider ID: 1025767 2102 Trinity Oaks Blvd Trinity, FL 34655 (727) 372-4001 Fax: (727) 372-4065 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Excel Medical Imaging Provider ID: 189582 5626 Gulf Dr New Port Richey, FL 34652 (727) 841-8212 Fax: (727) 841-9589 00 Yrs/130 Yrs Languages: Hindi M-F 8:00 AM - 6:00 PM Morton Plant Mease Diagnostic Cardiology Provider ID: 814346 Morton Plant Mease Diagnostic Cardi 6633 Forest Ave Ste 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Radiology Associates of West Pasco Provider ID: 9855 5539 Marine Pkwy Ste 7 New Prt Rchy, FL 34652 (727) 847-5122 Fax: (727) 846-8549 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM Sat 8:00 AM - 1:00 PM Radiology Associates of West Pasco Provider ID: 9855 7412 Community Ct Hudson, FL 34667 (727) 868-9553 Fax: (727) 846-8549 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM Radiology Associates of West Pasco Provider ID: 9855 Radiology Assoc of West Pasco 7525 SR 52 Hudson, FL 34667 (727) 847-5122 Fax: (727) 842-5150 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology 6900 Gall Blvd Zephyrhills, FL 33542 (813) 783-6736 Fax: (813) 788-4299 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM

Radiology Associates of West Rose Radiology Centers Inc Pasco Provider ID: 9855 Provider ID: 210006 2115 Little Rd Rose Radiology - Trinity New Port Richey, FL 34655 2144 Duck Slough Blvd Ste 102 (727) 844-7008 New Port Richey, FL 34655 Fax: (727) 842-5150 (727) 786-4989 00 Yrs/130 Yrs Fax: (727) 772-7938 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Ancillary Providers Pasco Diagnostic Imaging - cont. Westcoast Radiology LTD Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology - Wesley Chapel 27662 Cashford Cir Wesley Chapel, FL 33544 (813) 788-2500 Fax: (813) 788-4922 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM Tampa Bay Diagnostic Imaging Provider ID: 644450 24828 Hyde Park Blvd Land O Lakes, FL 34639 (813) 388-6837 Fax: (813) 388-6128 00 Yrs/130 Yrs Languages: Spanish, French, Russian, Portuguese M-F 8:00 AM - 4:30 PM Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Wesley Chape 2324 Oak Myrtle Ln Wesley Chapel, FL 33544 (813) 751-0422 Fax: (813) 751-0423 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM West Hernando Diag And MRI Center Provider ID: 9686 Pasco Imaging & Open MRI 7615 Jacque Rd Hudson, FL 34667 (727) 697-0100 Fax: (727) 697-1240 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 9892 Westcoast Radiology 2040 Short Ave Ste 103 Odessa, FL 33556 (727) 835-1450 Fax: (727) 835-1470 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Dialysis Gulf Coast Kidney Center Provider ID: 19995 Physicians Dialysis of America 14153 Yosemite Dr Ste 102 Hudson, FL 34667 (727) 862-0603 Fax: (727) 862-0027 18 Yrs/130 Yrs M-W 6:00 AM - 3:00 PM Gulf Coast Kidney Center-NPR Provider ID: 19562 Gulf Coast Kidney Center 4802 Grand Blvd New Prt Rchy, FL 34652 (727) 848-1274 18 Yrs/130 Yrs MTWTHFSat 6:00 AM - 6:00 PM Gulf Coast Kidney Center-NPR Provider ID: 19562 Gulf Coast Kidney Center Trinity 9332 SR 54 Ste 306 New Port Richey, FL 34655 (727) 848-1274 Fax: (727) 848-7943 18 Yrs/130 Yrs MWF 6:00 AM - 7:00 PM TTH 6:00 AM - 4:00 PM

New Port Richey Kidney Center Provider ID: 186557 Total Renal Care Inc 7421 Ridge Rd Port Richey, FL 34668 (727) 846-8401 Fax: (727) 844-0100 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM TRC Bayonet Point Dialysis Provider ID: 186552 Total Renal Care Inc 14144 Nephron Ln Hudson, FL 34667 (727) 863-5459 Fax: (727) 862-0723 00 Yrs/130 Yrs MTWTHFSat 6:30 AM - 4:00 PM Wesley Chapel Dialysis, LLC Provider ID: 558247 Wesley Chapel Dialysis 2255 Green Hedges Way Wesley Chapel, FL 33544 (813) 973-0153 Fax: (813) 973-0673 18 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM

Durable Medical Equipment Apria Healthcare LLC Provider ID: 1245926 16550 Scheer Blvd Ste 3 Hudson, FL 34667 (727) 868-2617 Fax: (888) 492-0010 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Lincare Inc Provider ID: 918563 14832 US Hwy 19 North Hudson, FL 34667 (727) 697-2663 Fax: (727) 697-3194 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Hearing Aid Supplier Antonucci, Iris Had Provider ID: TPV05578-02 Gender: Female HearUSA 8725 Little Rd. New Port Richey, FL 34654 (727) 372-8046 Fax: (727) 849-2608 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Aponte, Dawn Had Provider ID: TPV16563-02 Gender: Female HearUSA 5139 US Hwy 19 New PT Richey, FL 34652 (727) 849-6076 Fax: (727) 848-2830 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Aponte, Dawn Had Provider ID: TPV16563-03 Gender: Female HearUSA 8725 Little Rd. New Port Richey, FL 34654 (727) 372-8046 Fax: (727) 849-2608 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Ferrone, Damian Had Provider ID: TPV08799-02 Gender: Male HearUSA 7894 Gall Blvd. Zephyrhills, FL 33541 (813) 788-0603 Fax: (813) 788-9242 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Ferrone, Dimitri Had Provider ID: TPV08949-02 Gender: Male HearUSA 7894 Gall Blvd. Zephyrhills, FL 33541 (813) 788-0603 Fax: (813) 788-9242 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Pasco Home Health Care Medicor Healthcare Inc Provider ID: 1123280 33853 State Rd 54 Ste 101 Zephyrhills, FL 33543 (800) 250-4468 Fax: (866) 930-8001 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Visiting Nurse Association of Florida In Provider ID: 1349606 Visiting Nurse Association of Flori 8147 Copernicus Way New Port Richey, FL 34655 (800) 318-0399 Fax: (866) 227-6562 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Sat-Sun 8:00 AM - 4:30 PM

Hospice

Hph Hospice Provider ID: 21043 Hernando Pasco Hospice 6807 Rowan Rd New Port Richey, FL 34653 (727) 848-7160 Fax: (727) 849-9630 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Mammography Tower Imaging Inc Provider ID: 2000 Tower Radiology Center Wesley Chape 2324 Oak Myrtle Ln Wesley Chapel, FL 33544 (813) 751-0422 Fax: (813) 751-0423 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Orthotics & Prosthetics

Gulfside Hospice and Pasco Palliative Ca Provider ID: 1067156 Gulfside Hospice and Pasco Palliati 2061 Collier Pkwy Land O Lakes, FL 34639 (727) 845-5707 Fax: (727) 484-7951 00 Yrs/130 Yrs Languages: Spanish

Advanced Orthopedics and Prosthetics Inc Provider ID: 1068171 Advanced Orthopedics and Prosthetic 5402 Crafts St New Port Richey, FL 34652 (727) 849-5462 Fax: (727) 849-9438 40 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM

Hph Hospice Provider ID: 21043 Hernando Pasco Hospice 12107 Majestic Blvd Hudson, FL 34667 (727) 863-7971 Fax: (727) 868-9261 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Hanger Clinic Provider ID: 134894 8827 Hawbuck St New Port Richey, FL 34655 (727) 375-8196 Fax: (727) 375-9358 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Hph Hospice Provider ID: 21043 Hernando Pasco Hospice 37445 Clinton Ave Dade City, FL 33525 (813) 780-6797 Fax: (352) 521-4078 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Zephyrhills Brace&Limb Provider ID: 171438 Zephyrhills Brace and Limb 6417 Gall Blvd Zephyrhills, FL 33542 (813) 788-6879 Fax: (813) 783-1477 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Physical Therapy Integrated Therapy Alliance Provider ID: 1039970 Integrated Therapy Alliance Inc 5807 Argerian Dr Ste 101 Wesley Chapel, FL 33545 (813) 973-9068 Fax: (866) 542-4710 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Rehabilitation Facility Cora Health Services Inc Provider ID: 1049894 Cora Rehabilitation Clinics 3442 US Hwy 19 Holiday, FL 34691 (727) 841-8160 Fax: (727) 841-8164 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1085999 Cora Rehabilitation Clinics 1940 Bruce Downs Blvd Ste 107 Wesley Chapel, FL 33544 (813) 991-1555 Fax: (813) 991-1515 05 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Ewing and Thomas Inc Provider ID: 162388 5311 Grand Blvd New Prt Rchy, FL 34652 (727) 848-3962 Fax: (727) 848-7028 02 Yrs/130 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 5:00 PM

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The Back To Wellness Center LLC Provider ID: 1058637 The Back To Wellness Center 27454 Cashford Cir Wesley Chapel, FL 33544 (813) 973-4747 Fax: (813) 973-3799 00 Yrs/130 Yrs MW 9:00 AM - 6:00 PM T 9:00 AM - 1:00 PM TH 3:00 AM - 6:30 PM F 9:00 AM - 3:30 PM Therhappy Therapy Services Inc Provider ID: 1046168 Therhappy Therapy Sevices Inc 17933 East Rd Hudson, FL 34667 (727) 688-7442 Fax: (888) 345-5315 00 Yrs/18 Yrs M-F 9:00 AM - 4:00 PM Welch and McLoy Therapy Services PA Provider ID: 1087189 38051 Pasco Ave Dade City, FL 33525 (352) 567-7721 Fax: (727) 847-3107 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Welch and McLoy Therapy Services PA Provider ID: 1087189 6926 Hills Dr New Port Richey, FL 34653 (727) 848-6747 Fax: (727) 847-3107 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM

Skilled Nursing Facility Bear Creek Nursing Center Provider ID: 14773 8041 State Rte 52 Hudson, FL 34667 (727) 863-5488 Fax: (727) 862-9558 00 Yrs/130 Yrs Languages: Spanish, Polish

Last update 08/14/2017

Ancillary Providers Pasco Skilled Nursing Facility cont. CHC of Bayonet Point Provider ID: 419953 8132 Hudson Ave Hudson, FL 34667 (727) 863-3100 00 Yrs/130 Yrs Languages: Spanish Consulate Health Care of New Port Richey Provider ID: 371344 8417 Old County Rd 54 New Port Richey, FL 34653 (727) 376-1585 00 Yrs/130 Yrs Languages: Spanish Heartland of Zephyrhills Provider ID: 433976 Health Care & Retirement Corp 38220 Henry Dr Zephyrhills, FL 33542 (813) 788-7114 Fax: (813) 788-0758 00 Yrs/130 Yrs Heather Hill Nursing Home-Pcs Provider ID: 14784 6630 Kentucky Ave New Port Richey, FL 34653 (727) 849-6939 Fax: (727) 843-0262 00 Yrs/130 Yrs Languages: Spanish, French, Creole Heritage Park Health and Rehabilitation Provider ID: 322525 37135 Coleman Ave Dade City, FL 33525 (352) 567-8615 Fax: (352) 567-1737 18 Yrs/130 Yrs Languages: Spanish

Life Care Center of New Port Richey Provider ID: 230951 7400 Trouble Creek Rd New Prt Rchy, FL 34653 (727) 375-2999 Fax: (727) 569-1667 60 Yrs/130 Yrs

Sleep Diagnostic Studies Care One of Florida LLC Florida Apnea Diagnostics LLC

Provider ID: 348667 Care One of Florida 10435 US Hwy 19 Port Richey, FL 34668 (727) 378-4477 Fax: (727) 378-7755 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 783536 Florida Apnea Diagnostics LLC 2664 Cypress Rdg Blvd Ste 101 Wesley Chapel, FL 33544 (813) 279-5012 Orchard Ridge Rehab & Fax: (813) 907-8931 Nursing 12 Yrs/130 Yrs Provider ID: 179352 Doctors Urgent Care M-F 8:00 AM - 5:00 PM Orchard Ridge Rehab & Provider ID: 984858 Nursing Center Sleep Associates of Florida 2404 US Hwy 19 4927 Voorhees Rd Holiday, FL 34691 New Prt Rchy, FL 34653 (727) 945-0100 Provider ID: 204211 (727) 848-3578 Fax: (727) 945-0133 4508 Mayflower Dr Fax: (727) 842-1514 00 Yrs/130 Yrs New Port Richey, FL 34652 00 Yrs/130 Yrs M-F 9:00 AM - 7:00 PM (727) 849-2500 Sat-Sun 10:00 AM - 4:00 PM Fax: (727) 410-8810 Solaris Healthcare Bayonet 12 Yrs/130 Yrs Point Doctors Walk-In Clinics Languages: Spanish Provider ID: 163466 Provider ID: 324 M-F 9:00 AM 5:30 PM 7210 Beacon Woods Dr Med Express Urgent Care Hudson, FL 34667 Sleep Associates of Florida 8849 SR 52 (727) 863-1521 Hudson, FL 34667 Fax: (727) 863-7951 (727) 863-7150 Provider ID: 204211 00 Yrs/130 Yrs Fax: (727) 863-7248 Sleep Associates of Florida Languages: Spanish 00 Yrs/130 Yrs LLC M-F 8:00 AM - 8:00 PM Southern Pines Healthcare 35780 SR 54 Ste 102 Sat-Sun 8:00 AM - 5:30 PM Center Zephyrhills, FL 33541 (813) 780-1100 Provider ID: 628699 Florida Hospital Centra Care Fax: (813) 569-0105 US Managed Care Services University LLC 12 Yrs/130 Yrs Provider ID: 355950 6140 Congress St Languages: Spanish Florida Hospital Centra Care New Port Richey, FL 34653 M-F 9:00 AM - 5:30 PM Mount (727) 842-8402 1127 Bruce B Downs Blvd Urgent Care Center Fax: (727) 841-8060 Wesley Chapel, FL 33544 00 Yrs/130 Yrs (813) 973-2889 After Hours Pediatrics Fax: (813) 907-2173 Trinity Regional Rehab Center Practices Inc 00 Yrs/130 Yrs Provider ID: 216599 Languages: Spanish, Creole After Hours Pediatrics Provider ID: 506833 M-F 8:00 AM - 8:00 PM Practices In 2144 Welbilt Blvd Sat-Sun 8:00 AM - 5:00 PM 5400 Little Rd Trinity, FL 34655 New Port Richey, FL 34655 (727) 859-4100 (727) 203-8969 Fax: (757) 859-4150 Fax: (727) 203-8973 00 Yrs/130 Yrs 00 Yrs/00 Yrs Languages: Spanish M-F 5:00 AM - 11:00 PM Sat-Sun 1:00 AM - 11:00 PM

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Last update 08/14/2017

Ancillary Providers Pasco Urgent Care Center cont. Florida Hospital Centra Care University Provider ID: 355950 Florida Hospital Centra Care Mount 5504 Gateway Blvd Wesley Chapel, FL 33544 (813) 948-5400 Fax: (813) 907-2173 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 9:00 AM - 5:00 PM Gulf View Medical and Urgent Care Inc Provider ID: 698218 Gulf View Medical and Urgent Care 6329 State Rd 54 New Port Richey, FL 34653 (727) 844-5555 Fax: (727) 844-5550 00 Yrs/130 Yrs MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM Sat 8:00 AM - 4:00 PM Wee Care Clinic Inc Provider ID: 1129155 38184 Medical Center Ave Zephyrhills, FL 33540 (813) 715-2812 Fax: (813) 715-2814 00 Yrs/21 Yrs M-F 3:00 AM - 9:00 PM Your Family Walk In Clinic LLC Provider ID: 1038633 Your Family Walk In Clinic 17929 Hunting Bow Cir Lutz, FL 33558 (813) 792-8555 Fax: (813) 792-0555 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM

www.wellcare.com/Florida | 630

Last update 08/14/2017

Ancillary Providers Pinellas Ambulatory Surgery Center Bayfront Same Day Surgery Center Provider ID: 21041 Bayfront Medical Center 603 7th Ave S Saint Petersburg, FL 33701 (727) 893-6118 Fax: (727) 893-6985 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Belleair Surgi-Center-HCA Columbia Provider ID: 6875 Belleair Surgery Center LTD 1130 Ponce De Leon Blvd Clearwater, FL 33756 (727) 581-4800 Fax: (727) 585-8057 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Carillon Surgery Center LLC Provider ID: 535485 900 Carillon Pkwy Saint Petersburg, FL 33716 (727) 561-2710 Fax: (727) 561-2770 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM C-Med Ambulatory Surgery Center Provider ID: 216142 The Clearwater Orthopaedic ASC 2238 Drew St Clearwater, FL 33765 (727) 724-5653 Fax: (727) 797-5214 00 Yrs/130 Yrs M-F 7:00 AM - 5:00 PM Countryside Surgery Center Provider ID: 6876 Countryside Surgery Center LTD 3291 N McMullen Booth Rd Clearwater, FL 33761 (727) 725-5800 Fax: (727) 797-4002 00 Yrs/130 Yrs M-F 6:00 AM - 5:00 PM

St Petersburg Endoscopy Convenient Care Clinic E Street Endoscopy LLC Center Provider ID: 1096338 Minuteclinic LLC Westcoast Endoscopy Center Provider ID: 332374 St Petersburg Endscopy 616 E St Provider ID: 1129577 Center, LLC Clearwater, FL 33756 15129 Madeira Way 560 Jackson St N Ste 200 (727) 447-0888 Saint Petersburg, FL 33708 Saint Petersburg, FL 33705 Fax: (727) 447-0993 (866) 389-2727 (727) 820-7500 12 Yrs/130 Yrs Fax: (401) 216-3854 Fax: (727) 820-6333 M-F 6:30 AM - 5:00 PM 00 Yrs/130 Yrs 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Largo Surgery LLC DBA West Millenia Surgery Center Sat 9:00 AM - 5:30 PM Bay Surgery C Languages: Hindi, Urdu, Sun 10:00 AM - 5:30 PM Punjabi Provider ID: 1070471 M-F 7:00 AM - 4:00 PM West Bay Surgery Minuteclinic LLC 1401 W. Bay Dr Provider ID: 1129577 Tampa Bay Specialty Surgery Largo, FL 33770 Minuteclinic In CVS/ Center (727) 585-9500 Pharmacy Provider ID: 266587 Fax: (727) 584-1938 1000 E Tarpon Ave Tampa Bay Specialty Surgery 02 Yrs/130 Yrs Tarpon Springs, FL 34689 Center M-F 6:00 AM - 5:00 PM (866) 389-2727 6500 66th St N Sat 7:00 AM - 2:00 PM Fax: (401) 216-3854 Pinellas Park, FL 33781 00 Yrs/130 Yrs North Pinellas Surgery Center (727) 828-1460 M-F 8:30 AM - 7:30 PM Fax: (727) 828-1470 Sat 9:00 AM - 5:30 PM 00 Yrs/130 Yrs Provider ID: 200768 Sun 10:00 AM - 5:30 PM M-F 9:00 AM - 5:00 PM North Pinellas Surgery Center Minuteclinic LLC LLC West Park Surgery Center, LLC 2323 Curlew Rd Ste 5 Provider ID: 1129577 Provider ID: 303502 Dunedin, FL 34698 Minuteclinic In CVS/ 6640 78th Ave N Ste B Pharmacy (727) 771-8333 Pinellas Park, FL 33781 2175 Main St Fax: (727) 771-8844 (727) 287-0650 Dunedin, FL 34698 00 Yrs/130 Yrs Fax: (727) 549-0610 (866) 389-2727 North Pinellas Surgery Center 00 Yrs/130 Yrs Fax: (401) 216-3854 Languages: Spanish M-F 6:30 AM - 5:00 PM 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM M-F 8:30 AM - 7:30 PM Birthing Center St Anthonys Physicians Sat 9:00 AM - 5:30 PM Surgery Countryside Birthing Place Inc Sun 10:00 AM - 5:30 PM Provider ID: 449634 Minuteclinic LLC 705 16th St N Provider ID: 196845 Saint Petersburg, FL 33705 Provider ID: 1129577 3060 Jones Ln (727) 550-4500 Minuteclinic In CVS/ Clearwater, FL 33759 Pharmacy Fax: (727) 550-4501 (727) 796-7502 30387 US Hwy 19 N 00 Yrs/130 Yrs Fax: (727) 796-7072 Clearwater, FL 33761 M-F 9:00 AM - 5:00 PM 12 Yrs/130 Yrs (866) 389-2727 Languages: Spanish Fax: (401) 216-3854 MTWTHFSatSun 9:00 AM 00 Yrs/130 Yrs 8:00 PM M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM

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Last update 08/14/2017

Ancillary Providers Pinellas Convenient Care Clinic - Take Care Health cont. Provider ID: 705179 Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 3501 54th Ave S Saint Petersburg, FL 33711 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 3771 Tampa Rd Oldsmar, FL 34677 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 8001 9th St N Saint Petersburg, FL 33702 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 8905 Bryan Dairy Rd Largo, FL 33777 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM

33670 US Hwy 19 N Palm Harbor, FL 34684 (855) 925-4733 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Take Care Health Provider ID: 705179 Healthcare Clinic At Select Walgree 710 Welch Cswy Madeira Beach, FL 33708 (800) 935-9935 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 1477 Main St Dunedin, FL 34698 (866) 825-3227 00 Yrs/130 Yrs MWF 9:00 AM - 8:00 PM TTH 9:00 AM - 6:00 PM Sat-Sun 9:30 AM - 5:30 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 1801 Gulf To Bay Blvd Clearwater, FL 33765 (866) 825-3227 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 9:30 AM - 5:30 PM Take Care Health Provider ID: 705179 Take Care Health Services PA 3851 4th St N Saint Petersburg, FL 33703 (866) 825-3227 00 Yrs/130 Yrs MTF 8:00 AM - 8:00 PM WTH 8:00 AM - 6:00 PM Sat-Sun 9:30 AM - 5:30 PM

Take Care Health Provider ID: 705179 Take Care Health Services PA 6560 Ulmerton Rd Largo, FL 33771 (866) 825-3227 00 Yrs/130 Yrs M-W 8:00 AM - 8:00 PM THF 8:00 AM - 6:00 PM Sat-Sun 9:30 AM - 5:30 PM

Carlisle Imaging Center

Take Care Health Provider ID: 705179 Take Care Health Services PA 900 49th St N Saint Petersburg, FL 33710 (866) 825-3227 00 Yrs/130 Yrs MTH 8:00 AM - 6:00 PM TWF 8:00 AM - 8:00 PM Sat-Sun 9:30 AM - 5:30 PM

Gateway Radiology At McEr

Diagnostic Imaging Baycare Outpatient Imaging Provider ID: 269736 900 Carillon Pkwy Saint Petersburg, FL 33716 (727) 561-2300 Fax: (727) 820-7600 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Baycare Outpatient Imaging Provider ID: 811905 620 10th St N Saint Petersburg, FL 33705 (727) 502-4200 Fax: (727) 734-6462 00 Yrs/130 Yrs M-F 6:30 AM - 5:00 PM Baycare Outpatient Imaging Center Provider ID: 1025767 8787 Bryan Dairy Rd Largo, FL 33777 (727) 394-5900 Fax: (727) 394-5170 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

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Provider ID: 226985 400 Pinellas St Ste 101 Clearwater, FL 33756 (727) 462-7514 Fax: (727) 462-7613 00 Yrs/130 Yrs Languages: Spanish, Greek M-F 6:00 AM - 11:00 PM

Provider ID: 1223189 PM Radiology, Pl DBA Gateway Radilo 23607 US Hwy 27 Lake Wales, FL 33589 (863) 949-4949 Fax: (863) 949-4828 02 Yrs/130 Yrs Languages: Spanish, Hindi, Gujarati M-F 8:00 AM - 5:00 PM Gateway Radiology Consultants Provider ID: 7514 2100 1st Ave S Saint Petersburg, FL 33712 (727) 525-2121 Fax: (727) 526-5872 02 Yrs/130 Yrs Languages: Spanish, Hindi, Gujarati, Hungarian M-F 7:00 AM - 5:00 PM Gateway Radiology Consultants Provider ID: 7514 4800 Park Blvd N Pinellas Park, FL 33781 (727) 525-2121 Fax: (727) 526-5876 02 Yrs/130 Yrs Languages: Spanish, Hindi, Gujarati, Hungarian M-TH 7:00 AM - 7:00 PM F 7:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM

Last update 08/14/2017

Ancillary Providers Pinellas Diagnostic Imaging - cont. Palm Harbor MRI Med Specialist Imaging Provider ID: 437920 1064 Keene Rd Dunedin, FL 34698 (727) 733-9202 Fax: (727) 733-9233 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Morton Plant Mease Diagnostic Cardiology Provider ID: 814346 Morton Plant Mease Diagnostic Cardi 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 724-0425 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Morton Plant Mease Diagnostic Cardiology Provider ID: 814346 Morton Plant Mease Diagnostic Cardi 455 Pinellas St Ste 330 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 724-0425 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM MRI Associates of St Pete Provider ID: 28667 750 94th Ave N Ste 206 Saint Petersburg, FL 33702 (727) 577-2220 Fax: (727) 577-7230 05 Yrs/130 Yrs Languages: Spanish M-F 6:00 AM - 10:00 PM Sat 8:00 AM - 4:00 PM Open MRI of Pinellas Inc Provider ID: 315970 9555 Seminole Blvd Ste 101 Seminole, FL 33772 (727) 398-5999 Fax: (727) 398-1990 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

Provider ID: 28665 32615 US Hwy 19 N Ste 4 Palm Harbor, FL 34684 (727) 787-6900 Fax: (727) 785-4003 00 Yrs/130 Yrs M-F 6:00 AM - 10:00 PM Sat 8:00 AM - 4:00 PM PET CT Center Provider ID: 328511 1201 5th Ave N Ste 100 Saint Petersburg, FL 33705 (727) 820-7600 Fax: (727) 820-7613 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology - Largo 13787 Belcher Rd S Ste 300 Largo, FL 33771 (727) 531-5444 Fax: (727) 531-1122 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM Rose Radiology Centers Inc Provider ID: 210006 Rose Radiology Boot Ranch 4133 Woodlands Pkwy Palm Harbor, FL 34685 (727) 781-3888 Fax: (727) 781-3881 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM Susan Cheek Needler Breast Center Provider ID: 672943 400 Pinellas St Ste 100 Clearwater, FL 33756 (727) 298-6670 Fax: (727) 298-6699 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 7:00 PM

Vymed Diagnostic Imaging Tampa LLC Provider ID: 528937 6600 66th St N Ste B Pinellas Park, FL 33781 (727) 544-1001 Fax: (727) 471-2197 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Westcoast Radiology LTD Provider ID: 9892 Westcoast Radiology 3451 66th St N Ste B Saint Petersburg, FL 33710 (727) 347-4674 Fax: (727) 344-0144 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Westcoast Radiology LTD Provider ID: 9892 Westcoast Radiology 36463 US Hwy 19 N Palm Harbor, FL 34684 (727) 771-2795 Fax: (727) 786-7265 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Westcoast Radiology LTD Provider ID: 9892 Westcoast Radiology 501 S Lincoln Ave Ste 15 Clearwater, FL 33756 (727) 446-6760 Fax: (727) 441-2465 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

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Dialysis American Dialysis Center Inc Provider ID: 347748 American Dialysis Center 446 4th St S Saint Petersburg, FL 33701 (727) 896-5500 Fax: (727) 898-5317 18 Yrs/130 Yrs Languages: Spanish, Polish M-F 5:00 AM - 4:00 PM Bay Breeze Dialysis Provider ID: 186506 Total Renal Care Inc 11550 Ulmerton Rd Largo, FL 33778 (727) 584-4047 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM BMA of Clearwater Provider ID: 164597 BMA of Florida Inc 2565 Enterprise Rd Clearwater, FL 33763 (813) 796-9122 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM FMC Belleair Dialysis Center Provider ID: 569517 617 Lakeview Rd Ste B Clearwater, FL 33756 (727) 441-8590 Fax: (727) 441-8805 18 Yrs/130 Yrs M-W 6:00 AM - 4:30 PM FMC Belleair Home Therapies Provider ID: 649752 617 Lakeview Rd Ste C Clearwater, FL 33756 (727) 441-2913 Fax: (727) 441-4291 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Pinellas Dialysis - cont. FMC Pinellas Park Provider ID: 582278 7910 US Hwy 19 N Pinellas Park, FL 33781 (727) 544-5916 Fax: (727) 546-4216 18 Yrs/130 Yrs MTWTHFSat 6:00 AM - 5:00 PM Gulf Breeze Dialysis Center Provider ID: 179907 1519 Main St Dunedin, FL 34698 (727) 738-4425 Fax: (727) 736-3353 18 Yrs/130 Yrs MTWTHFSat 6:00 AM - 4:30 PM Gulf Breeze Dialysis Center Provider ID: 179907 Total Renal Care Inc 1121 Overcash Dr Dunedin, FL 34698 (727) 738-4425 Fax: (727) 736-3353 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Pinellas West Shore Dialysis Provider ID: 555706 3451 66th St N Ste A Saint Petersburg, FL 33710 (727) 345-8389 Fax: (727) 345-8410 18 Yrs/130 Yrs M-W 8:00 AM - 10:00 PM RAI - 9th Street North - St Petersburg Provider ID: 332961 1101 9th St N Saint Petersburg, FL 33701 (727) 895-1472 Fax: (727) 882-0268 18 Yrs/130 Yrs MTWTHFSat 6:00 AM - 4:00 PM

Austin Respiratory Equipment Elsworth, Thomas Had Inc Provider ID: TPV05591-01 Provider ID: 1126166 Gender: Male Austin Respiratory Equipment, HearUSA Inc 1430 66th St North The 1676 N Belcher Rd Shoppes At Royal Clearwater, FL 33765 Saint Petersburg, FL 33710 (727) 467-0606 (727) 343-3019 Fax: (727) 447-3899 Fax: (727) 345-3738 00 Yrs/130 Yrs 21 Yrs/99 Yrs RAI-US 19 N-Clearwater/Palm M-F 8:30 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Harbor Sat 10:00 AM - 1:00 PM Elsworth, Thomas Had Provider ID: 315567 Mercury Medical 29296 US Hwy 19 N Ste 1 Provider ID: TPV05591-02 Provider ID: 1139288 Clearwater, FL 33761 Gender: Male Mercury Enterprises, Inc DBA (727) 772-9036 HearUSA Mercur Fax: (727) 772-8027 30545 US Hwy 19N 11300 49th St N 00 Yrs/130 Yrs Palm Harbor, FL 34684 Clearwater, FL 33762 M-F 9:00 AM - 9:00 PM (727) 781-1760 (727) 573-7689 Fax: (727) 786-8477 St Petersburg Dialysis Fax: (727) 456-1997 21 Yrs/99 Yrs 00 Yrs/130 Yrs Provider ID: 332557 M-F 9:00 AM - 5:00 PM Languages: Spanish, Greek Dva Renal Healthcare Inc Home Health Care M-F 8:00 AM - 5:00 PM 1117 Arlington Ave N Saint Petersburg, FL 33705 One Source Medical Group Access Home Health Care Inc (727) 896-9026 LLC DBA Preferre Fax: (727) 896-7269 Provider ID: 1151474 Provider ID: 1310432 00 Yrs/130 Yrs 13505 Icot Blvd Ste 209 Preferred Touch Home Care M-F 9:00 AM - 5:00 PM Clearwater, FL 33760 Inc St Petersburg South Dialysis (866) 834-7473 447 3rd Ave N Ste 205 Fax: (877) 490-9111 Saint Petersburg, FL 33701 00 Yrs/130 Yrs (813) 925-1000 Provider ID: 357275 M-F 8:30 AM 5:00 PM Fax: (813) 925-8333 Dva Renal Healthcare Inc 00 Yrs/130 Yrs 2850 34th St S Option Care Languages: Spanish, Russian, Saint Petersburg, FL 33711 Provider ID: 671908 Vietnamese (727) 864-4050 2880 Scherer Dr N Ste 840 Fax: (727) 864-0013 Alere Womens and Childrens 850 00 Yrs/130 Yrs Health Saint Petersburg, FL 33716 M-F 9:00 AM - 5:00 PM (800) 396-2933 Provider ID: 24963 Fax: (727) 592-0050 25400 US 19 N Ste 204 Durable Medical 00 Yrs/130 Yrs Clearwater, FL 33763 Equipment M-F 8:00 AM - 5:00 PM (800) 207-0918 Fax: (727) 532-0333 Alliance Oxygen and Medical Hearing Aid Supplier 12 Yrs/130 Yrs Equipment Languages: Spanish Provider ID: 1131182 Balmick, Reshma Had M-F 9:00 AM - 5:00 PM Alliance Oxygen and Medical Provider ID: TPV08943-01 Equipme Gender: Female 2840 Scherer Dr N Ste 425 HearUSA Saint Petersburg, FL 33716 1430 66th St North The (727) 449-9119 Shoppes At Royal Fax: (727) 449-0764 Saint Petersburg, FL 33710 00 Yrs/130 Yrs (727) 343-3019 M-F 8:00 AM - 5:00 PM Fax: (727) 345-3738 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM RAI Starkey Largo Provider ID: 315572 RAI Care Centers of Florida 12505 Starkey Rd Ste B Largo, FL 33773 (727) 531-8227 Fax: (727) 539-0706 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Last update 08/14/2017

Ancillary Providers Pinellas Home Health Care - cont. Harmony Home Health LLC Best Care Providers Inc Provider ID: 1123734 2401 W. Bay Dr Ste 305 Largo, FL 33770 (727) 223-5969 Fax: (727) 223-5970 00 Yrs/130 Yrs Languages: Spanish MTWTHFSat 9:00 AM - 5:00 PM Brightstar of Pinellas County Provider ID: 1426126 13923 Icot Blvd Ste 807 Clearwater, FL 33760 (727) 828-6030 Fax: (727) 828-6032 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Easy Living Inc. Provider ID: 1141541 Easy Living Inc 1180 Pnc De Leon Blvd Ste 701 Clearwater, FL 33756 (727) 447-5845 Fax: (727) 443-5258 18 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Fusion Healthcare Provider ID: 1266999 10901 Corporate Cir N Ste A Saint Petersburg, FL 33716 (727) 328-8308 Fax: (727) 328-8338 18 Yrs/110 Yrs Languages: Spanish MTWTHFSatSun 8:00 AM 5:00 PM Harmony Home Health LLC Provider ID: 1371543 1099 N McMullen Booth Rd Clearwater, FL 33759 (727) 723-7532 Fax: (727) 797-4733 40 Yrs/130 Yrs

Provider ID: 1371543 13787 Belcher Rd S Ste 220 Largo, FL 33771 (727) 723-7532 Fax: (727) 797-4733 40 Yrs/130 Yrs

Maxim Healthcare Services Inc Provider ID: 1217370 15950 Bay Vista Dr Ste 100 Clearwater, FL 33760 (727) 524-2727 Fax: (727) 530-4673 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Right At Home Central Pinellas Provider ID: 1136294 Florida Concerned Care, LLC 1310 Heather Ridge Blvd Dunedin, FL 34698 (727) 437-4170 Fax: (727) 674-1540 18 Yrs/130 Yrs

Hospice Hospice of The Florida Suncoast Inc Provider ID: 12448 5771 Roosevelt Blvd Clearwater, FL 33760 (727) 586-4432 Fax: (813) 584-9136 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Infusion Therapy Option Care Provider ID: 671908 2880 Scherer Dr N Ste 840 850 Saint Petersburg, FL 33716 (800) 396-2933 Fax: (727) 592-0050 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Mobile Diagnostic Radiance Radiology Provider ID: 841008 Radiance Diaology Inc 37566 US Hwy 19 N Palm Harbor, FL 34684 (727) 934-5500 Fax: (727) 934-5507 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Symphony Diagnostic Services No1 LLC DBA Provider ID: 1030591 13773 Icot Blvd Ste 502 Clearwater, FL 33760 (800) 970-0389 Fax: (727) 442-7851 00 Yrs/130 Yrs Trident Mobile Clinical Services Provider ID: 1043647 Trident Mobile Clinical Services LL 13773 Icot Blvd Ste 502 Clearwater, FL 33760 (800) 786-8015 Fax: (443) 662-4238 00 Yrs/130 Yrs Ultra Healthcare Services Provider ID: 3667 21913 US Hwy 19 N Clearwater, FL 33765 (800) 557-8787 Fax: (727) 669-8589 18 Yrs/130 Yrs

Orthotics & Prosthetics Clearwater Limb & Brace Provider ID: 186747 Clearwater Brace & Limb 516 Lakeview Rd Villa 1 Clearwater, FL 33756 (727) 446-9485 Fax: (727) 449-9393 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Clearwater Prosthetics & Orthotics Provider ID: 197977 In Step Inc 1000 Lakeview Rd Ste 6 Clearwater, FL 33756 (727) 447-2650 Fax: (727) 447-2353 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 4:00 PM Florida Brace & Limb Inc Provider ID: 25524 2445 Tampa Rd Ste H Palm Harbor, FL 34683 (727) 786-0880 Fax: (727) 786-0882 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Florida Brace & Limb Inc Provider ID: 25524 6219 66th St N Pinellas Park, FL 33781 (727) 548-1808 Fax: (727) 548-1945 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Hanger Clinic Provider ID: 134894 1237 S Myrtle Ave Clearwater, FL 33756 (727) 441-8163 Fax: (727) 443-2132 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hanger Clinic Provider ID: 134894 1840 Mease Dr Ste 403 A Safety Harbor, FL 34695 (727) 726-2095 Fax: (727) 726-2602 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Pinellas Orthotics & Prosthetics cont. Hanger Clinic Provider ID: 134894 Hanger Prosthetics & Orthotics East 625 6th Ave S Unit 130 Saint Petersburg, FL 33701 (727) 803-2555 Fax: (727) 823-2060 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Orthotic and Prosthetic Centers Inc Provider ID: 165372 3611 5th Ave N Saint Petersburg, FL 33713 (727) 327-3332 Fax: (727) 327-7304 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM St Petersburg Limb & Brace Provider ID: 9041 1001 37th St N Ste B Saint Petersburg, FL 33713 (727) 321-3900 Fax: (727) 323-9516 00 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 4:00 PM Superior Medical Equipment Plus LLC Provider ID: 962061 821 Clearwater Largo Rd N Largo, FL 33770 (727) 461-5278 Fax: (727) 447-2950 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Westcoast Brace & Limb Provider ID: 550 3343 Tampa Rd Palm Harbor, FL 34684 (727) 785-0100 Fax: (727) 785-7773 00 Yrs/130 Yrs

Physical Therapy Watson Center Provider ID: 163298 6925 112th Cir Ste 103 Largo, FL 33773 (727) 544-4433 Fax: (727) 544-5511 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM

Rehabilitation Facility Cora Health Services Inc Provider ID: 1049894 Cora Rehabilitation Clinics 1944 N Hercules Ave Ste C Clearwater, FL 33763 (727) 797-8100 Fax: (727) 797-8110 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1049894 Cora Rehabilitation Clinics 2130 E Bay Dr Largo, FL 33771 (727) 587-0582 Fax: (727) 587-0583 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1049894 Cora Rehabilitation Clinics 4110 34th St S Saint Petersburg, FL 33711 (727) 867-0737 Fax: (727) 867-0738 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Services Inc Provider ID: 1050624 Cora Rehabilitation Clinics 8601 4th St N Ste 101 Saint Petersburg, FL 33702 (727) 579-7974 Fax: (727) 579-7944 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Cora Rehabilitation Clinics Seminole Provider ID: 1086066 Cora Rehabilitation Clinics Seminol 11224 Park Blvd Seminole, FL 33772 (727) 394-0949 Fax: (727) 394-7031 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Apollo Health and Rehabilitation Center Provider ID: 201233 Apollo Health and Rehabiliation Center 1000 24th St N Saint Petersburg, FL 33713 (727) 323-4711 Fax: (727) 321-5963 00 Yrs/130 Yrs Languages: Spanish

Lamperts Home Therapy Inc.

Bay Pointe Nursing Pavilion

Provider ID: 565161 Lamperts Therapy Group 8254 118th Ave Ste 100 Largo, FL 33773 (727) 541-5304 Fax: (727) 546-8527 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Skilled Nursing Facility Advanced Care Center Provider ID: 1221075 401 Fairwood Ave Clearwater, FL 33759 (727) 797-6480 Fax: (727) 726-4134 00 Yrs/130 Yrs Languages: Spanish, Creole, German Alhambra Health & Rehab Center Provider ID: 247138 7501 38th Ave N Saint Petersburg, FL 33710 (727) 345-9307 00 Yrs/130 Yrs Alpine Health Rehabilitation Center Provider ID: 654372 3456 21st Ave S Saint Petersburg, FL 33711 (727) 327-1988 Fax: (727) 327-7794 00 Yrs/130 Yrs

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Provider ID: 4378 4201 31st St S Saint Petersburg, FL 33712 (727) 867-1104 Fax: (727) 864-4627 18 Yrs/130 Yrs Languages: Spanish Bay Tree Care and Rehabilitation Center Provider ID: 179340 Bay Tree Care and Rehabilitation Center 2600 Highlands Blvd N Palm Harbor, FL 34684 (727) 785-5671 Fax: (727) 787-5486 00 Yrs/130 Yrs Bayside Rehab & Nursing Provider ID: 206841 811 Jackson St N Saint Petersburg, FL 33705 (727) 209-3600 Fax: (727) 821-2453 00 Yrs/130 Yrs Baywood Nursing Center Provider ID: 461290 2000 17th Ave S Saint Petersburg, FL 33712 (727) 821-3544 Fax: (727) 821-0414 18 Yrs/130 Yrs Boca Ciega Center Provider ID: 3454 1414 59th St S Gulfport, FL 33707 (727) 344-4608 Fax: (727) 345-0189 00 Yrs/130 Yrs

Last update 08/14/2017

Ancillary Providers Pinellas Skilled Nursing Facility cont. Bon Secours Maria Manor Nursing Care Cen Provider ID: 1043636 Bon Secour Maria Manor 10300 4th St N Saint Petersburg, FL 33716 (727) 568-1025 Fax: (727) 568-1089 18 Yrs/130 Yrs Languages: Spanish Carrington Place of St Pete Provider ID: 511425 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 (727) 577-3800 Fax: (727) 578-5255 00 Yrs/130 Yrs Languages: Spanish

Countryside Healthcare Center Provider ID: 167552 3825 Countryside Blvd N Palm Harbor, FL 34684 (727) 784-2848 00 Yrs/130 Yrs Languages: Spanish

Gulfport Rehabilitation Center Provider ID: 929300 1430 Pasadena Ave S South Pasadena, FL 33707 (727) 344-8525 Fax: (727) 350-0356 18 Yrs/130 Yrs

Cross Terrace Rehabilitation Center Provider ID: 66446 1351 San Christopher Dr Dunedin, FL 34698 (727) 736-1421 Fax: (727) 738-2765 00 Yrs/130 Yrs

Harbourwood Health & Rehab Center Manor Care of Palm Harbor #386 Provider ID: 377685 549 Sky Harbor Dr Bldg 31 Provider ID: 171273 Clearwater, FL 33759 2851 Tampa Rd (727) 724-6800 Palm Harbor, FL 34684 Fax: (727) 724-6848 (727) 787-4777 18 Yrs/130 Yrs Fax: (727) 784-3256 00 Yrs/130 Yrs Highland Pines Rehab Center Morton Plant Rehab Center Provider ID: 187988 Provider ID: 240982 Baycare Health Systems 1111 S Highland Ave 400 Corbett St Clearwater, FL 33756 Clearwater, FL 33756 (727) 446-0581 (727) 462-7600 Fax: (727) 442-9425 Fax: (727) 298-6064 00 Yrs/130 Yrs 00 Yrs/130 Yrs Lakeside Oaks Care Center North Rehabilitation Center

Egret Cove Provider ID: 627684 550 62nd St S Saint Petersburg, FL 33707 (727) 347-6151 Fax: (727) 347-5683 18 Yrs/130 Yrs

Clear Water Care and Rehabilitation Cent Glen Oaks Health and Provider ID: 976175 Rehabilitation Cent Comprehensive Healthcare of Provider ID: 687490 Clearwa 1100 N Pine St 2055 Palmetto St Clearwater, FL 33756 Clearwater, FL 33765 (727) 442-7106 (727) 461-6613 Fax: (727) 442-7100 Fax: (727) 674-2696 00 Yrs/130 Yrs 00 Yrs/130 Yrs Languages: Spanish Consulate Health Care of Golfview Healthcare Center Safety Harbor Provider ID: 419808 Provider ID: 628789 1410 Dr M L King Jr St US Managed Care Services Safety Harbor, FL 34695 LLC (727) 726-1181 3636 10th Ave N 00 Yrs/130 Yrs Saint Petersburg, FL 33713 Languages: Spanish (727) 323-3611 Consulate Health Care of St Fax: (727) 327-5802 Petersburg 18 Yrs/130 Yrs Provider ID: 419055 9393 Park Blvd Gracewood Rehabilitation Seminole, FL 33777 Provider ID: 423047 (727) 391-2200 8600 US Hwy 19 N 00 Yrs/130 Yrs Pinellas Park, FL 33782 Languages: Spanish (727) 541-7515 Fax: (727) 545-9473 40 Yrs/130 Yrs

Provider ID: 193127 1061 Virginia St Dunedin, FL 34698 (727) 733-4189 Fax: (727) 734-7551 18 Yrs/130 Yrs Largo Rehab and Spa Provider ID: 720882 9035 Bryan Dairy Rd Largo, FL 33777 (727) 395-9619 Fax: (727) 392-7203 00 Yrs/130 Yrs Languages: Spanish Laurellwood Nursing Center Provider ID: 465319 3127 57th Ave N Saint Petersburg, FL 33714 (727) 527-2171 Fax: (727) 522-5929 00 Yrs/130 Yrs

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Lexington Health & Rehab Ctrs Provider ID: 201528 6300 46th Ave N Saint Petersburg, FL 33709 (727) 544-1444 Fax: (727) 545-4089 00 Yrs/130 Yrs Languages: Spanish

Provider ID: 175883 1301 16th St N Saint Petersburg, FL 33705 (727) 898-5119 Fax: (727) 894-7896 00 Yrs/130 Yrs Oak Manor Healthcare & Rehab Center Provider ID: 217145 McCfl Network 3500 Oak Manor Ln Largo, FL 33774 (727) 581-9427 Fax: (727) 581-5786 40 Yrs/130 Yrs Languages: Spanish Palm Garden of Clearwater Provider ID: 199544 3480 N McMullen Booth Rd Clearwater, FL 33761 (727) 786-6697 Fax: (727) 781-0516 18 Yrs/130 Yrs Languages: Spanish

Last update 08/14/2017

Ancillary Providers Pinellas Skilled Nursing Facility cont. Palm Garden of Largo Provider ID: 688126 10500 Starkey Rd Largo, FL 33777 (727) 397-8166 Fax: (727) 319-3704 00 Yrs/130 Yrs Palm Garden of Pinellas- NHC Provider ID: 26699 200 16th Ave SE Largo, FL 33771 (727) 585-9377 Fax: (727) 588-9038 18 Yrs/130 Yrs Languages: Spanish Peninsula Care & Rehab Center Provider ID: 460056 900 Beckett Way Tarpon Springs, FL 34689 (727) 934-0876 Fax: (727) 942-6790 18 Yrs/130 Yrs Personacare At St Petersburg Provider ID: 165863 Vencor Inc 7101 9th St N Saint Petersburg, FL 33702 (727) 527-7231 Fax: (727) 522-2486 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Pinellas Park Care & Rehab Provider ID: 230793 8701 49th St N Pinellas Park, FL 33782 (727) 546-4661 Fax: (727) 545-8783 18 Yrs/130 Yrs Rehabilitation Center of St Petersburg Provider ID: 520755 435 42nd Ave S Saint Petersburg, FL 33705 (727) 822-1871 Fax: (727) 894-0836 18 Yrs/130 Yrs Languages: Spanish

Sabal Palms Health Care Center Provider ID: 930709 Individual 499 Alternate Keene Rd Largo, FL 33771 (727) 586-4211 Fax: (727) 581-1098 00 Yrs/130 Yrs Shore Acres Care Center Provider ID: 28482 United Health Management 4500 Indianapolis St NE Saint Petersburg, FL 33703 (727) 527-5801 Fax: (727) 522-4178 50 Yrs/110 Yrs St Petersburg Nursing and Rehab Provider ID: 284772 521 69th Ave Saint Petersburg, FL 33702 (727) 526-7000 Fax: (727) 527-7270 18 Yrs/130 Yrs St Petersburg Nursing and Rehabilitation Provider ID: 1246528 St Petersburg Nursing and Rehabilit 521 69th Ave Saint Petersburg, FL 33702 (727) 526-7000 Fax: (727) 527-7270 18 Yrs/130 Yrs Languages: Spanish, French, Creole Stratford Court of Palm Harbor Provider ID: 971019 45 Katherine Blvd Palm Harbor, FL 34684 (727) 787-1500 Fax: (727) 786-3269 40 Yrs/130 Yrs Sylvan Health Center Provider ID: 229495 McCfl Network 2770 Regency Oaks Blvd Clearwater, FL 33759 (727) 791-1500 00 Yrs/130 Yrs Languages: Spanish

Wrights Healthcare & Rehab Center Provider ID: 228076 McCfl Network 11300 110th Ave Seminole, FL 33778 (727) 391-9986 Fax: (727) 456-5555 The Abbey Rehabilitation and 18 Yrs/130 Yrs Nursing Languages: Spanish Provider ID: 627635 Sleep Diagnostic Studies 7101 MLK St N Saint Petersburg, FL 33702 Largo Medical Center-Sleep (727) 527-7321 Center 00 Yrs/130 Yrs Provider ID: 164927 The Health and Rehabilitation 201 14th St SW Largo, FL 33770 Centre At (727) 588-5200 Provider ID: 722740 Fax: (727) 588-5907 1820 Shore Dr S 00 Yrs/130 Yrs Saint Petersburg, FL 33707 (727) 384-9300 Urgent Care Center 00 Yrs/130 Yrs Languages: Spanish Afc Urgent Care West Bay Rehab & Nursing Provider ID: 718656 Center 1500 N McMln Bth Rd Ste A1 Provider ID: 179363 A2 Harborside Healthcare Clearwater, FL 33759 3865 Tampa Rd (727) 266-1266 Oldsmar, FL 34677 Fax: (727) 266-1276 (813) 855-4661 18 Yrs/130 Yrs Fax: (813) 854-2129 M-F 8:00 AM - 8:00 PM 00 Yrs/130 Yrs Sat-Sun 9:00 AM - 4:00 PM Tarpon Bayou Center Provider ID: 21249 515 Chesapeake Dr Tarpon Spgs, FL 34689 (727) 934-4629 Fax: (727) 938-6513 18 Yrs/130 Yrs

Westchester Gardens Rehabilitation Care Provider ID: 924956 Westchester Gardens Rehabilitation 3301 N McMullen Booth Rd Clearwater, FL 33761 (727) 785-8335 Fax: (727) 789-0980 18 Yrs/130 Yrs Westminster Suncoast Provider ID: 486280 6909 Dr MLK St South Saint Petersburg, FL 33705 (727) 867-1131 Fax: (727) 864-0154 00 Yrs/130 Yrs Languages: Spanish

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After Hours Pediatrics Practices Inc Provider ID: 216599 After Hours Pediatrics Practices In 3450 E Lake Rd Palm Harbor, FL 34685 (727) 789-8887 Fax: (727) 771-2998 00 Yrs/00 Yrs M-F 5:00 AM - 11:00 PM Sat-Sun 1:00 AM - 11:00 PM Doctors Urgent Care Provider ID: 984858 34621 US Hwy 19 N Palm Harbor, FL 34684 (727) 953-9888 Fax: (727) 945-0133 00 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM Sat-Sun 10:00 AM - 4:00 PM

Last update 08/14/2017

Ancillary Providers Pinellas Urgent Care Center cont. Doctors Walk-In Clinics Provider ID: 324 Med Express Urgent Care 10500 Ulmerton Rd Ste 202 Largo, FL 33771 (727) 518-2273 Fax: (727) 585-6320 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 8:00 AM - 5:30 PM Doctors Walk-In Clinics Provider ID: 324 Medexpress Urgent Care 26812 US Hwy 19 N Clearwater, FL 33761 (727) 799-2727 Fax: (727) 210-0810 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 8:00 AM - 5:30 PM

Healthnow Urgent Care LLC Provider ID: 726227 Healthnow Urgent Care LLC 2086 Gulf To Bay Blvd Clearwater, FL 33765 (727) 462-0100 Fax: (727) 462-0177 00 Yrs/130 Yrs Languages: Spanish, Vietnamese M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Signature Urgent Care Provider ID: 1148691 120 2nd St S Saint Petersburg, FL 33701 (727) 851-9993 Fax: (727) 851-9992 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 4:00 PM

Evening Pediatrics Inc Provider ID: 714238 12190 Seminole Blvd Ste A Largo, FL 33778 (727) 586-6483 Fax: (727) 525-1015 00 Yrs/21 Yrs M-F 6:00 AM - 11:00 PM Sat-Sun 11:00 AM - 11:00 PM Evening Pediatrics Inc Provider ID: 714238 4040 49th St N Saint Petersburg, FL 33709 (727) 526-6483 Fax: (727) 525-1015 00 Yrs/21 Yrs M-TH 6:00 AM - 11:00 PM F 6:00 AM - 1:00 PM Sat-Sun 11:00 AM - 11:00 PM

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Last update 08/14/2017

Ancillary Providers Polk Ambulatory Surgery Center Central Florida Surgicenter Provider ID: 6891 Surgicare of Central Florida 900 Griffin Rd Lakeland, FL 33805 (863) 686-3344 Fax: (863) 686-1711 00 Yrs/130 Yrs Central Florida Surgicenter M-F 9:00 AM - 5:00 PM Davenport Ambulatory Surgery Center LLC Provider ID: 1285356 Davenport Ambulatory Surgery Center 107 Park Place Blvd Davenport, FL 33837 (407) 256-0933 Fax: (863) 419-2821 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 4:30 PM Lakeland Florida Endodba Surgery Center of Lake Provider ID: 314347 3340 Lakeland Hills Blvd Lakeland, FL 33805 (863) 682-3239 Fax: (863) 682-3462 00 Yrs/130 Yrs Lakeland Florida Endodba Surgery Center of Lake M-F 6:00 AM - 5:00 PM Winter Haven Amb Surgical Center Provider ID: 17695 325 Ave B NW Winter Haven, FL 33881 (863) 291-4000 Fax: (863) 298-8312 00 Yrs/130 Yrs M-F 6:00 AM - 5:00 PM

Convenient Care Clinic Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 5010 S Florida Ave Lakeland, FL 33813 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM Minuteclinic LLC Provider ID: 1129577 Minuteclinic In CVS/ Pharmacy 7575 Osceola Polk Line Rd Davenport, FL 33896 (866) 389-2727 Fax: (401) 216-3854 00 Yrs/130 Yrs M-F 8:30 AM - 7:30 PM Sat 9:00 AM - 5:30 PM Sun 10:00 AM - 5:30 PM

Diagnostic Imaging Advanced Technological Radiology Provider ID: 16580 24040 US Hwy 27 Lake Wales, FL 33859 (863) 456-2200 Fax: (863) 295-5719 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Advanced Technological Radiology Provider ID: 16580 Advance Technological Radiology PA 2235 North Blvd W Davenport, FL 33837 (863) 421-8674 Fax: (863) 421-2675 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Advanced Technological Radiology Provider ID: 16580 Advance Technological Radiology PA 315 E Central Ave Winter Haven, FL 33880 (863) 295-5674 Fax: (863) 295-5719 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM MRI Associates of Lakeland LLC Provider ID: 617652 Highland MRI 2946 Lakeland Highlands Rd Lakeland, FL 33803 (863) 510-5944 Fax: (863) 510-5939 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Dialysis Bartow Dialysis Provider ID: 343570 Dva Renal Healthcare Inc 1190 E Church St Bartow, FL 33830 (863) 533-1601 Fax: (563) 533-8144 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Davenport Dialysis Center Provider ID: 364252 Renal Life Link Inc 45597 Hwy 27 Davenport, FL 33897 (863) 419-7408 Fax: (863) 420-9165 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lake Vista Dialysis Provider ID: 669518 3187 US Hwy 98 N Lakeland, FL 33805 (863) 603-2130 Fax: (863) 686-5687 18 Yrs/130 Yrs M-W 6:00 AM - 12:00 PM

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Lake Wales Dialysis Provider ID: 343510 1125 Bryn Mawr Ave Lake Wales, FL 33853 (941) 679-9851 Fax: (941) 679-9856 18 Yrs/130 Yrs MTWTHFSat 6:00 AM - 5:00 PM Lakeland Dialysis Provider ID: 344269 Dva Renal Healthcare Inc 515 E Bella Vista St Lakeland, FL 33805 (863) 688-5463 Fax: (863) 688-7150 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lakeland South Dialysis Provider ID: 342477 4774 S Florida Ave Lakeland, FL 33813 (863) 646-0462 Fax: (863) 647-0802 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Poinciana Dialysis Provider ID: 590724 1002 Cypress Pkwy Kissimmee, FL 34759 (321) 697-5658 Fax: (321) 697-5435 18 Yrs/130 Yrs M-W 6:00 AM - 4:00 PM RAI Sr 60 East Lake Wales Provider ID: 322793 RAI Care Centers of Florida 1344 Hwy 60 E Lake Wales, FL 33853 (615) 661-1100 00 Yrs/130 Yrs M-W 6:00 AM - 7:00 PM Winter Haven Dialysis Provider ID: 355051 1625 Martin Luther King Dr Winter Haven, FL 33881 (949) 930-4400 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Ancillary Providers Polk Dialysis - cont. Winter Haven Dialysis Provider ID: 355051 1625 Unity Way NW Winter Haven, FL 33881 (863) 294-8851 Fax: (863) 294-5212 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Winter Haven South Dialysis Provider ID: 969939 7220 Cypress Gardens Blvd Winter Haven, FL 33884 (863) 324-5040 Fax: (863) 324-8492 18 Yrs/130 Yrs M-F 7:00 AM - 5:00 PM

Durable Medical Equipment Airlife Medical LLC Provider ID: 1129486 Airlife Medical, LLC 205 Main St Auburndale, FL 33823 (863) 965-4410 Fax: (863) 965-4412 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Apria Healthcare LLC Provider ID: 1245926 2325 Commerce Point Dr Ste 150 Lakeland, FL 33801 (863) 665-0308 Fax: (888) 492-0010 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Medi Health Care Inc Provider ID: 1142174 Medi-Health Care 401 Bartow Rd Lakeland, FL 33801 (863) 686-0300 Fax: (863) 683-6218 00 Yrs/130 Yrs Languages: Spanish, Russian, Czech M-F 8:30 AM - 5:00 PM Sat 10:00 AM - 2:00 PM

Medical Systems of Central Florida Inc Provider ID: 1199119 Medical Systems of Central Florida 2416 Lakeland Hills Blvd Lakeland, FL 33805 (863) 683-1170 Fax: (863) 680-1870 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Qualimed Respiratory and Mobility Inc Provider ID: 1127094 Qualimed Respiratory and Mobility 704 3rd St SW Winter Haven, FL 33880 (863) 293-3066 Fax: (863) 293-3036 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Southeastern Medical Supply Inc Provider ID: 1364873 3615 Century Blvd Unit Ste 1 Lakeland, FL 33811 (863) 965-8856 Fax: (863) 551-1777 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Home Health Care Care and Life Home Health Services Provider ID: 1404811 5304 S Florida Ave Ste 441 Lakeland, FL 33813 (863) 940-4938 Fax: (863) 570-5359 00 Yrs/130 Yrs Languages: Spanish MTWTHFSatSun 0:00 AM 24:00 PM

Maxim Healthcare Services Inc Provider ID: 1215289 Maxim Healthcare Services, Inc. 303 S Florida Ave Lakeland, FL 33801 (863) 683-2699 Fax: (863) 686-5648 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Philadelphia Professionals Inc Provider ID: 1421727 Home Health Care Services 1804 E Gary Rd Lakeland, FL 33801 (863) 333-0650 Fax: (863) 333-0649 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM PSA Healthcare Provider ID: 1233084 101 W Main St Ste 121 Lakeland, FL 33815 (863) 583-4953 Fax: (863) 583-4996 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Hospice Compassionate Care Hospice of Central Florida Provider ID: 1365333 Compassionate Care Hospice of Centr 220 S Dixie Dr Haines City, FL 33844 (863) 709-0099 Fax: (863) 709-0077 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:30 AM - 5:00 PM

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Compassionate Care Hospice of Central Florida Provider ID: 1365333 Compassionate Care Hospice of Centr 2393 Ef Griffin Rd Bartow, FL 33830 (863) 709-0099 Fax: (863) 709-0077 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:30 AM - 5:00 PM Compassionate Care Hospice of Central Florida Provider ID: 1365333 Compassionate Care Hospice of Centr 2525 Drane Field Rd Ste 4 Lakeland, FL 33811 (863) 709-0099 Fax: (863) 709-0077 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:30 AM - 5:00 PM Good Shepherd Hospice Inc Provider ID: 996424 105 Arneson Ave Auburndale, FL 33823 (863) 292-4377 Fax: (863) 968-1797 00 Yrs/130 Yrs Languages: Spanish Good Shepherd Hospice Inc Provider ID: 996424 1239 E Main St Bartow, FL 33830 (863) 533-0203 Fax: (863) 519-9683 00 Yrs/130 Yrs Languages: Spanish Good Shepherd Hospice Inc Provider ID: 996424 3450 Lakeland Hills Blvd Lakeland, FL 33805 (863) 583-3300 Fax: (863) 583-3950 00 Yrs/130 Yrs Languages: Spanish

Last update 08/14/2017

Ancillary Providers Polk Hospice - cont. Good Shepherd Hospice Inc Provider ID: 996424 Good Shepherd Hospice 3470 Lakeland Hills Blvd Lakeland, FL 33805 (863) 682-0027 Fax: (863) 682-3006 00 Yrs/130 Yrs Languages: Spanish Vitas Healthcare Corporation of Florida Provider ID: 755923 6850 New Tampa Hwy Ste 600 Lakeland, FL 33815 (877) 534-6774 Fax: (863) 583-7050 00 Yrs/130 Yrs

Orthotics & Prosthetics

Hanger Clinic Provider ID: 134894 Hanger Prosthetics and Orthotics 295 Patterson Rd Ste 102 Haines City, FL 33844 (863) 422-0918 Fax: (863) 422-0941 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Integrity Prosthetics and Orthotics LLC Provider ID: 536913 2606 Lakeland Hills Blvd Lakeland, FL 33805 (863) 937-9200 Fax: (863) 937-9199 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM

Physical Therapy Core Rehabilitation Inc

Hanger Clinic Provider ID: 134894 1205 E Orange St Lakeland, FL 33801 (863) 682-6696 Fax: (863) 682-6796 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Provider ID: 1036299 61 W Central Ave Lake Wales, FL 33853 (863) 678-0705 Fax: (863) 421-2000 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 12:00 PM

Hanger Clinic Provider ID: 134894 215 1st St N Ste 300A Winter Haven, FL 33881 (863) 299-8555 Fax: (863) 293-7243 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Rehabilitation Facility

Hanger Clinic Provider ID: 134894 250 1st St S Winter Haven, FL 33880 (877) 754-6542 Fax: (863) 293-7243 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Beth Ingram and Associates Inc Provider ID: 1355 Beth Ingram Therapy Services Inc 1818 Harden Blvd Lakeland, FL 33803 (863) 683-4726 Fax: (863) 682-1705 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

Central Florida Speech Hearing Center I Provider ID: 1040840 Central Florida Speech and Hearing 3020 Lakeland Highlands Rd Lakeland, FL 33803 (863) 686-3189 Fax: (863) 682-1348 02 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 8:00 AM - 4:00 PM Cora Health Systems Provider ID: 1047699 Cora Rehabilitation Clinics 35902 Hwy 27 Haines City, FL 33844 (863) 421-1777 Fax: (863) 421-7070 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Systems Provider ID: 1047709 Cora Rehabilitation Clinics 3127 US Hwy 98 N Lakeland, FL 33805 (863) 665-8881 Fax: (863) 665-8851 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cora Health Systems Provider ID: 1047729 Cora Rehabilitation Clinics 1601 6th St SE Ste B Winter Haven, FL 33880 (863) 294-0350 Fax: (863) 294-0381 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Physical Therapy Specialists of Pine Cas Provider ID: 1041259 Physical Therapy Specialists 104 Park Place Blvd Davenport, FL 33837 (863) 547-9793 Fax: (863) 547-9794 05 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

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Skilled Nursing Facility Astoria Health and Rehabilitaiton Center Provider ID: 655698 701 Overlook Dr Winter Haven, FL 33884 (863) 318-5000 Fax: (863) 324-7251 00 Yrs/130 Yrs Auburndale Oaks Care and Rehabilitation Provider ID: 1285470 Auburndale Oaks Care and Rehab 919 Old Winter Haven Rd Auburndale, FL 33823 (863) 967-4125 Fax: (863) 551-9407 18 Yrs/130 Yrs Bartow Center Provider ID: 3984 Genesis 2055 E Georgia St Bartow, FL 33830 (863) 533-0578 Fax: (863) 553-0736 18 Yrs/130 Yrs Languages: Spanish Brandywyne Health Care Center Provider ID: 9709 1801 Lake Mariam Dr Winter Haven, FL 33884 (863) 293-1989 Fax: (863) 299-6427 00 Yrs/130 Yrs Consulate Health Care At Lake Parker Provider ID: 367610 2020 W Lake Parker Dr Lakeland, FL 33805 (863) 682-7580 00 Yrs/130 Yrs Languages: Spanish Consulate Health Care of Lakeland Provider ID: 374244 5245 N Socrum Loop Rd Lakeland, FL 33809 (863) 859-1446 00 Yrs/130 Yrs Languages: Spanish

Last update 08/14/2017

Ancillary Providers Polk Skilled Nursing Facility cont. Consulate Health Care of Winter Haven Provider ID: 370361 2701 Lake Alfred Rd Winter Haven, FL 33881 (863) 298-5000 00 Yrs/130 Yrs Languages: Spanish Florida Presbyterian Homes Inc Provider ID: 1200068 16 Lake Hunter Dr Lakeland, FL 33803 (863) 688-5521 Fax: (863) 687-4088 00 Yrs/130 Yrs Languages: Spanish, French M-TH 12:00 AM - 5:00 PM Grace Healthcare of Lake Wales Provider ID: 883010 730 N Scenic Hwy Lake Wales, FL 33853 (863) 676-1512 Fax: (863) 676-6315 00 Yrs/130 Yrs Haines City Health Care Center Provider ID: 541214 409 S 10th St Haines City, FL 33844 (863) 422-8656 Fax: (863) 422-8008 18 Yrs/130 Yrs Languages: Spanish Lake Wales Medical Centers Inc Provider ID: 3974 414 S 11th St Lake Wales, FL 33853 (863) 676-1433 Fax: (863) 676-9323 00 Yrs/130 Yrs

Lakeland Hills Center Provider ID: 3457 Genesis 610 E Bella Vista St Lakeland, FL 33805 (863) 688-8591 Fax: (863) 683-6705 00 Yrs/130 Yrs Languages: Spanish Lakeland Nursing And Rehabilitation Provider ID: 1246534 1919 Lakeland Nursing And Rehabilitation Lakeland, FL 33805 (863) 688-5612 Fax: (863) 687-8870 18 Yrs/130 Yrs Languages: Spanish Life Care Center of Winter Haven Provider ID: 413640 1510 Cypress Gardens Blvd Winter Haven, FL 33884 (863) 318-8646 Fax: (863) 618-0012 21 Yrs/130 Yrs Oakbridge Healthcare Center Provider ID: 720871 3110 Oakbridge Boulvard East Lakeland, FL 33803 (863) 648-4800 00 Yrs/130 Yrs Languages: Spanish Palm Terrace of Lakeland Provider ID: 284762 McCfl Network 1919 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-5612 Fax: (863) 688-1389 18 Yrs/130 Yrs Languages: Spanish

The Groves Center Provider ID: 3456 Genesis 512 S 11th St Lake Wales, FL 33853 (863) 676-8502 Fax: (863) 679-9531 00 Yrs/130 Yrs Wedgewood Healthcare Center Provider ID: 373932 1010 Carpenters Way Lakeland, FL 33809 (863) 815-0488 00 Yrs/130 Yrs

Sleep Diagnostic Studies Mousli, Hasan MD Provider ID: 1355846 Gender: Male Brain and Spine Sleep Institute LL 1120 Carlton Ave Ste 1300 Lake Wales, FL 33853 (863) 676-6383 Fax: (863) 676-3124 05 Yrs/130 Yrs Lake Wales Medical Center Languages: Arabic M-F 8:00 AM - 5:00 PM Mousli, Hasan MD Provider ID: 1355846 Gender: Male Brain and Spine Sleep Institute LL 2250 Osprey Blvd Ste 108 Bartow, FL 33830 (863) 676-6386 Fax: (863) 676-3124 05 Yrs/130 Yrs Lake Wales Medical Center Languages: Arabic M-F 8:00 AM - 5:00 PM

The Crossroads Provider ID: 547643 US Managed Care Services LLC 206 W Orange St Davenport, FL 33837 (954) 927-0508 Fax: (954) 927-3127 18 Yrs/130 Yrs

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Urgent Care Center Doctor Today Urgent Care LLC Provider ID: 715382 700 1st St S Winter Haven, FL 33880 (863) 858-8000 Fax: (863) 291-0500 00 Yrs/130 Yrs Languages: Spanish, Creole, Hindi M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 5:00 PM Doctor Today Urgent Care LLC Provider ID: 715382 Doctor Today Urgent Caqre LLC 4435 US Hwy 98 N Ste A Lakeland, FL 33809 (863) 858-8000 Fax: (863) 858-8005 00 Yrs/130 Yrs Languages: Spanish, Creole, Hindi M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 5:00 PM First Care Winter Haven LLC Provider ID: 316668 First Care Winter Haven PLLC 400 1st St N Winter Haven, FL 33881 (863) 299-2420 Fax: (863) 299-2460 00 Yrs/130 Yrs MTWTHFSat 8:30 AM - 7:00 PM First Help Urgent Care Clinic Provider ID: 60430 235 N Commonwealth Ave Polk City, FL 33868 (863) 984-8000 Fax: (863) 984-8009 00 Yrs/130 Yrs M-F 8:30 AM - 6:30 PM Sat 9:00 AM - 3:00 PM

Last update 08/14/2017

Ancillary Providers Polk Urgent Care Center cont. First Help Urgent Care Clinic Provider ID: 60430 320 1st St S Winter Haven, FL 33880 (863) 299-8485 Fax: (863) 293-8450 00 Yrs/130 Yrs MTWTHFSatSun 8:30 AM 6:30 PM Haines City Hma Urgent Care LLC Provider ID: 1311453 7375 Cypress Gardens Blvd Winter Haven, FL 33884 (863) 325-8185 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Nite Owl Pediatrics Urgent Care MD Provider ID: 324181 3242 S Florida Ave Lakeland, FL 33803 (863) 644-7337 Fax: (863) 904-0398 00 Yrs/130 Yrs MTWTHFSatSun 10:00 AM 10:00 PM Premier Walkin Clinic Provider ID: 706247 Premier Walk In Clinic 5676 S Florida Ave Lakeland, FL 33813 (863) 644-3400 Fax: (863) 619-2400 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Sat 8:00 AM - 2:30 PM

www.wellcare.com/Florida | 644

Last update 08/14/2017

Ancillary Providers Sarasota Ambulatory Surgery Center Aesculapian Surgery Center, LLC Provider ID: 227434 3333 Cattlemen Rd Ste 100 Sarasota, FL 34232 (941) 379-5884 Fax: (941) 379-1760 00 Yrs/130 Yrs Bayview Surgery Center Provider ID: 716276 2800 Bahia Vista St Ste 300 Sarasota, FL 34239 (941) 373-9808 Fax: (941) 373-9818 00 Yrs/130 Yrs M-F 7:00 AM - 4:00 PM Doctors Same Day Surgery Center-HCA Provider ID: 12535 5741 Bee Ridge Rd Ste 105 Sarasota, FL 34233 (941) 342-1303 Fax: (941) 342-1403 00 Yrs/130 Yrs M-F 6:00 AM - 5:00 PM Healthsouth Surg Center of Saras Provider ID: 149758 Healthsouth 983 S Beneva Rd Sarasota, FL 34232 (941) 365-5355 Fax: (941) 953-7080 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Premier Surgery Center of Sarasota Provider ID: 560149 983 S Beneva Rd Sarasota, FL 34232 (941) 365-5355 Fax: (941) 365-6567 00 Yrs/130 Yrs M-F 6:00 AM - 5:00 PM

Sarasota Physicians Surgical Center LLC Provider ID: 665976 Sarasota Physicians Surgical Center 3201 S Tamiami Trl Sarasota, FL 34239 (941) 556-3515 Fax: (941) 556-3522 00 Yrs/130 Yrs M-F 6:00 AM - 5:00 PM

Choice Diagnostic Imaging

Rose Radiology Centers Inc

Provider ID: 554485 5831 Bee Ridge Rd Ste 102 Sarasota, FL 34233 (941) 954-1900 Fax: (941) 342-7847 00 Yrs/130 Yrs M-F 7:30 AM - 11:00 PM Sat 8:00 AM - 4:00 PM

Provider ID: 210006 Rose Radiology Sarasota 4917 Clark Rd Sarasota, FL 34233 (941) 927-7711 Fax: (941) 927-7710 00 Yrs/130 Yrs Languages: Spanish, Creole M-F 8:00 AM - 5:00 PM

Partners Imaging Center of Surgery Center At St Andrews Naples Provider ID: 367621 Provider ID: 162872 Partners Imaging Center of 1350 E Venice Ave Sarasota Venice, FL 34285 1250 S Tamiami Trl Ste 103 (941) 488-2030 Sarasota, FL 34239 Fax: (941) 484-2010 (941) 951-2100 02 Yrs/130 Yrs Fax: (941) 951-2110 M-F 7:00 AM - 5:00 PM 05 Yrs/130 Yrs Languages: Spanish Birthing Center M-F 6:00 AM - 6:00 PM Birthways Family Birth Center Partners Imaging of Venice Provider ID: 598531 Birthways Midwifery Care Inc Provider ID: 549204 4222 McIntosh Ln Patners Imaging Center of Sarasota, FL 34232 Venice (941) 366-2229 842 Sunset Lake Blvd Ste 301 Fax: (941) 706-1534 Venice, FL 34292 00 Yrs/130 Yrs (941) 441-0060 M-F 9:00 AM - 5:00 PM Fax: (941) 441-0070 00 Yrs/130 Yrs Rosemary Birthing Home Inc M-F 7:00 AM - 7:00 PM Provider ID: 556915 800 Central Ave Sarasota, FL 34236 (941) 330-9966 Fax: (941) 330-9921 18 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 10:00 AM - 3:00 PM

Diagnostic Imaging Bowes Imaging Center LLC

Partners Imaging of Venice LLC Provider ID: 1169526 Partners Imaging Center of Venice L 842 Sunset Lake Blvd Ste 301 Venice, FL 34292 (941) 441-0060 Fax: (941) 441-0070 00 Yrs/130 Yrs M-F 7:00 AM - 7:00 PM

Provider ID: 880187 3900 Clark Rd Ste P Sarasota, FL 34233 (941) 924-8600 Fax: (941) 924-2300 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Dialysis FMC Sarasota Coastal Dialysis Center Provider ID: 1142358 FMC Sarasota Coastal Dialysis 2989 Fruitville Rd Sarasota, FL 34237 (941) 373-9270 Fax: (941) 954-3598 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Manasota Dialysis Provider ID: 1131240 6960 Professional Pkwy E Units 4 5 Sarasota, FL 34240 (941) 362-2864 Fax: (941) 907-4720 18 Yrs/130 Yrs M-W 6:00 AM - 5:00 PM Palm Breeze Dialysis Provider ID: 582746 Total Renal Care Inc 14942 Tamiami Trl Ste E North Port, FL 34287 (941) 429-0443 Fax: (941) 429-2241 00 Yrs/130 Yrs M-W 8:00 AM - 3:00 PM RAI Care Centers of Sarasota LLC Provider ID: 152049 Dsi Sarasota Dialysis 1921 Waldemere St Ste 107 Sarasota, FL 34239 (941) 917-6444 Fax: (941) 917-6448 18 Yrs/130 Yrs MWF 6:00 AM - 9:00 PM TTHSat 6:00 AM - 4:30 PM

Last update 08/14/2017

Ancillary Providers Sarasota Dialysis - cont. RTC Venice Provider ID: 953452 816 Pinebrook Rd Venice, FL 34285 (941) 486-9057 Fax: (941) 484-9624 18 Yrs/130 Yrs MTWTHFSat 5:00 AM - 3:00 PM

Durable Medical Equipment Alliance Oxygen and Medical Equipment Provider ID: 1131168 Alliance Oxygen and Medical Equipme 4562 McAshton St Unit 11 Sarasota, FL 34233 (941) 926-8090 Fax: (941) 926-8059 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Guardian Medical Inc Provider ID: 1121417 Guardian Medical 4553 Mariotti Ct Ste 102 Sarasota, FL 34233 (941) 923-4447 Fax: (941) 923-4448 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Hearing Aid Supplier Smith, Michael Had Provider ID: TPV08642-02 Gender: Male HearUSA 2650 S. Tamiami Trail Sarasota, FL 34239 (941) 953-4855 Fax: (941) 951-2445 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Home Health Care All Stat Home Health Inc Provider ID: 1131642 8520 S Tamiami Trl Unit 1 Sarasota, FL 34238 (941) 923-0880 Fax: (941) 923-4738 18 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 5:00 PM Family First Homecare LLC Provider ID: 1159479 Family First Homecare, LLC 5310 Clark Rd Ste 206 Sarasota, FL 34233 (941) 444-2432 Fax: (941) 444-2433 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Hoveround Corporation Provider ID: 1189273 6010 Cattleridge Dr Sarasota, FL 34232 (800) 771-6565 Fax: (800) 517-8202 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Fusion Healthcare Provider ID: 1260830 6003 Honore Ave Ste 201 Sarasota, FL 34238 (941) 342-9400 Fax: (941) 342-9403 18 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 5:00 PM

Matrix Medical LLC Provider ID: 1001435 4562 McAshton St Unit 12 Sarasota, FL 34233 (941) 926-1982 Fax: (941) 926-1971 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Matrix Home Care LLC Provider ID: 1124284 1505 Tamiami Trl S Ste 402B Venice, FL 34285 (941) 493-0767 Fax: (877) 670-4785 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

One Key Home Care Florida LLC DBA Firstlight Provider ID: 1361064 Firstlight Homecare of Port Charlot 779 Medical Dr Ste 2 Englewood, FL 34223 (941) 208-3109 Fax: (941) 208-3110 18 Yrs/130 Yrs Right Accord Private Duty Home Health Ca Provider ID: 1418157 Right Accord Private Duty Home Hea 4071 Bee Ridge Rd Ste 201 Sarasota, FL 34233 (941) 366-0801 Fax: (941) 240-2145 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Hospice Tidewell Hospice Inc Provider ID: 400833 12731 Tamiami Trl S North Port, FL 34287 (941) 564-1400 Fax: (941) 926-4883 00 Yrs/130 Yrs Tidewell Hospice Inc Provider ID: 400833 1751 Mound St Sarasota, FL 34236 (941) 487-3100 Fax: (941) 926-4883 00 Yrs/130 Yrs Tidewell Hospice Inc Provider ID: 400833 210 Wexford Blvd Venice, FL 34293 (941) 441-4042 Fax: (941) 926-4883 00 Yrs/130 Yrs Tidewell Hospice Inc Provider ID: 400833 220 Wexford Blvd Venice, FL 34293 (941) 441-2000 Fax: (941) 926-4883 00 Yrs/130 Yrs

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Tidewell Hospice Inc Provider ID: 400833 5955 Rand Blvd Sarasota, FL 34238 (941) 522-7500 Fax: (941) 926-4883 00 Yrs/130 Yrs Tidewell Hospice Inc Provider ID: 400833 5957 Rand Blvd Sarasota, FL 34238 (941) 921-0861 Fax: (941) 926-4883 00 Yrs/130 Yrs

Mammography Choice Diagnostic Imaging Provider ID: 554485 5831 Bee Ridge Rd Ste 102 Sarasota, FL 34233 (941) 954-1900 Fax: (941) 342-7847 00 Yrs/130 Yrs M-F 7:30 AM - 11:00 PM Sat 8:00 AM - 4:00 PM

MRI Open Sarasota Outpatient MRI Provider ID: 147821 Medical Resources LLC 1843 Floyd St Ste 201 Sarasota, FL 34239 (941) 954-0082 Fax: (941) 255-5152 00 Yrs/130 Yrs M-F 6:30 AM - 6:00 PM Sat 8:00 AM - 2:00 PM

Orthotics & Prosthetics Gulf Coast Orthotics Prosthetics Center Provider ID: 906298 Gulf Coast Orthotics and Prosthetic 4120 Woodmere Park Blvd Ste 7 Sarasota, FL 34293 (941) 497-3800 Fax: (941) 497-7775 00 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM

Last update 08/14/2017

Ancillary Providers Sarasota Orthotics & Prosthetics - SMH Sports Medicine Center Consulate Health Care of Sarasota cont. Hanger Clinic Provider ID: 134894 5432 Bee Ridge Rd Ste 100 Sarasota, FL 34233 (941) 377-5765 Fax: (941) 342-0745 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hanger Clinic Provider ID: 134894 802 Pinebrook Rd Venice, FL 34292 (941) 485-1430 Fax: (941) 485-8460 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hanger Clinic Provider ID: 134894 Hanger Prosthetics and Orthotics 1838 Hillview St Sarasota, FL 34239 (941) 365-7588 Fax: (941) 366-8513 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Physical Therapy SMH Sports Medicine Center Provider ID: 26445 1900 Hillview St Sarasota, FL 34239 (941) 917-7600 Fax: (941) 917-7603 05 Yrs/130 Yrs MWF 7:30 AM - 4:30 PM TTH 7:30 AM - 12:00 PM SMH Sports Medicine Center Provider ID: 26445 5880 Rand Blvd Sarasota, FL 34238 (941) 917-5111 Fax: (941) 917-7603 05 Yrs/130 Yrs

Provider ID: 26445 8301 Potter Park Dr Sarasota, FL 34238 (941) 917-7010 Fax: (941) 365-5604 05 Yrs/130 Yrs M-F 7:00 AM - 6:00 PM

Rehabilitation Facility Blackburn Point Ambulatory Car Provider ID: 28403 SMH Physician Services Inc 929 S Tamiami Trl Osprey, FL 34229 (941) 917-4490 Fax: (941) 917-4598 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Suncoast Therapy LLC Provider ID: 1157517 411 Commercial Ct Ste F Venice, FL 34292 (941) 485-0121 Fax: (410) 510-1199 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Skilled Nursing Facility Bay Village of Sarasota Provider ID: 728637 8400 Vamo Rd Sarasota, FL 34231 (941) 966-5611 Fax: (941) 966-4040 00 Yrs/130 Yrs Languages: Spanish Beneva Lakes Healthcare and Rehabilitati Provider ID: 720132 741 S Beneva Rd Sarasota, FL 34232 (941) 957-0310 00 Yrs/130 Yrs

Provider ID: 422760 4783 Fruitville Rd Sarasota, FL 34232 (941) 378-8000 00 Yrs/130 Yrs Languages: Spanish

Harbor Chase of Venice Provider ID: 687995 950 Pinebrook Rd Venice, FL 34285 (941) 484-8801 Fax: (941) 484-3450 18 Yrs/130 Yrs Hawthorne Health and Rehab of Sarasota Provider ID: 913189 5381 Desoto Rd Sarasota, FL 34235 (941) 355-6111 Fax: (941) 355-1750 00 Yrs/130 Yrs Heartland Health Care Sarasota Provider ID: 4664 Health Care & Retirement Corp 5401 Sawyer Rd Sarasota, FL 34233 (941) 925-3427 Fax: (941) 925-8469 00 Yrs/130 Yrs Heritage Health Care Center Provider ID: 167573 1026 Albee Farm Rd Venice, FL 34285 (941) 484-0425 00 Yrs/130 Yrs Languages: Spanish, French, Creole, Italian Kensington Manor Provider ID: 4665 Health Care & Retirement Corp 3250 12th St Sarasota, FL 34237 (941) 365-4185 Fax: (941) 365-4465 00 Yrs/130 Yrs

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Magnolia Health and Rehabilitation Center Provider ID: 192504 1507 S Tuttle Ave Sarasota, FL 34239 (941) 366-0336 00 Yrs/130 Yrs Manor Care Health Services Venice Provider ID: 171279 1450 E Venice Ave Venice, FL 34292 (941) 486-8088 Fax: (941) 488-1276 00 Yrs/130 Yrs Manorcare Health Services Sarasota Bu 53 Provider ID: 171276 5511 Swift Rd Sarasota, FL 34231 (941) 921-7462 00 Yrs/130 Yrs Palmer Ranch Rehab& Healthcare Provider ID: 414555 5111 Palmer Ranch Pkwy Sarasota, FL 34238 (941) 926-7733 Fax: (941) 926-7755 00 Yrs/130 Yrs Languages: Spanish Pinebrook Center Provider ID: 930712 1240 Pinebrook Rd Venice, FL 34285 (941) 488-6733 Fax: (941) 484-7924 00 Yrs/130 Yrs Quality Health of North Port Provider ID: 809034 6940 Outreach Way North Port, FL 34287 (941) 426-8411 Fax: (941) 423-1572 18 Yrs/130 Yrs

Last update 08/14/2017

Ancillary Providers Sarasota Skilled Nursing Facility cont. Sarasota Health Rehab Provider ID: 655695 1524 S East Ave Sarasota, FL 34239 (941) 365-2422 Fax: (941) 952-1756 00 Yrs/130 Yrs Sarasota Memorial Nursing and Rehab Center Provider ID: 26451 1700 S Tamiami Trl Sarasota, FL 34239 (941) 917-6450 Fax: (941) 917-4282 00 Yrs/130 Yrs Sarasota Memorial Nursing and Rehabilita Provider ID: 303134 5640 Rand Blvd Sarasota, FL 34238 (941) 917-4950 Fax: (941) 924-8440 00 Yrs/130 Yrs M-F 8:00 AM - 4:30 PM

The Springs At Lake Pointe Woods Provider ID: 302960 3280 Lake Pointe Blvd Sarasota, FL 34238 (941) 929-2700 Fax: (941) 929-2638 00 Yrs/130 Yrs Languages: Spanish, Polish

Urgent Care Center Doctors Walk-In Clinics Provider ID: 324 Medexpress Urgent Care 5616 Tuscola Blvd North Port, FL 34287 (941) 240-6273 Fax: (941) 240-6428 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Sunnyside Properties of Sarasota Inc Provider ID: 1181130 Sunnyside Properties of Sarasota In 5201 Bahia Vista St Sarasota, FL 34232 (941) 371-2729 Fax: (941) 378-9720 00 Yrs/130 Yrs Sunset Lake Health& Rehab Provider ID: 418433 832 Sunset Lake Blvd Venice, FL 34292 (941) 492-5313 Fax: (941) 492-5315 00 Yrs/130 Yrs Tarpon Point Nursing and Rehabilitation Provider ID: 1079047 5157 Park Club Dr Sarasota, FL 34235 (941) 377-0022 Fax: (941) 379-2819 00 Yrs/130 Yrs

www.wellcare.com/Florida | 648

Last update 08/14/2017

Allied Providers De Soto Family Practice

General Practice

Cetin, Kenan PA Back, Kendra ARNP Provider ID: 1029469 Provider ID: 1007198 Gender: Male Gender: Female Community Care Family Clinic Desoto County Dept of Health 1148 E Gibson St Bldg C 1031 E Oak St Arcadia, FL 34266 Arcadia, FL 34266 (863) 494-6222 (863) 491-7580 Fax: (863) 494-3227 Fax: (863) 491-7598 00 Yrs/130 Yrs 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM Desoto Memorial Hospital Sun 9:00 AM - 5:00 PM Languages: Spanish M-F 7:00 AM - 5:00 PM Kasten, Camille ARNP Cassels, Lewellyn ARNP Provider ID: 1173354 Gender: Female Twin Rivers Medical Center Provider ID: 1007996 888 N Robert Ave Gender: Female Arcadia, FL 34266 Desoto County Dept of (863) 494-8401 Health Fax: (863) 993-7622 1031 E Oak St 00 Yrs/130 Yrs Arcadia, FL 34266 MTWTHSat 8:00 AM - 8:00 (863) 993-4601 PM Fax: (863) 491-7598 F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs M-F 7:00 AM - 5:00 PM Kasten, Camille ARNP Provider ID: 1173356 Folkner, James ARNP Gender: Female Provider ID: 952770 Community Care Family Clinic Gender: Male 1148 E Gibson St Bldg C Desoto Memorial Center For Arcadia, FL 34266 Family H (863) 494-6222 888 N Robert Ave Fax: (863) 494-3227 Arcadia, FL 34266 00 Yrs/130 Yrs (863) 494-8401 MTWTHSat 8:00 AM - 8:00 Fax: (863) 494-5709 PM 00 Yrs/130 Yrs F 8:00 AM - 5:00 PM Languages: Spanish Sun 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Persons, Mylissa PA Provider ID: 1049386 Gender: Female Community Care Family Center 1148 E Gibson St Bldg C Arcadia, FL 34266 (863) 494-6222 Fax: (863) 494-3227 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM

Larson, Danelle ARNP Provider ID: 955592 Gender: Female Desoto Memorial Center For Family H 888 N Robert Ave Arcadia, FL 34266 (863) 494-8401 Fax: (863) 494-5709 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Parsley, Chandra ARNP Provider ID: 1007194 Gender: Female Desoto County Dept of Health 1031 E Oak St Arcadia, FL 34266 (863) 993-4601 Fax: (863) 491-7598 02 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 5:00 PM

Sine, Jennifer ARNP Provider ID: 672992 Gender: Female Arcadia Medical Associates PA 425 Nursing Home Dr Arcadia, FL 34266 (863) 993-2966 Fax: (863) 494-5491 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Mental Health Schackman, Cynthia ARNP

Winston, Beverley ARNP Provider ID: 1007803 Gender: Female Desoto County Dept of Health 1031 E Oak St Arcadia, FL 34266 (863) 491-7580 Fax: (863) 491-7598 00 Yrs/130 Yrs Desoto Memorial Hospital M-F 7:00 AM - 5:00 PM

Infectious Disease Green-Blair, Jean ARNP Provider ID: 1025683 Gender: Female Desoto County Dept of Health 34 S Baldwin Ave Arcadia, FL 34266 (863) 993-4601 Fax: (863) 993-4574 12 Yrs/130 Yrs Desoto Memorial Hospital M-F 9:00 AM - 5:00 PM

Internal Medicine Blackmon, Jennifer ARNP Provider ID: 973619 Gender: Female 425 Nursing Home Dr Arcadia, FL 34266 (863) 993-2966 Fax: (863) 494-5491 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM FSat 8:00 AM - 12:00 PM

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Provider ID: 1181678 Gender: Female Manatee County Rural Health Service 725 N 12th Ave Arcadia, FL 34266 (863) 494-1242 Fax: (863) 491-0466 05 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 4:00 PM

Occupational Therapy Jean, Gerda OT Provider ID: 1042998 Gender: Female Therapeuticfx LLC 1311 E Oak St Arcadia, FL 34266 (863) 491-7055 Fax: (863) 491-7056 00 Yrs/130 Yrs Languages: Creole M-F 9:00 AM - 5:00 PM

Physical Therapy Babilonia, Gerardo PT Provider ID: 1172736 Gender: Male Therapeutic Fx,LLC 1311 E Oak St Arcadia, FL 34266 (863) 491-7055 Fax: (863) 491-7056 02 Yrs/130 Yrs MTWTHFSatSun 9:00 AM 5:00 PM

Last update 08/14/2017

Allied Providers De Soto Speech Therapy Spencer, Kathleen SLP Provider ID: 1093016 Gender: Female Therapeuticfx LLC 1311 E Oak St Arcadia, FL 34266 (863) 491-7055 Fax: (863) 491-7056 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Urology Belilovskiy, Elina ARNP Provider ID: 1224573 Gender: Female 21st Century Oncology LLC DBA Rtr U 830 N Mills Ave Arcadia, FL 34266 (941) 485-3351 Fax: (941) 485-7677 16 Yrs/130 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM

www.wellcare.com/Florida | 650

Last update 08/14/2017

Allied Providers Hardee Family Practice

Wright, Melissa ARNP

Knight, Amelia ARNP Provider ID: 1272029 Gender: Female Central Florida Health Care, Inc. W 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-6946 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 5:30 AM - 5:30 PM

Provider ID: 1122359 Gender: Female Central Florida Health Care, Inc. 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Metts, Huey ARNP Provider ID: 1074534 Gender: Male Central Florida Health Care Inc 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 18 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM

Russell, Laura ARNP Provider ID: 1228759 Gender: Female Central Florida Health Care Wauchu 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 767-0697 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 767-0697 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Wright, Melissa ARNP Provider ID: 1122359 Gender: Female Central Florida Health Care, Inc. 121 K D Revell Rd Wauchula, FL 33873 (863) 767-0696 Fax: (863) 767-0697 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Nurse Midwife

Pediatrics Mathis, Karen PA Provider ID: 719103 Gender: Female Heartland Pediatrics Association of 120 Heartland Way Wauchula, FL 33873 (863) 767-1414 Fax: (863) 767-1763 00 Yrs/21 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:00 PM Mueller Barker, Denise ARNP Provider ID: 658319 Gender: Female Sonnis Pediatrics 1125 S 6th Ave Wauchula, FL 33873 (863) 267-1616 Fax: (863) 767-1619 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Mueller-Barker, Denise ARNP Provider ID: 1000931 Gender: Female Sonnis Pediatrics 1125 S 6th Ave Wauchula, FL 33873 (863) 267-1616 Fax: (863) 767-1619 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Mueller-Battaglia, Denise ARNP Provider ID: 972212 Gender: Female Sonnis Pediatrics 1125 S 6th Ave Wauchula, FL 33873 (863) 767-1616 Fax: (863) 767-1619 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Rivera, Stephanie ARNP Provider ID: 917178 Gender: Female Heartland Pediatrics Association of 120 Heartland Way Wauchula, FL 33873 (863) 767-1414 Fax: (863) 767-1763 00 Yrs/21 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM

Physical Therapy Knight, Carrie PT Provider ID: 614537 Gender: Female Rehab Consutltants 437 Carlton St Wauchula, FL 33873 (863) 773-3317 Fax: (863) 773-3312 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

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Speech Therapy Oliver Fulse, Joyce SLP Provider ID: 765796 Gender: Female J Oliver Speech Pathology Services 107 Hanchey Rd Wauchula, FL 33873 (863) 773-0776 Fax: (863) 773-0597 00 Yrs/21 Yrs M-F 7:00 AM - 6:00 PM

Last update 08/14/2017

Allied Providers Highlands Family Practice Barberet, Leigh ARNP Provider ID: 187888 Gender: Female Central Fla Healthcare 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3060 Fax: (863) 452-3069 00 Yrs/130 Yrs M-F 7:30 AM - 5:30 PM Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 950 County Rd 17A W Avon Park, FL 33825 (863) 452-3000 Fax: (863) 452-3069 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

General Practice Winston, Beverley ARNP Provider ID: 1007803 Gender: Female Highlands County Health Department 7205 S George Blvd Sebring, FL 33875 (863) 238-6604 Fax: (863) 386-6048 00 Yrs/130 Yrs Desoto Memorial Hospital M-F 7:00 AM - 5:00 PM

Internal Medicine Ruch, James PA Provider ID: 925706 Gender: Male 2341 US Hwy 27 S Sebring, FL 33870 (863) 471-3500 Fax: (863) 382-8104 18 Yrs/130 Yrs Highlands Regional Medical Languages: Spanish M-F 9:00 AM - 5:00 PM

Ruch, James PA Provider ID: 925706 Gender: Male Sebring Hma Physician Management LL 3700 Emergency Ln Sebring, FL 33870 (863) 386-4302 Fax: (863) 382-3928 18 Yrs/130 Yrs Highlands Regional Medical Languages: Spanish M-F 9:00 AM - 5:00 PM

Nephrology Campbell, Hannah ARNP

Interventional Cardiology

Provider ID: 909512 Gender: Female Fabio Oliveros Associates PA 130 Medical Center Ave Sebring, FL 33870 (863) 385-2606 Fax: (863) 385-7723 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM

Yantorni, Lauren ARNP

Occupational Therapy

Provider ID: 1344855 Gender: Female Heart and Vascular Institute of Flo 7 Ryant Blvd Sebring, FL 33870 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Licensed Mental Health Counselor Hollywood, Amanda LMHC Provider ID: 930391 Gender: Female Abundance Mental Health Counseling 32313 Broadway St Ste 310 Sebring, FL 33870 (863) 446-2853 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Castelli, Jennifer OT Provider ID: 554391 Gender: Female The Hand Rehabilitation Center of F 123 US Hwy 27 N Sebring, FL 33870 (863) 471-6303 Fax: (863) 471-1251 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Pediatrics Grimes, Amy PA Provider ID: 765904 Gender: Female Avon Park Pediatrics Inc 1571 US Hwy 27 N Avon Park, FL 33825 (863) 453-7337 Fax: (863) 452-9790 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Grimes, Amy PA Provider ID: 788060 Gender: Female Heartland Pediatrics 344 E Royal Palm St Ste 3 Lake Placid, FL 33852 (863) 699-1414 Fax: (863) 699-9790 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM

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Grimes, Amy PA Provider ID: 789684 Gender: Female Sebring Pediatrics 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Sat 8:30 AM - 12:30 PM Mueller Barker, Denise ARNP Provider ID: 658319 Gender: Female 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Mueller Barker, Denise ARNP Provider ID: 658319 Gender: Female Avon Park Pediatrics 1571 US Hwy 27 N Avon Park, FL 33825 (863) 463-7337 Fax: (863) 452-0790 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Mueller Barker, Denise ARNP Provider ID: 658319 Gender: Female Heartland Pediatrics of Lake Placid 344 E Royal Palm St Ste 3 Lake Placid, FL 33852 (863) 696-1414 Fax: (863) 699-9790 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM

Last update 08/14/2017

Allied Providers Highlands Pediatrics - cont. Mueller-Barker, Denise ARNP Provider ID: 1000931 Gender: Female Avon Park Pediatrics 1571 US Hwy 27 N Avon Park, FL 33825 (863) 463-7337 Fax: (863) 452-0790 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Mueller-Barker, Denise ARNP Provider ID: 1000931 Gender: Female Sebring Pediatrics 3201 Medical Way Ste 101 Sebring, FL 33870 (863) 382-0770 Fax: (863) 471-9968 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Mueller-Battaglia, Denise ARNP Provider ID: 975905 Gender: Female Avon Park Pediatrics 1571 US Hwy 27 N Avon Park, FL 33825 (863) 453-7337 Fax: (863) 452-9790 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM

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Last update 08/14/2017

Allied Providers Hillsborough Adolescent Medicine Marcelin, Jackie ARNP Provider ID: 814019 Gender: Female USF Physicians Group 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2311 Fax: (813) 974-7181 00 Yrs/21 Yrs Languages: Spanish, French, Creole M-F 9:00 AM - 5:00 PM

Audiology Oldfield, Christopher AUD Provider ID: TPV17173-04 Gender: Male HearUSA 3669 W. Waters Ave. Tampa, FL 33614 (813) 931-2307 Fax: (813) 931-8664 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Oldfield, Christopher AUD Provider ID: TPV17173-07 Gender: Male HearUSA 729 Cortaro Dr Ste 15 Ruskin, FL 33573 (813) 633-8517 Fax: (813) 633-0922 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Oldfield, Christopher AUD Provider ID: TPV17173-08 Gender: Male HearUSA 807 E Bloomingdale Ave. Brandon, FL 33511 (813) 685-2462 Fax: (813) 685-8162 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Vecchio, Christine AUD Provider ID: TPV09045-04 Gender: Female HearUSA 807 E Bloomingdale Ave. Brandon, FL 33511 (813) 685-2462 Fax: (813) 685-8162 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Wickert, Cecilia AUD Provider ID: TPV04948-01 Gender: Female HearUSA 729 Cortaro Dr Ste 15 Ruskin, FL 33573 (813) 633-8517 Fax: (813) 633-0922 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Wickert, Cecilia AUD Provider ID: TPV04948-02 Gender: Female HearUSA 729 Cortaro Dr Ste 15 Ruskin, FL 33573 (813) 633-8517 Fax: (813) 633-0922 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Cardiology

Bartell, Lisa ARNP Provider ID: 721026 Gender: Female Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Douglas, Jamie PA Provider ID: 377280 Gender: Female University Medical Svc Assoc 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7589 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Elliott, Danielle ARNP Provider ID: 1328346 Gender: Female USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-0600 Fax: (813) 974-4695 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Appler, Bonnie PA Provider ID: 1198505 Gender: Female USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-0600 Fax: (813) 974-4695 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Elliott, Danielle ARNP Provider ID: 1328346 Gender: Female USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Barnes-Murphy, Cheryl ARNP

Gimpelevich, Natalie ARNP

Provider ID: 1034045 Gender: Female Baycare Medical Group 4612 N Habana Ave Fl 2 Tampa, FL 33614 (813) 875-9000 Fax: (813) 874-3278 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Provider ID: 724039 Gender: Female Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Mason, Carol ARNP Provider ID: 285252 Gender: Female USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0600 Fax: (813) 259-8679 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Mudge, Tracie ARNP Provider ID: 717175 Gender: Female Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Paxson, Alicia PA Provider ID: 718181 Gender: Female Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Remo Platt, Elizabeth ARNP Provider ID: 673175 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-0665 18 Yrs/130 Yrs Languages: Tagalog M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Cardiology - cont. Remo Platt, Elizabeth ARNP Provider ID: 673175 Gender: Female USF Physicians Group 509 S Armenia Ave Ste 200 Tampa, FL 33609 (813) 353-1515 Fax: (813) 353-0865 18 Yrs/130 Yrs Languages: Tagalog M-F 8:00 AM - 5:00 PM Wallner, Jean PA Provider ID: 1198510 Gender: Female USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 259-0600 Fax: (813) 974-4695 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

Certified Nurse Midwife Berry, Mattie ARNP Provider ID: 1047543 Gender: Female USF Physicians Group 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Edmondson, Ellen CNM Provider ID: 148135 Gender: Female Womens Care Florida LLC 2818 W Virginia Ave Tampa, FL 33607 (813) 872-8551 Fax: (813) 871-3708 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Edmondson, Ellen CNM Provider ID: 148135 Gender: Female Womens Care Florida LLC 5 Tampa General Cir Ste 650 Tampa, FL 33606 (813) 644-6200 Fax: (813) 304-2427 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Edmondson, Ellen CNM Provider ID: 148135 Gender: Female Womens Care Florida LLC 727 W Fletcher Ave Tampa, FL 33612 (813) 908-2229 Fax: (813) 963-7045 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Glidewell, Gloria CNM Provider ID: 1328350 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8623 12 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Glidewell, Gloria CNM Provider ID: 1328350 Gender: Female USF Physicians Group 5802 N 30th St 3rd Fl Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 12 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM

Kendrick, Elizabeth CNM Provider ID: 804338 Gender: Female USF Physicians Group 2 Tampa General Cir Ste 4000 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Kuebler, Elizabeth CNM Provider ID: 1350629 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8623 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Kuebler, Elizabeth CNM Provider ID: 1350629 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 238-1385 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM McMorris Soucy, Sally CNM Provider ID: 1308810 Gender: Female M and D Care Inc DBA Women's Health 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 8:00 AM - 5:00 PM

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O'Leary, Christina CNM Provider ID: 1322728 Gender: Female Women's Health Care 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Smith, Karla CNM Provider ID: 1296966 Gender: Female M and D Care Inc DBA Women's Health 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Whipple, Judith CNM Provider ID: 1322726 Gender: Female Women's Health Care 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Child Neurology Arroyo, Lizbeth ARNP Provider ID: 981155 Gender: Female Pediatric Epilepsy Neurology Specia 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs Languages: Spanish M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Child Neurology - cont. Fritch, Kristin ARNP Provider ID: 1365951 Gender: Female Pediatric Epilepsy and Neurology SP 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs M-F 7:30 AM - 4:00 PM Green, April ARNP Provider ID: 975663 Gender: Female Pediatric Epilepsy Neurology Specia 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM Soto, Adelene ARNP Provider ID: 1270916 Gender: Female Pediatric Epilepsy and Neurology SP 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs M-TH 7:00 AM - 6:00 PM F 8:00 AM - 5:00 PM

Colon & Rectal Surgery Pitts, Brianne ARNP Provider ID: 1418052 Gender: Female Accelecare Wound Professionals Of K 701 S Howard Ave Ste 106 239 Tampa, FL 33606 (855) 267-4138 Fax: (440) 627-2157 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Dermatology Carpenter, Sandra ARNP Provider ID: 718348 Gender: Female 4915 Ehrlich Rd Tampa, FL 33624 (813) 960-2400 Fax: (813) 960-2410 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Cinquegrano, Amanda ARNP Provider ID: 1289502 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4744 Fax: (813) 974-2132 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Cinquegrano, Amanda ARNP Provider ID: 1289502 Gender: Female USF Physicians Group 17 Davis Blvd Tampa, FL 33606 (813) 974-4744 Fax: (813) 259-8698 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Dare, Erika ARNP Provider ID: 765884 Gender: Female 17 Davis Blvd Ste 402 Tampa, FL 33606 (813) 974-4744 Fax: (813) 259-8698 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Hogue, Nicole ARNP Provider ID: 699420 Gender: Female 17 Davis Blvd Tampa, FL 33606 (813) 974-4744 Fax: (813) 259-8698 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Leto, Melissa PA Provider ID: 495256 Gender: Female USF Physicians Group 12901 Bruce B Downs Blvd Tampa, FL 33612 (813) 974-4744 Fax: (813) 974-2132 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Moran, Robin PA Provider ID: 693218 Gender: Female USF Physicians Group 17 Davis Blvd Ste 402 Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-8698 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

Leto, Melissa PA Provider ID: 495256 Gender: Female USF Physicians Group 17 Davis Blvd Ste 402 Tampa, FL 33606 (813) 974-4744 Fax: (813) 259-8691 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Nelson, Tony PA Provider ID: 919071 Gender: Male 2835 W De Leon St Ste 103 Tampa, FL 33609 (813) 287-0443 Fax: (813) 977-1664 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Leynes, Rebecca PA Provider ID: 1278595 Gender: Female Leavitt Medical Associates of Flori 6919 N Dale Mabry Hwy Ste 325 Tampa, FL 33614 (813) 875-7333 Fax: (813) 875-8833 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Moran, Robin PA Provider ID: 693218 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4744 Fax: (813) 974-2132 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

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Obradovich, Shelia PA Provider ID: 957260 Gender: Female Advanced Dermatology Cosmetic Surg 13142 Elk Mountain Dr Riverview, FL 33579 (813) 287-0443 Fax: (813) 289-3552 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Obradovich, Shelia PA Provider ID: 957260 Gender: Female Advanced Dermatology Cosmetic Surg 14521 University Point Pl Tampa, FL 33613 (813) 977-3600 Fax: (813) 977-1664 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Obradovich, Shelia PA Provider ID: 957260 Gender: Female Leavitt Medial Associates of Florid 2835 W De Leon St Tampa, FL 33609 (813) 287-0443 Fax: (813) 289-3552 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Dermatology - cont. Porras, Anabel PA Provider ID: 1021761 Gender: Female Francis A Caban MD PA 109 Margaret St Brandon, FL 33511 (813) 654-2544 Fax: (813) 653-4391 02 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Porras, Anabel PA Provider ID: 1021761 Gender: Female Francis A Caban MD PA 4164 N Armenia Ave Tampa, FL 33607 (813) 879-7546 Fax: (813) 871-6842 02 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Quintero, Yaquelin ARNP Provider ID: 918354 Gender: Female 14521 University Point Pl Tampa, FL 33613 (813) 977-3600 Fax: (813) 977-1664 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Shulstad, Raymond ARNP Provider ID: 905860 Gender: Male 13142 Elk Mountain Dr Riverview, FL 33579 (813) 287-0443 Fax: (813) 289-3552 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Shulstad, Raymond ARNP Provider ID: 905860 Gender: Male 14521 University Point Pl Tampa, FL 33613 (813) 977-3600 Fax: (813) 977-1664 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Shulstad, Raymond ARNP Provider ID: 905860 Gender: Male 2835 W De Leon St Ste 103 Tampa, FL 33609 (813) 287-0443 Fax: (813) 289-3552 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Snyder, Sandra PA Provider ID: 716689 Gender: Female 4200 N Armenia Ave Tampa, FL 33607 (813) 877-4811 Fax: (813) 872-8978 00 Yrs/130 Yrs M-TH 7:00 AM - 5:00 PM F 7:00 AM - 4:00 PM

Ear, Nose & Throat Dang, Hoc PA Provider ID: 361912 Gender: Female USF Physicicans Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-4673 18 Yrs/130 Yrs Languages: Vietnamese M-F 8:00 AM - 5:00 PM

Gonzalez, Joanna PA Provider ID: 765890 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-4683 Fax: (813) 974-7586 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Gonzalez, Joanna PA Provider ID: 765890 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-4683 Fax: (813) 250-2217 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Endocrinology, Diabetes, Metabolism Cruz, Tatiana ARNP Provider ID: 1328336 Gender: Female USF Physicians Group 128 S W. Shore Blvd Tampa, FL 33609 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Cruz, Tatiana ARNP Provider ID: 1328336 Gender: Female USF Physicians Group 13330 USF Laurel Dr 5th Fl Tampa, FL 33612 (813) 396-2580 Fax: (813) 905-8970 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

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Cruz, Tatiana ARNP Provider ID: 1328336 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 905-8970 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Family Practice Antigua-Suarez, Nathaly PA Provider ID: 778677 Gender: Female 508 N Maryland Ave Plant City, FL 33563 (813) 349-7600 Fax: (813) 349-7661 00 Yrs/130 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 9:00 AM - 7:00 PM Sat 8:00 AM - 2:00 PM Antigua-Suarez, Nathaly PA Provider ID: 778677 Gender: Female Palm River CHC 7728 Palm River Rd Tampa, FL 33619 (813) 630-3600 Fax: (813) 620-1614 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Antigua-Suarez, Nathaly PA Provider ID: 778677 Gender: Female Ruskin HC 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Family Practice - cont. Antigua-Suarez, Nathaly PA Provider ID: 778677 Gender: Female Wimauma CHC 5121 SR 674 Wimauma, FL 33598 (813) 653-6100 Fax: (813) 633-2669 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Beagle, Linda ARNP Provider ID: 1108138 Gender: Female Bluestone Physician Services Florid 300 S Hyde Park Ave Ste 210 Tampa, FL 33606 (813) 259-1013 Fax: (813) 354-0396 18 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM Blue, Sharon ARNP Provider ID: 1199094 Gender: Female Blue Horizon Medical Clinic 5101 E Busch Blvd Ste 11 Tampa, FL 33617 (813) 559-8282 Fax: (813) 433-5553 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Calderon, Nancy ARNP Provider ID: 552293 Gender: Female DBA Tgmg Fcc Apollo Beach 6488 N US Hwy 41 Apollo Beach, FL 33572 (813) 844-7500 Fax: (813) 844-1141 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Clanton, Rosemary ARNP Provider ID: 158302 Gender: Female Wimauma Family Health Centers 5121 SR 674 Wimauma, FL 33598 (727) 834-8833 Fax: (727) 834-8842 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Coronica, Helen ARNP Provider ID: 1234880 Gender: Female Brandon Community Health Center 313 S Lakewood Dr Brandon, FL 33511 (813) 349-7900 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Coronica, Helen ARNP Provider ID: 1234880 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 349-7600 Fax: (813) 938-6423 00 Yrs/130 Yrs M-F 7:45 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Coronica, Helen ARNP Provider ID: 1234880 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 938-6421 00 Yrs/130 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM

Coronica, Helen ARNP Provider ID: 1234880 Gender: Female Schc Pediactrics 502 N Mobley St Plant City, FL 33563 (813) 349-7450 Fax: (813) 938-6424 00 Yrs/130 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM Sat 8:00 AM - 2:00 PM

Harper, William PA Provider ID: 1109899 Gender: Male Bluestone Physician Services Florid 300 S Hyde Park Ave Ste 210 Tampa, FL 33606 (813) 259-1013 Fax: (813) 354-0396 18 Yrs/130 Yrs MTWTHFSat 8:00 AM - 5:00 PM

Coronica, Helen ARNP Provider ID: 1234880 Gender: Female Tom Lee Community Health Center 14254 SR 574 Dover, FL 33527 (813) 349-7700 Fax: (813) 938-6422 00 Yrs/130 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM

Mallozzi, Christopher ARNP Provider ID: 1311429 Gender: Male Tgmg Harbourside 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1688 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM

Russello, Flor ARNP Coronica, Helen ARNP Provider ID: 1013732 Provider ID: 1234880 Gender: Female Gender: Female Shriners Hospitals For Wimauma Community Health Children Center 12502 USF Pine Dr 5121 State Rd 674 Tampa, FL 33612 Wimauma, FL 33598 (813) 972-2250 (813) 653-6100 00 Yrs/18 Yrs Fax: (813) 938-6421 M-F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs Stanley, Cheryl ARNP MWTHF 8:00 AM - 5:00 PM Provider ID: 1322859 T 8:00 AM - 7:00 PM Gender: Female Sat 8:00 AM - 2:00 PM Tampa Family Care Center Denzer, Lisa ARNP 13601 N 22nd St Provider ID: 5016 Tampa, FL 33613 Gender: Female (813) 307-8058 Tampa Bay Diagnostic Clinic 00 Yrs/130 Yrs 1439 Oakfield Dr M-F 9:00 AM - 5:00 PM Brandon, FL 33511 (813) 689-2853 Stanley, Cheryl ARNP Fax: (813) 654-1722 Provider ID: 1322859 16 Yrs/130 Yrs Gender: Female Languages: Spanish Tampa Family Care Center M-F 8:30 AM - 5:00 PM 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Hillsborough Family Practice - cont. Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 1514 N Florida Ave Ste 300 Tampa, FL 33602 (813) 490-1957 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 2103 N Rome Ave Tampa, FL 33607 (813) 490-1426 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 8108 N Nebraska Ave Tampa, FL 33604 (813) 712-1930 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 8213 W Waters Ave Tampa, FL 33615 (813) 490-5420 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Center 9827 Sheldon Rd Tampa, FL 33635 (813) 307-8053 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Stanley, Cheryl ARNP Provider ID: 1322859 Gender: Female Tampa Family Care Centers 3901 S W. Shore Blvd Tampa, FL 33611 (813) 712-1940 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Stewart, Brittany ARNP Provider ID: 1353816 Gender: Female Tampa Family Health Centers 302 W Fletcher Ave Tampa, FL 33612 (813) 397-5305 Fax: (813) 549-7855 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Zipeto, Teresa ARNP Provider ID: 1231621 Gender: Female Continucare Medical Center South Ta 200 S Macdill Ave Tampa, FL 33609 (813) 837-2814 Fax: (813) 837-4336 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Gastroenterology Jingtao, Chen ARNP Provider ID: 558707 Gender: Male University Med Svcs Assoc, Inc 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 974-2201 Fax: (813) 396-2488 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

General Practice Epstein, Patricia ARNP Provider ID: 1244484 Gender: Female USF Physicians Group 4001 E Fletcher Ave Tampa, FL 33613 (813) 974-4355 Fax: (813) 866-1612 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

General Surgery Armstrong, Ashley PA Provider ID: 436928 Gender: Female Pediatric Physician Services Inc 3003 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 554-8343 Fax: (813) 554-8345 16 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Bravo, Flavia ARNP Provider ID: 1310220 Gender: Female Tgmg Fcc Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5544 Fax: (813) 844-1655 00 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM

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Escalante, Pamela PA Provider ID: 308383 Gender: Female USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7968 Fax: (813) 844-4049 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Giarelli, Natalie ARNP Provider ID: 320117 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7968 Fax: (813) 844-4049 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Giarelli, Natalie ARNP Provider ID: 320117 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 844-7968 Fax: (813) 844-4049 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Patel, Tracie PA Provider ID: 203583 Gender: Female USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 259-0920 Fax: (813) 259-0886 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Patel, Tracie PA Provider ID: 203583 Gender: Female USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0920 Fax: (813) 259-0886 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough General Surgery - cont. Prator, Bettina ARNP Provider ID: 699210 Gender: Female 1 Tampa General Cir Tampa, FL 33606 (813) 844-7473 Fax: (813) 844-1920 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM

Richardson Sullivan, Tonia ARNP Provider ID: 1408952 Gender: Female Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5470 Fax: (813) 844-1655 18 Yrs/130 Yrs M-TH 7:30 AM - 5:00 PM F 7:30 AM - 5:30 PM

Quinn, Erik PA Provider ID: 672677 Gender: Male USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7314 Fax: (813) 844-7396 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Sumner, Warren PA Provider ID: 1323372 Gender: Male Baycare Medical Group Inc 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 321-6580 Fax: (813) 443-8185 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Quinn, Erik PA Provider ID: 672677 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 844-7314 Fax: (813) 844-7396 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Ware, Rachel PA Provider ID: 1279596 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0929 Fax: (813) 844-3976 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM

Quinn, Erik PA Provider ID: 672677 Gender: Male USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 844-7314 Fax: (813) 844-7396 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Ware, Rachel PA Provider ID: 1279596 Gender: Female USF Physicians Group 2 Tampa General Cir 3rd Fl Tampa, FL 33612 (813) 259-0929 Fax: (813) 844-3976 00 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM

Geriatric Medicine Morales, Valerie ARNP Provider ID: 13012 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-7917 Fax: (813) 974-2580 65 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM

Gynecological Oncology Preston, Nancy ARNP Provider ID: 612129 Gender: Female Florida Health Sciences Center Inc 1 Tampa General Cir Tampa, FL 33606 (813) 844-3952 Fax: (813) 844-5882 18 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM

Hearing Aid Therapy & Specialist Arnold, Michelle AUD Provider ID: 678050 Gender: Female 4202 E Fowler Ave Tampa, FL 33620 (813) 974-8804 Fax: (813) 974-0822 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Hematology & Oncology Dorsey, Hazel ARNP Provider ID: 1281225 Gender: Female Jawan Ayer Cole MD, LLC 800 W MLK Blvd Unit Ste 4 Tampa, FL 33603 (813) 910-8700 18 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

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Joseph, Hazina ARNP Provider ID: 1191444 Gender: Female USF Physicians Group 13330 USF Laurel Dr 6th Fl Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-9476 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Overcash, Janine ARNP Provider ID: 228670 Gender: Female University Medical Svc Associates 12902 USF Magnolia Dr Tampa, FL 33612 (813) 979-3980 65 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Infectious Disease Bush, Jennifer ARNP Provider ID: 708923 Gender: Female Infectious Disease Assoc of Tampa 4729 N Habana Ave Tampa, FL 33614 (813) 251-8444 Fax: (813) 254-6414 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Varda, Janice ARNP Provider ID: 452334 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8015 Fax: (813) 276-2999 16 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Internal Medicine Baysa, Darlene ARNP Provider ID: 1289498 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2142 Fax: (813) 974-7550 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Burke, Christina PA Provider ID: 1072561 Gender: Female Comprehensive Care Center 1315 E 7th Ave Tampa, FL 33605 (727) 321-3854 Fax: (727) 826-0875 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Hall, Lois ARNP Provider ID: 1027379 Gender: Female Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 12 Yrs/130 Yrs Languages: Spanish M-F 7:30 AM - 4:30 PM Kurtyka, Donald ARNP Provider ID: 192746 Gender: Male Hillsborough County Health Dept 1105 E Kennedy Blvd Tampa, FL 33602 (813) 307-8064 Fax: (813) 276-2999 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Morgan, Hillary ARNP Smith, Vevian ARNP Provider ID: 232825 Provider ID: 668633 Gender: Female Gender: Female Seffner Premier Healthcare PA American Care 907 N Parsons Ave 11211 N Nebraska Ave Ste A5 Brandon, FL 33510 Tampa, FL 33612 (813) 689-8020 (813) 514-2333 Fax: (813) 689-8381 Fax: (813) 514-2216 12 Yrs/130 Yrs 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish M-F 8:00 AM - 5:00 PM Patrick, Christine ARNP Stutzman, Sandra ARNP Provider ID: 1160680 Gender: Female Provider ID: 19432 Terrace Family Health Gender: Female 10801 N 56th St Hillsborough County Health Temple Terrace, FL 33617 Dept (813) 615-2488 1105 E Kennedy Blvd Fax: (813) 988-2779 Tampa, FL 33602 18 Yrs/130 Yrs (813) 307-8015 M-F 8:00 AM - 5:00 PM Fax: (813) 276-8689 12 Yrs/130 Yrs Ritchie, Tera ARNP Languages: Spanish Provider ID: 716637 M-F 8:00 AM - 5:00 PM Gender: Female Wynnephillips, Heather ARNP Internal Medicine and Pediatrics of 10111 Wilsky Blvd Provider ID: 1276732 Tampa, FL 33625 Gender: Female (813) 961-2222 USF Physicians Group Fax: (813) 961-2220 4001 E Fletcher Ave 3rd Fl 00 Yrs/130 Yrs Tampa, FL 33613 M-TH 8:00 AM - 6:00 PM (813) 974-4355 F 8:00 AM - 5:00 PM Fax: (813) 866-1612 00 Yrs/130 Yrs Smith, Vevian ARNP M-F 9:00 AM - 5:00 PM Provider ID: 1170835 Gender: Female Interventional Cardiology American Care of Tampa 11211 N Nebraska Ave A-5 Yantorni, Lauren ARNP Tampa, FL 33612 (813) 517-4888 Provider ID: 1344855 Fax: (813) 482-0015 Gender: Female 12 Yrs/130 Yrs Heart and Vascular Institute Languages: Spanish of Flo M-F 8:00 AM - 5:00 PM 310 W Alexander St Plant City, FL 33563 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

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Licensed Mental Health Counselor Huertas, Erica LMHC Provider ID: 1232418 Gender: Female Erica Huertas, LMHC 5835 Memorial Hwy Ste 19 Tampa, FL 33615 (813) 586-1414 05 Yrs/130 Yrs Languages: Spanish M-F 6:00 AM - 8:00 PM McKenzie, Amy LMHC Provider ID: 1344591 Gender: Female Mahmoud Hassan LMHC Inc 8910 N Dale Mabry Hwy Ste 12 Tampa, FL 33614 (813) 389-3930 Fax: (813) 933-2100 00 Yrs/21 Yrs M-F 9:00 AM - 6:00 PM Petry, Harold LMHC Provider ID: 1422865 Gender: Male Metropolitan Charities, Inc 1315 E 7th Ave Tampa, FL 33605 (813) 232-3808 Fax: (813) 234-3075 00 Yrs/130 Yrs MTTH 9:00 AM - 5:00 PM W 9:30 AM - 5:00 PM Rigberg, Matthew LMHC Provider ID: 1344516 Gender: Male Locicero Medical Group 2605 W Swann Ave Ste 600 Tampa, FL 33609 (813) 876-7073 Fax: (813) 877-1277 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Licensed Mental Health Counselor - cont. Towey, Brigit LMHC Provider ID: 1432614 Gender: Female Life Balance and Beauty LLC 10013 Water Works Ln Riverview, FL 33578 (813) 677-1555 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Sun 3:00 AM - 6:00 PM

Pabon, Carly ARNP Provider ID: 419950 Gender: Female Florida Cancer Specialists 425 S Parsons Ave Ste 101 Brandon, FL 33511 (813) 982-3460 Fax: (813) 982-3461 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Rummel, Jenavieve PA Provider ID: 1317842 Gender: Female Florida Cancer Specialists Treadway, Benjamin LMHC 3402 W Dr MLK Blvd Tampa, FL 33607 (813) 875-3950 Provider ID: 1418066 Fax: (813) 872-2741 Gender: Male 18 Yrs/110 Yrs Mahmoud Hassan LMHC Inc 8910 N Dale Mabry Hwy Ste 12 M-F 9:00 AM - 5:00 PM Tampa, FL 33614 Rummel, Jenavieve PA (813) 933-2100 Provider ID: 1317842 Fax: (813) 933-2100 Gender: Female 00 Yrs/130 Yrs Florida Cancer Specialists P L MTWTHFSat 9:00 AM - 6:00 2111 W Swann Ave Ste 102 PM Tampa, FL 33606 Medical Oncology (813) 254-7227 Fax: (813) 253-0285 Guerra Arias, Laura ARNP 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM Provider ID: 1223775 Stopczynski, Kim ARNP Gender: Female Florida Cancer Specialists Pl Provider ID: 997425 2111 W Swann Ave Ste 102 Gender: Female Tampa, FL 33606 Florida Cancer Specialists Pl (239) 274-8200 425 S Parsons Ave Ste 101 Fax: (239) 278-3350 Brandon, FL 33511 18 Yrs/130 Yrs (813) 982-3460 Languages: Spanish Fax: (813) 982-3461 M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs Litschauer, Sharon ARNP M-F 9:00 AM - 5:00 PM Provider ID: 365879 Gender: Female 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-4673 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Mental Health Counselor Harwood-Warndahl, Debra Ferreira, Felicia LMHC Provider ID: 1308369 Gender: Female Pediatric Epilepsy and Neurology SP 508 S Habana Ave Ste 340 Tampa, FL 33609 (813) 873-7367 Fax: (813) 875-9722 00 Yrs/21 Yrs Languages: Spanish M-TH 7:30 AM - 6:30 PM F 7:30 AM - 4:30 PM Marteli, Rosalia LMHC Provider ID: 1304966 Gender: Female R Wellness Counseling 601 N Lois Ave Ste 27 Tampa, FL 33609 (813) 361-1365 Fax: (813) 284-5042 02 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM

ARNP Provider ID: 717727 Gender: Female 1 Tampa General Cir Ste 4 Tampa, FL 33606 (813) 844-7224 Fax: (813) 844-1671 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Johnson, Laura ARNP Provider ID: 214207 Gender: Female USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-3547 Fax: (813) 844-1671 00 Yrs/12 Yrs M-F 8:00 AM - 5:00 PM

Mahan, Teresa ARNP Provider ID: 611129 Gender: Female USF Physicians Group 1 Tampa General Cir Towey, Brigit LMHC Tampa, FL 33606 Provider ID: 1275526 (813) 844-3547 Gender: Female Fax: (813) 844-1671 Mahmoud Hassan LMHC Inc 00 Yrs/21 Yrs 8910 N Dale Mabry Hwy Ste 12 M-F 9:00 AM - 5:00 PM Tampa, FL 33614 Mahan, Teresa ARNP (813) 389-3930 Provider ID: 611129 Fax: (813) 933-2100 Gender: Female 00 Yrs/21 Yrs USF Physicians Group M-F 9:00 AM - 6:00 PM 2 Tampa General Cir 2nd Fl Neonatal Perinatal Tampa, FL 33606 Medicine (813) 259-8700 Fax: (813) 250-2101 Devries, Jennifer ARNP 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Provider ID: 978490 Quinones-Edgecomb, Donna Gender: Female ARNP USF Physicians Group Provider ID: 227381 1 Tampa General Cir Gender: Female Tampa, FL 33606 University Med Svcs Assoc Inc (813) 844-3437 1 Tampa General Cir Fax: (813) 844-1671 Tampa, FL 33606 00 Yrs/18 Yrs (813) 844-3437 M-F 8:00 AM - 5:00 PM Fax: (813) 844-1671 00 Yrs/12 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Hillsborough Nephrology Jeffords, Jamie ARNP Provider ID: 1261677 Gender: Female Florida Health Sciences Center Inc 1 Tampa General Cir Tampa, FL 33606 (813) 844-5460 Fax: (813) 844-1655 18 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM Jeffords, Jamie ARNP Provider ID: 1261677 Gender: Female Tgmg Bayshore-Nephrology 409 Bayshore Blvd Tampa, FL 33606 (813) 844-1655 Fax: (813) 844-1655 18 Yrs/130 Yrs Tampa General Hospital M-F 7:30 AM - 5:00 PM

Neurology Bozeman, Andrea ARNP Provider ID: 687533 Gender: Female 2 Tampa General Cir Tampa, FL 33606 (813) 396-9478 Fax: (813) 905-9962 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Casady, Lise ARNP Provider ID: 347700 Gender: Female USF Physicians Group 13330 USF Laurel Dr Fl 3 Tampa, FL 33612 (813) 396-9478 Fax: (813) 974-7138 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Hussey, Kelly PA Provider ID: 713903 Gender: Female 4001 E Fletcher Ave Tampa, FL 33613 (813) 396-0751 Fax: (813) 905-9829 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Jones, Tracy ARNP Provider ID: 911615 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 974-2201 Fax: (813) 974-7590 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Neurosurgery Carmichael, Melissa ARNP Provider ID: 487743 Gender: Female Gulf To Bay Anesthesiology 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-0094 12 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Hodill, Dylan PA Provider ID: 1226287 Gender: Male 2727 W Dr MLK Blvd Ste 460 Tampa, FL 33607 (813) 879-4328 Fax: (813) 443-8152 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Mann, Stacy ARNP Provider ID: 1119163 Gender: Female USF Physicians Group 2 Tampa General Cir 7th Fl Tampa, FL 33606 (813) 259-0965 Fax: (813) 259-0858 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Pulido, Laura ARNP Provider ID: 1328343 Gender: Female USF Physicians Group 13330 USF Laurel Dr 6th Fl Tampa, FL 33612 (813) 396-2580 Fax: (813) 259-0858 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Le, Thanh Xuan ARNP Provider ID: 1022684 Gender: Female 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

Roopnarain, Samantra ARNP

Le, Thanh Xuan ARNP Provider ID: 1022684 Gender: Female 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

Provider ID: 1187416 Gender: Female USF Physicians Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-0904 Fax: (813) 259-0858 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Roopnarain, Samantra ARNP Provider ID: 1187416 Gender: Female USF Physicians Group 3001 W Dr MLK Blvd Tampa, FL 33607 (813) 259-0904 Fax: (813) 259-0858 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM

Nurse Midwife Grinnell, Michelle CNM Provider ID: 1296968 Gender: Female Women's Health Care 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

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Le, Thanh Xuan ARNP Provider ID: 1022684 Gender: Female 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5188 00 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Murphy, Heather ARNP Provider ID: 1070039 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-0827 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Murphy, Heather ARNP Provider ID: 1070039 Gender: Female USF Physicians Group 2 Tampa General Cir Fl 4 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Nurse Midwife - cont. Murphy, Heather ARNP Provider ID: 1070039 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5188 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Reneau, Carolyn CNM Provider ID: 179351 Gender: Female Brandon Community Health Center 710 Oakfield Dr Ste 120 Brandon, FL 33511 (813) 645-6690 Fax: (813) 349-7596 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM Reneau, Carolyn CNM Provider ID: 179351 Gender: Female Oakfield Community Health Center 1463 Oakfield Dr Ste 113 Brandon, FL 33511 (813) 349-7800 Fax: (813) 349-7596 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM

Reneau, Carolyn CNM Provider ID: 179351 Gender: Female Ruskin Health Center 2814 14th Ave SE Ruskin, FL 33570 (813) 349-7800 Fax: (813) 349-7861 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM Reneau, Carolyn CNM Provider ID: 179351 Gender: Female Suncoast Mobile Medical Bus 14254 Martin Luther King Blvd Dover, FL 33527 (813) 312-1558 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM Reneau, Carolyn CNM Provider ID: 179351 Gender: Female Tom Lee Community Health Center 14254 SR 574 Dover, FL 33527 (813) 349-7700 Fax: (813) 349-7761 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM

Runyan, Fuying ARNP Provider ID: 691190 Gender: Female 1 Tampa General Cir Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM Runyan, Fuying ARNP Provider ID: 691190 Gender: Female 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs Languages: Chinese M-F 9:00 AM - 5:00 PM Runyan, Fuying ARNP Provider ID: 691190 Gender: Female 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8593 00 Yrs/130 Yrs Languages: Chinese M-F 8:00 AM - 5:00 PM

Runyan, Fuying ARNP Provider ID: 691190 Gender: Female Reneau, Carolyn CNM 5802 N 30th St Provider ID: 179351 Tampa, FL 33610 Gender: Female (813) 259-8500 Reneau, Carolyn CNM Wimauma Community Health Fax: (813) 259-8593 Provider ID: 179351 Center 00 Yrs/130 Yrs Gender: Female 5121 SR 674 Languages: Chinese Palm River Community Health Wimauma, FL 33598 M-F 8:00 AM - 5:00 PM Center (813) 349-7800 7728 Palm River Rd Fax: (813) 349-7596 Stephens, Pamela CNM Tampa, FL 33619 18 Yrs/130 Yrs (813) 349-7567 Languages: Thai Provider ID: 1293685 Fax: (813) 349-7596 M-F 8:00 AM - 5:00 PM Gender: Female 18 Yrs/130 Yrs M and D Care Inc DBA Languages: Thai Women's Health M-F 8:00 AM - 5:00 PM 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

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Nurse Practitioner Montana Benincasa, Judy ARNP Provider ID: 1104797 Gender: Female Pinnacle Health Group PA 2605 W Swann Ave Ste 100 Tampa, FL 33609 (813) 874-5500 Fax: (813) 871-5505 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Mulder, Joanna Np Provider ID: 1422382 Gender: Female Solutions Counseling 400 E MLK Blvd Ste 107 Tampa, FL 33603 (813) 442-7505 Fax: (813) 769-9834 00 Yrs/130 Yrs M-F 8:00 AM - 7:00 PM Sat 10:00 AM - 6:00 PM Schamaun, Jonathan ARNP Provider ID: 1091349 Gender: Male Pinnacle Health Group PA 2605 W Swann Ave Ste 100 Tampa, FL 33609 (813) 845-5500 Fax: (813) 874-5505 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Servoss, Christopher ARNP Provider ID: 1408956 Gender: Male Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5470 Fax: (813) 844-1655 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Nurse Practitioner - cont. Seneque, Renette ARNP Zaldana, Sabrina ARNP Provider ID: 1414967 Gender: Female Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5470 Fax: (813) 844-1655 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM Zambito, Ashlie ARNP Provider ID: 720872 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7117 Fax: (813) 975-7129 00 Yrs/18 Yrs

Nurse Practitioner Acute Care Bremmer, Pamela ARNP Provider ID: 1342837 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 281-8115 Fax: (813) 281-8656 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Nurse Practitioner Family Medicine Dowding, Angela ARNP Provider ID: 1408950 Gender: Female Tgmg Bayshore 409 Bayshore Blvd Tampa, FL 33606 (813) 844-5470 Fax: (813) 844-1655 18 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM

Provider ID: 1365914 Gender: Female Tampa Family Health Centers 4620 N 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 247-5591 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 5:00 PM Villar, Nelson ARNP Provider ID: 1364944 Gender: Male Tampa Family Health 8213 W Waters Ave Tampa, FL 33615 (813) 490-5420 Fax: (813) 490-5421 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 5:00 PM

Nurse Practitioner Orthopedics Granger, Sally ARNP Provider ID: 781880 Gender: Female Shriners Hospitals For Children Pro 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7117 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Nurse Practitioner Pediatric Dittmer, Amy ARNP Provider ID: 1322116 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 972-2250 Fax: (813) 975-7125 00 Yrs/18 Yrs MTWTHFSatSun 8:00 AM 5:00 PM

Fuschini, Linda ARNP Provider ID: 1136960 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7117 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Obstetrics Abraham, Andria ARNP Provider ID: 985710 Gender: Female Womens Care Florida 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:30 PM Abraham, Andria ARNP Provider ID: 985710 Gender: Female Womens Care Florida 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM Edmondson, Ellen CNM Provider ID: 148135 Gender: Female Womens Care Florida LLC 2818 W Virginia Ave Tampa, FL 33607 (813) 872-8551 Fax: (813) 871-3708 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Edmondson, Ellen CNM Provider ID: 148135 Gender: Female Womens Care Florida LLC 5 Tampa General Cir Ste 650 Tampa, FL 33606 (813) 644-6200 Fax: (813) 304-2427 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Edmondson, Ellen CNM Provider ID: 148135 Gender: Female Womens Care Florida LLC 727 W Fletcher Ave Tampa, FL 33612 (813) 908-2229 Fax: (813) 963-7045 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Fallen, Tina ARNP Provider ID: 396195 Gender: Female Womens Care Florida 103 Southern Oaks Dr Plant City, FL 33563 (813) 754-7561 Fax: (813) 754-5489 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Fallen, Tina ARNP Provider ID: 396195 Gender: Female Womens Care Florida 13123 Kings Lake Dr Ste 102 Gibsonton, FL 33534 (813) 574-1350 Fax: (813) 574-1360 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Obstetrics - cont. Fallen, Tina ARNP Provider ID: 396195 Gender: Female Womens Care Florida 5470 Lithia Pinecrest Rd Lithia, FL 33547 (813) 699-1006 Fax: (813) 699-1012 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Fallen, Tina ARNP Provider ID: 396195 Gender: Female Womens Care Florida 731 S Parsons Ave Brandon, FL 33511 (813) 681-9171 Fax: (813) 681-7580 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Moler, Connie ARNP Provider ID: 985325 Gender: Female Womens Care Florida 5 Tampa General Cir Tampa, FL 33606 (813) 644-6200 Fax: (813) 304-2427 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Moler, Connie ARNP Provider ID: 985325 Gender: Female Womens Care Florida 727 W Fletcher Ave Tampa, FL 33612 (813) 908-2229 Fax: (813) 963-7045 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Moler, Connie ARNP Provider ID: 985325 Gender: Female Womens Care Florida LLC 2818 W Virginia Ave Tampa, FL 33607 (813) 878-8551 Fax: (813) 871-3708 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Moore, Patricia ARNP Provider ID: 984997 Gender: Female Womens Care Florida LLC 3268 Cove Bend Dr Tampa, FL 33613 (813) 971-4555 Fax: (813) 972-3782 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM Moore, Patricia ARNP Provider ID: 984997 Gender: Female Womens Care Florida LLC 4150 N Armenia Ave Ste 200 Tampa, FL 33607 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM Ottl, Linda ARNP Provider ID: 644152 Gender: Female 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM Ottl, Linda ARNP Provider ID: 644152 Gender: Female 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Ottl, Linda ARNP Provider ID: 644152 Gender: Female 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Ottl, Linda ARNP Provider ID: 644152 Gender: Female OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Obstetrics/Gynecology Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 2550 W Dr MLK Blvd Ste C Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

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Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

Last update 08/14/2017

Allied Providers Hillsborough Obstetrics/Gynecology - Ballo, Amanda ARNP cont. Provider ID: 707609 Bainbridge, Megan CNM Provider ID: 1197989 Gender: Female Planned Parenthood 8068 N 56th St Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 05 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 2550 W MLK Jr Blvd Ste C Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM

Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM

Barany, Pamela CNM Provider ID: 373917 Gender: Female Exdous Women's Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM

Barany, Pamela CNM Provider ID: 373917 Gender: Female Exodus Womens Center 2550 W Dr MLK Blvd Ste C Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM

Barany, Pamela CNM Provider ID: 373917 Gender: Female Exdous Women's Center 2701 Dr W Martin Luther King Jr Blvd Tampa, FL 33607 (813) 684-2273 Fax: (813) 564-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM

Barany, Pamela CNM Provider ID: 373917 Gender: Female Exodus Womens Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM

Barany, Pamela CNM Provider ID: 373917 Gender: Female Exodus Women's Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 4:30 PM Barany, Pamela CNM Provider ID: 373917 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM

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Barany, Pamela CNM Provider ID: 373917 Gender: Female Exodus Womens Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM Brumley, Jessica ARNP Provider ID: 245301 Gender: Female USF Physicicans Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Obstetrics/Gynecology - Bryant-Barnett, Paula ARNP cont. Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exdous Women's Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 2550 W Dr MLK Blvd Ste C Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM

Provider ID: 693909 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Davis, Patrice ARNP Provider ID: 334601 Gender: Female USF Physicicans Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8623 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Davis, Patrice ARNP Provider ID: 334601 Gender: Female USF Physicicans Group 5802 N 30th St Tampa, FL 33610 (813) 236-5200 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Dyer, Diana ARNP Provider ID: 797257 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 12 Yrs/130 Yrs MT 9:00 AM - 7:00 PM W 8:00 AM - 5:00 PM THF 9:00 AM - 5:00 PM Sat-Sun 9:00 AM - 2:00 PM Frazier, Cathy ARNP Provider ID: 1224525 Gender: Female Planned Parenthood-Tampa 8068 N 56th St Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Guerette, Nathan ARNP Provider ID: 924864 Gender: Male USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-8500 Fax: (813) 259-0827 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Guerette, Nathan ARNP Provider ID: 924864 Gender: Male USF Physicians Group 2 Tampa General Cir Ste 4000 Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0827 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Guerette, Nathan ARNP Provider ID: 924864 Gender: Male USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5136 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Kelly, Pamela ARNP Provider ID: 198277 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8623 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Kelly, Pamela ARNP Provider ID: 198277 Gender: Female USF Physicians Group 5802 N 30th St Tampa, FL 33610 (813) 236-5100 Fax: (813) 236-5136 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Obstetrics/Gynecology - Marshall, Brenda ARNP cont. Lopez-Rosa, Magda ARNP Provider ID: 796157 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs Languages: Spanish M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Lozan, Krystan PA Provider ID: 1362310 Gender: Female Women's Care Florida LLC 4213 N Gomez Ave Tampa, FL 33607 (813) 530-4950 Fax: (813) 530-4951 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Lozan, Krystan PA Provider ID: 1362310 Gender: Female Women's Care Florida LLC 602 Vonderburg Dr Ste 101 Brandon, FL 33511 (813) 530-4950 Fax: (813) 530-4951 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Marshall, Brenda ARNP Provider ID: 173227 Gender: Female Tampa Family Health Center 3601 N 22nd St Tampa, FL 33605 (813) 307-8058 Fax: (813) 866-0929 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Provider ID: 173227 Gender: Female Tampa Family Health Center 4620 N 22nd St Tampa, FL 33610 (813) 272-6420 Fax: (813) 866-0929 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Marshall, Brenda ARNP Provider ID: 173227 Gender: Female Tampa Family Health Center 4704B W Montgomery Ave Tampa, FL 33616 (813) 307-8055 Fax: (813) 866-0929 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Marshall, Brenda ARNP Provider ID: 173227 Gender: Female Tampa Family Health Center 7814 N Dale Mabry Hwy Tampa, FL 33614 (813) 866-0930 Fax: (813) 866-0929 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Marshall, Brenda ARNP Provider ID: 173227 Gender: Female Tampa Family Health Center 8605 N Mitchell Ave Tampa, FL 33604 (813) 307-8054 Fax: (813) 866-0929 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Marshall, Brenda ARNP Provider ID: 173227 Gender: Female Tampa Family Health Center 9827 Sheldon Rd Tampa, FL 33635 (813) 866-0930 Fax: (813) 866-0929 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Marshall-Accardi, Brenda ARNP Provider ID: 15038 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd FLOOR3 Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Mashandure, Mercy ARNP Provider ID: 800492 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs Languages: Spanish, Swahili M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM

McGinty, Susanne ARNP Provider ID: 705322 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM McKinnie, Cynthia ARNP Provider ID: 811213 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM McPartland, Leslie ARNP Provider ID: 918329 Gender: Female Exodus Women's Center 14710 Bruce B Downs Blvd Tampa Palms, FL 33613 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM McPartland, Leslie ARNP Provider ID: 918329 Gender: Female Exodus Women's Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Hillsborough Obstetrics/Gynecology - McPartland, Leslie ARNP cont. McPartland, Leslie ARNP Provider ID: 918329 Gender: Female Exodus Women's Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM McPartland, Leslie ARNP Provider ID: 918329 Gender: Female Exodus Women's Center 2550 W Martib Luther King Jr Blvd Ste C Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM McPartland, Leslie ARNP Provider ID: 918329 Gender: Female Exodus Women's Center 2701 W Martin Luther King Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM McPartland, Leslie ARNP Provider ID: 918329 Gender: Female Exodus Women's Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

Provider ID: 918329 Gender: Female Exodus Women's Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Messier Besser, Irene CNM Provider ID: 755126 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Messier Besser, Irene CNM Provider ID: 755126 Gender: Female Exodus Womens Center 2550 W Dr MLK Blvd Ste C Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Messier Besser, Irene CNM Provider ID: 755126 Gender: Female Exodus Womens Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

Messier Besser, Irene CNM Provider ID: 755126 Gender: Female Exodus Womens Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 2550 W Martin Luther King Jr Blvd Ste C Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 2701 W Martin Luther King Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

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Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Nash, Michelle ARNP Provider ID: 294515 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Nash, Michelle ARNP Provider ID: 294515 Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Nash, Michelle ARNP Provider ID: 294515 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M 8:00 AM - 6:30 PM TWTHF 8:00 AM - 5:30 PM

Last update 08/14/2017

Allied Providers Hillsborough Obstetrics/Gynecology - Paine, Lisa ARNP cont. Provider ID: 1189423 Ottl, Linda ARNP Provider ID: 644152 Gender: Female 116 Parsons Park Dr Brandon, FL 33511 (813) 681-6625 Fax: (813) 684-6043 12 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM Ottl, Linda ARNP Provider ID: 644152 Gender: Female 13149 Elk Mountain Dr Riverview, FL 33579 (813) 675-8326 Fax: (813) 675-8336 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Ottl, Linda ARNP Provider ID: 644152 Gender: Female 1503 W Reynolds St Plant City, FL 33563 (813) 752-4103 Fax: (813) 759-6166 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Ottl, Linda ARNP Provider ID: 644152 Gender: Female OB GYN Associates 16301 Fishhawk Blvd Ste 102 Lithia, FL 33547 (813) 530-4180 Fax: (813) 530-4181 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Gender: Female Planned Parenthood of Southwest and 8068 N 56th St Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 0:00 AM - 7:00 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Purvis, Susan ARNP Provider ID: 934899 Gender: Female 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Purvis, Susan ARNP Provider ID: 934899 Gender: Female 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Purvis, Susan ARNP Provider ID: 934918 Gender: Female 2701 W MLK Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Purvis, Susan ARNP Provider ID: 934918 Gender: Female 505 Oakfield Dr Brandon, FL 33511 (813) 654-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Putnam, Lindsey ARNP Provider ID: 710720 Gender: Female Exodus Womens Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Putnam, Lindsey ARNP Provider ID: 710720 Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Putnam, Lindsey ARNP Provider ID: 710720 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

Purvis, Susan ARNP Provider ID: 934918 Gender: Female 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

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Reames, Amanda ARNP Provider ID: 1075286 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Redlin, Jacqueline ARNP Provider ID: 357586 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Shreve, Tanya PA Provider ID: 802457 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Obstetrics/Gynecology - Strong, Shannon ARNP cont. Staal, Jacqueline ARNP Provider ID: 801634 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-3804 00 Yrs/130 Yrs MT 9:00 AM - 7:00 PM W 8:00 AM - 5:00 PM THF 9:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM Sun 9:00 AM - 2:00 PM Stephens, Pamela CNM Provider ID: 1293685 Gender: Female M and D Care Inc DBA Women's Health 5 Tampa General Cir Ste 240 Tampa, FL 33606 (813) 258-3309 Fax: (813) 251-4454 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Women's Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Women's Center 1513 W Busch Blvd Tampa, FL 33612 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 1025779 Gender: Female Exodus Women's Center 2550 W Dr MLK Blvd Ste C Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Women's Center 2701 W Dr MLK Blvd Tampa, FL 33607 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Women's Center 514 Sugar Creek Dr Plant City, FL 33563 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Women's Center 5537 Sheldon Rd Ste N Tampa, FL 33615 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Womens Center Inc 401 Oakfield Dr Brandon, FL 33511 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Zimmerman, Linda ARNP Provider ID: 395483 Gender: Female Exodus Womens Center 14710 Bruce B Downs Blvd Tampa, FL 33613 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Zimmerman, Linda ARNP

Valentin, Socorro ARNP Provider ID: 678864 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Ward, Leslie ARNP Provider ID: 701949 Gender: Female Planned Parenthood of SW and Centra 8068 N 56th St Ste 201 Tampa, FL 33617 (813) 980-3555 Fax: (813) 341-1111 00 Yrs/130 Yrs M 9:00 AM - 5:30 PM TF 9:00 AM - 3:00 PM W 11:00 AM - 7:30 PM TH 9:00 AM - 4:30 PM Sat 9:00 AM - 2:00 PM Young, Caroline ARNP Provider ID: 199864 Gender: Female USF Physicicans Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-8582 18 Yrs/130 Yrs Languages: French M-F 8:00 AM - 5:00 PM

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Provider ID: 395483 Gender: Female Exodus Womens Center 2701 W MLK Jr Blvd Tampa, FL 33607 (813) 684-2229 Fax: (813) 654-2273 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Zimmerman, Linda ARNP Provider ID: 395483 Gender: Female Exodus Womens Center 401 Oakfield Dr Brandon, FL 33511 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

Occupational Therapy Ames, Robin OT Provider ID: 1173276 Gender: Female Kidsensable Therapy LLC 4367 Lynx Paw Trl Valrico, FL 33596 (813) 662-7949 Fax: (813) 662-7943 00 Yrs/21 Yrs M-F 8:30 AM - 4:30 PM

Last update 08/14/2017

Allied Providers Hillsborough Occupational Therapy cont. Blacker, Julie OT Provider ID: 1120664 Gender: Female Etikids 13602 S Village Dr Apt 204 Tampa, FL 33618 (813) 856-9449 Fax: (813) 960-5483 00 Yrs/21 Yrs M 9:00 AM - 6:30 PM TTH 9:30 AM - 8:00 PM W 8:30 AM - 6:30 PM F 8:30 AM - 5:00 PM Sat 9:00 AM - 1:30 PM Blacker, Julie OT Provider ID: 1120664 Gender: Female Etikids 14502 N Dale Mabry Hwy Ste 330 Tampa, FL 33618 (813) 856-9449 Fax: (813) 960-5483 00 Yrs/21 Yrs MW 9:00 AM - 6:30 PM TTH 1:00 AM - 6:00 PM F 9:00 AM - 12:00 PM Douglas, Rodney OT Provider ID: 1042317 Gender: Male United Cerebral Palsy of Tampa Bay 2215 E Henry Ave Tampa, FL 33610 (813) 974-2201 Fax: (813) 237-3091 00 Yrs/130 Yrs MTWTHFSatSun 7:30 AM 6:00 PM Ferreyra, Stephanie OT Provider ID: 1418116 Gender: Female Communication Corner and More 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/21 Yrs M-F 9:00 AM - 7:00 PM

Gallea, Elisabeth OT Provider ID: 1352375 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Riley-Naylor, Erin OT Provider ID: 1047503 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM

Lamke, Kimberly OT Provider ID: 1043176 Gender: Female Communication Corner and More! Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM

Thal, Julie OT Kelsey, Ashley PA Provider ID: 1049536 Provider ID: 1226672 Gender: Female Gender: Female United Crebral Palsy of Tampa Baycare Medical Group Inc Inc 3003 W Dr MLK Blvd 2nd Fl 2215 E Henry Ave Tampa, FL 33607 Tampa, FL 33610 (813) 321-6580 (813) 239-1179 Fax: (813) 443-8185 Fax: (813) 237-3091 18 Yrs/130 Yrs 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish Nieuwenhoff, Fawn ARNP M-F 8:00 AM - 6:00 PM

Larussa, Suzette OT Provider ID: 1042348 Gender: Female Therakids Plus Inc 16102 N Florida Ave Lutz, FL 33549 (813) 873-1936 Fax: (813) 873-8837 00 Yrs/130 Yrs M-TH 8:00 AM - 8:00 PM F 8:00 AM - 6:00 PM Prabhakaran, John OT Provider ID: 1045421 Gender: Male Therapy Station 6911 Pistol Range Rd Ste 103A Tampa, FL 33635 (813) 814-5971 Fax: (813) 814-5972 00 Yrs/130 Yrs M-F 9:00 AM - 5:30 PM

Orthopaedic Surgery Bhat, Anjali PA Provider ID: 668867 Gender: Female Michael J Buscemi Jr DO PA 10968 Sheldon Rd Tampa, FL 33626 (813) 926-4010 Fax: (813) 926-5424 02 Yrs/130 Yrs Languages: Spanish, Hindi M-W 9:00 AM - 6:00 PM TH 9:00 AM - 12:00 PM Carter, Jenny PA Provider ID: 1226671 Gender: Female Baycare Medical Group Inc 2727 W Dr MLK Blvd 320 Tampa, FL 33607 (813) 877-6748 Fax: (813) 443-8154 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Hussey, Karen ARNP Provider ID: 1268355 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7117 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 730592 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7117 Fax: (813) 975-7128 00 Yrs/18 Yrs

Pain Management Lawson, Tracie ARNP Provider ID: 1248742 Gender: Female Florida Pain Relief Group 3450 E Fletcher Ave Ste 130 Tampa, FL 33613 (813) 739-7499 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Pediatric Cardiology Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 15045 Bruce B Downs Blvd Tampa, FL 33647 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (813) 870-4000 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 427 Parsons Ave Ste 122 Brandon, FL 33511 (727) 767-4200 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Oshrine, Kathleen ARNP Provider ID: 1312672 Gender: Female Pediatrix Medical Group of Florida 3003 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Oshrine, Kathleen ARNP Provider ID: 1312672 Gender: Female Pediatrix Medical Group of Florida 427 S Parsons Ave Ste 122 Brandon, FL 33511 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Pavlock, Amanda ARNP Provider ID: 1356296 Gender: Female Pediatrix Medical Gorup of Florida 3003 W Dr MLK Blvd 3rd Fl Tampa, FL 33607 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Pediatric Gastroenterology Berner, Melissa ARNP Provider ID: 1352218 Gender: Female Pediatric Gastroenterology and Nutr 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/21 Yrs St Josephs Hospital M-F 7:00 AM - 4:30 PM Preseau, Ranae ARNP Provider ID: 932148 Gender: Female Pediatric Gastroenterology Hepatolo 5205 E Fletcher Ave Temple Terrace, FL 33617 (813) 987-2911 Fax: (813) 987-2853 00 Yrs/18 Yrs St Josephs Hospital M-F 7:30 AM - 5:00 PM

Preseau, Ranae ARNP Provider ID: 932148 Gender: Female Pediatric Gastroenterology Hepatolo 885 S Parsons Ave Brandon, FL 33511 (813) 987-2911 Fax: (813) 987-2853 00 Yrs/18 Yrs St Josephs Hospital M-F 7:30 AM - 5:00 PM Sarnaik, Shawn PA Provider ID: 919473 Gender: Female 5205 E Fletcher Ave Tampa, FL 33617 (813) 987-2911 Fax: (813) 987-2853 00 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM Tenn, Alicia ARNP Provider ID: 509163 Gender: Female Pediatric Gastroenterology 3003 W MLK Blvd Ste 3 Tampa, FL 33607 (813) 870-4948 Fax: (813) 554-8044 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM Terranova, Kelly PA Provider ID: 1360091 Gender: Female Thiru Arasu MD 3003 W Dr MLK Blvd Tampa, FL 33607 (813) 870-4438 Fax: (813) 870-4153 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

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Pediatric Infectious Disease Marion, Alicia ARNP Provider ID: 226235 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Ryder, Stephanie ARNP Provider ID: 708861 Gender: Female 1 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Pediatric Orthopaedics Carney, Jacquelyn PA Provider ID: 1074572 Gender: Female Cossa 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM Cimilluca, Cara PA Provider ID: 424842 Gender: Female Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 879-2663 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Pediatric Orthopaedics cont. Graham, Adria PA Provider ID: 1340748 Gender: Female Children's Orthopaedic Scoliosis S 3440 W Dr MLK Jr Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Hunter, Lara PA Provider ID: 1063089 Gender: Female Cossa 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Shepard, Ashleigh PA Provider ID: 1335739 Gender: Female Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Jr Blvd Ste 200 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Thompson, Cody PA Provider ID: 973391 Gender: Male Childrens Orthopaedic and Scoliosis 3440 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 879-2663 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM

Pediatric Pulmonology Adkinson, Jason ARNP Provider ID: 1310293 Gender: Male USF Physicians Group 13101 Bruce B Downs Blvd Tampa, FL 33612 (813) 259-8767 Fax: (813) 259-8770 00 Yrs/18 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM Adkinson, Jason ARNP Provider ID: 1310293 Gender: Male USF Physicians Group 17 Davis Blvd Ste 100 Tampa, FL 33606 (813) 259-8767 Fax: (813) 259-8770 00 Yrs/18 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

Pediatric Surgery Carter, Kristyn ARNP Provider ID: 977916 Gender: Female USF Physicians Group 1 Tampa General Cir Tampa, FL 33606 (813) 844-4148 Fax: (813) 844-8045 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Davis, Jennifer PA Provider ID: 240875 Gender: Female Pediatric Physician Services Inc 3003 W Dr MLK Blvd Ste 200 Tampa, FL 33607 (813) 554-8343 Fax: (813) 554-8345 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Pediatrics

Cravatta, Vanessa ARNP Provider ID: 955995 Gender: Female Orlando Pediatric Pulmonary And Sle 16606 N Dale Mabry Hwy Tampa, FL 33618 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Anzalone, Kelli ARNP Provider ID: 958675 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Leinbach, Mary ARNP Provider ID: 954504 Gender: Female Orlando Pediatric Pulmonary And Sle 16606 N Dale Mabry Hwy Tampa, FL 33618 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Balunos Mitchell, Mary Rose ARNP Provider ID: 694548 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Bock, Christie ARNP Provider ID: 921925 Gender: Female USF Physicians Group 2 Tampa General Cir Fl 2 Tampa, FL 33606 (813) 259-8700 Fax: (813) 250-2101 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Brendel, Dana PA Provider ID: 1226232 Gender: Female Baycare Medical Group Inc 3003 W Dr Martin Luther King 2nd Fl Tampa, FL 33607 (813) 357-0520 Fax: (813) 554-8480 00 Yrs/18 Yrs St Josephs Hospital M-F 9:00 AM - 5:00 PM Bryant, June ARNP Provider ID: 991417 Gender: Female Total Pediatric Healthcare PA 10036 Water Works Ln Riverview, FL 33578 (813) 671-1872 Fax: (813) 671-1056 00 Yrs/18 Yrs Languages: Spanish MWF 8:00 AM - 5:00 PM TTH 1:00 AM - 8:00 PM Bryant, June ARNP Provider ID: 991422 Gender: Female Total Pediatric Healthcare PA 131 N Oakwood Ave Brandon, FL 33510 (813) 655-5106 Fax: (813) 655-4460 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Pediatrics - cont.

Dougherty, Aimee ARNP

Buchholz, Emily PA Provider ID: 1328339 Provider ID: 622589 Gender: Female Gender: Female USF Physicians Group Plant City Pediatrics 4202 E Fowler Ave 2370 Walden Woods Dr Ste A Tampa, FL 33620 Plant City, FL 33563 (813) 974-2331 (813) 659-9800 Fax: (813) 974-7181 Fax: (813) 659-9807 00 Yrs/18 Yrs 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish Fallon, Kourtney ARNP M-TH 7:30 AM - 6:00 PM F 7:30 AM - 4:00 PM Provider ID: 1176335 Buckley, Janet ARNP Gender: Female Provider ID: 331115 17 Davis Blvd 1st Fl Gender: Female Tampa, FL 33606 Nadal Pediatrics (813) 259-8700 376 E Bloomingdale Ave Fax: (813) 259-8710 Brandon, FL 33511 00 Yrs/21 Yrs (813) 681-7101 M-F 8:00 AM - 5:00 PM Fax: (813) 571-7158 00 Yrs/21 Yrs Fleischer, Jeannette ARNP M-TH 8:00 AM - 8:00 PM Provider ID: 202303 F 8:00 AM - 5:00 PM Gender: Female USF Physicicans Group Buckley, Janet ARNP 2 Tampa General Cir 2nd Fl Provider ID: 331115 Tampa, FL 33606 Gender: Female (813) 259-8700 Nadal Pediatrics Fax: (813) 259-8771 621 Victoria St 00 Yrs/21 Yrs Brandon, FL 33510 M-F 8:00 AM - 5:00 PM (813) 655-0292 Fax: (813) 655-4302 Fleming, Connie ARNP 00 Yrs/21 Yrs Provider ID: 1128305 M 9:00 AM - 8:00 PM Gender: Female TWTH 8:00 AM - 5:00 PM 2806 N Armenia Ave Ste 600 F 8:00 AM - 12:00 PM Tampa, FL 33607 (813) 250-6670 Campbell, Kristy ARNP Fax: (813) 250-6654 00 Yrs/18 Yrs Provider ID: 1176377 M-F 8:00 AM - 5:00 PM Gender: Female Freed, Heather ARNP 17 Davis Blvd 2nd Fl Tampa, FL 33606 Provider ID: 816978 (813) 259-8760 Gender: Female Fax: (813) 259-8765 Petersburg Pediatrics Tampa 00 Yrs/21 Yrs 2550 W MLK Jr Blvd M-F 8:00 AM - 5:00 PM Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1762 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:30 PM

Giparas, Stephanie PA Provider ID: 1265899 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 281-8115 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Gordon, Jessica ARNP Provider ID: 995225 Gender: Female Pediatrics of Tampa Bay 13381 N 56th St Tampa, FL 33617 (813) 983-9495 Fax: (813) 983-9496 00 Yrs/18 Yrs Languages: Spanish M-F 8:30 AM - 5:00 PM Green, Lisa ARNP Provider ID: 1268386 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 975-7130 Fax: (813) 975-7129 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Haynes, Bettina ARNP Provider ID: 928102 Gender: Female USF Physicians Group 2806 N Armenia Ave Ste 600 Tampa, FL 33607 (813) 250-6670 Fax: (813) 250-6653 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Kidd, Jamie ARNP Provider ID: 612097 Gender: Female Kids First Pediatric Care 16301 Fishhawk Blvd Lithia, FL 33547 (813) 681-3800 Fax: (813) 681-3883 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM

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Marcelin, Jackie ARNP Provider ID: 814019 Gender: Female USF Physicians Group 4202 E Fowler Ave Tampa, FL 33620 (813) 974-2311 Fax: (813) 974-7181 00 Yrs/21 Yrs Languages: Spanish, French, Creole M-F 9:00 AM - 5:00 PM Marion, Alicia ARNP Provider ID: 226235 Gender: Female USF Physicicans Group 2 Tampa General Cir 2nd Fl Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM Martinez, Sofia ARNP Provider ID: 188035 Gender: Female Plant City Family Care 508 N Maryland Ave Plant City, FL 33563 (813) 341-7450 Fax: (813) 349-7661 00 Yrs/21 Yrs Languages: Spanish MWTHF 8:00 AM - 5:00 PM T 10:00 AM - 7:00 PM Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Tampa 2550 W Dr MLK Blvd Tampa, FL 33607 (813) 871-5437 Fax: (813) 425-1762 00 Yrs/18 Yrs M-F 8:30 AM - 5:30 PM

Last update 08/14/2017

Allied Providers Hillsborough Pediatrics - cont. Nadkarni, Julie ARNP Provider ID: 315402 Gender: Female 2806 N Armenia Ave Tampa, FL 33607 (813) 250-6670 Fax: (813) 250-6653 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Schebel, Janette ARNP Provider ID: 1128308 Gender: Female 17 Davis Blvd Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8792 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Shulman, Sandra ARNP Provider ID: 315401 Gender: Female USF Physicicans Group 1 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8771 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Stefanic, Laurie ARNP Provider ID: 688636 Gender: Female 1 Tampa General Cir Tampa, FL 33606 (813) 259-8700 Fax: (813) 259-8710 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Young, Joyce ARNP Provider ID: 365021 Gender: Female Nadal Pediatrics 376 E Bloomingdale Ave Brandon, FL 33511 (813) 681-7101 Fax: (813) 571-7158 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM

Young, Joyce ARNP Provider ID: 365021 Gender: Female Nadal Pediatrics 621 Victoria St Brandon, FL 33510 (813) 655-0292 Fax: (813) 655-4302 00 Yrs/21 Yrs M 9:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM F 9:00 AM - 12:00 PM

Coronado, Zaida PT Provider ID: 1042319 Gender: Female United Cerebral Palsy of Tampa Bay 2215 E Henry Ave Tampa, FL 33610 (813) 239-1179 Fax: (813) 237-3091 00 Yrs/130 Yrs MTWTHFSatSun 7:30 AM 6:00 PM

Corrick, Kyle PT Provider ID: 1041924 Gender: Male Renewal Rehabilitation, Inc PT Advanced Rehabilitation Inc 2907 W Bay To Bay Blvd Ste Provider ID: 17239 100 613 S Magnolia Ave Ste 2 Tampa, FL 33629 Tampa, FL 33606 (813) 250-1208 (813) 254-9475 Fax: (813) 250-1209 Fax: (813) 251-0460 00 Yrs/130 Yrs 00 Yrs/130 Yrs M-TH 7:30 AM - 6:30 PM M-F 9:00 AM - 5:00 PM F 7:30 AM - 1:00 PM Physical Therapy Sat 8:00 AM - 12:00 PM

Physical Medicine & Rehabilitation

Arrigo, Christopher PT Provider ID: 1041909 Gender: Male Advanced Rehabilitation Inc 4357 Lynx Paw Trl Valrico, FL 33596 (813) 657-1208 Fax: (813) 662-1209 00 Yrs/130 Yrs M-TH 7:30 AM - 6:30 PM F 7:30 AM - 1:00 PM Sat 8:00 AM - 12:00 PM

Corrick, Kyle PT Provider ID: 1041924 Gender: Male Advanced Rehabilitation Inc 4357 Lynx Paw Trl Valrico, FL 33596 (813) 657-1208 Fax: (813) 662-1209 00 Yrs/130 Yrs M-TH 7:30 AM - 6:30 PM F 7:30 AM - 1:00 PM Sat 8:00 AM - 12:00 PM

Bajsanski, Lori PT Provider ID: 1119679 Gender: Female Genesis Rehabilitation Services Inc 13005 Community Campus Dr Tampa, FL 33625 (813) 962-7138 Fax: (813) 960-2362 50 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM

CortinasSmall,

Maria PT

Provider ID: 1047515 Gender: Female United Cerebral Palsy of Tampa Bay 2215 E Henry Ave Tampa, FL 33610 (813) 239-1179 Fax: (813) 239-8513 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

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Doris, Kevin PT Provider ID: 392445 Gender: Male Prime Physical Therapy Inc 4895 W Waters Ave Ste E-J Tampa, FL 33634 (813) 932-3315 Fax: (813) 935-9835 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Guida, Meghan PT Provider ID: 1044640 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM Heuberger, David PT Provider ID: 1264010 Gender: Male Children's Orthopaedic Scoliosis S 3440 W Dr MLK Jr Blvd Ste 200 Tampa, FL 33607 (813) 879-2663 Fax: (813) 879-0286 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Jonesjennings, Ivory PT Provider ID: 1365525 Gender: Female Journey To Harmony Physical Therapy 5232 Moon Shell Dr Apollo Beach, FL 33572 (904) 536-7262 Fax: (904) 536-7262 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Physical Therapy - cont. Le, Hoang PT Provider ID: 360454 Gender: Female Ginger Fitness and Rehab 8455 W Linebaugh Ave Tampa, FL 33625 (813) 631-9700 Fax: (813) 631-9770 00 Yrs/130 Yrs Languages: Spanish, French, Vietnamese M-F 9:00 AM - 5:00 PM Neiswender, Holly PT Provider ID: 1042318 Gender: Female United Cerebral Palsy of Tampa Bay 2215 E Henry Ave Tampa, FL 33610 (813) 239-1179 Fax: (813) 237-3091 00 Yrs/130 Yrs MTWTHFSatSun 7:30 AM 6:00 PM Quinones, Lourdes PT Provider ID: 1045401 Gender: Female Therapeds Physical Therapy Services 9528 Citrus Glen Pl Tampa, FL 33618 (813) 344-0960 Fax: (813) 344-0965 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Sat 10:00 AM - 3:00 PM Rosenberg, Melissa PT Provider ID: 1045431 Gender: Female Therapy Station 6911 Pistol Range Rd Ste 103A Tampa, FL 33635 (813) 814-5971 Fax: (813) 814-5972 00 Yrs/130 Yrs M-F 9:00 AM - 5:30 PM

Watson, Ashlyn PT Provider ID: 1041919 Gender: Female Advanced Rehabilitation Inc 2907 W Bay To Bay Blvd Ste 100 Tampa, FL 33629 (813) 250-1208 Fax: (813) 250-1209 00 Yrs/130 Yrs M-TH 7:30 AM - 6:30 PM F 7:30 AM - 1:00 PM Sat 8:00 AM - 12:00 PM Watson, Ashlyn PT Provider ID: 1041919 Gender: Female Advanced Rehabilitation Inc 4357 Lynx Paw Trl Valrico, FL 33596 (813) 657-1208 Fax: (813) 662-1209 00 Yrs/130 Yrs M-TH 7:30 AM - 6:30 PM F 7:30 AM - 1:00 PM Sat 8:00 AM - 12:00 PM

Physician Assistant Boulay, Sheryllyn PA Provider ID: 1303927 Gender: Female Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 281-8115 Fax: (813) 281-8656 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Meabe, Mark PA Provider ID: 1319989 Gender: Male Shriners Hospitals For Children 12502 USF Pine Dr Tampa, FL 33612 (813) 281-8115 Fax: (813) 281-8656 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Pulmonary Disease Bernal, Ellen ARNP Provider ID: 186784 Gender: Female 13801 Bru B Downs Blvd Ste 204 Tampa, FL 33613 (813) 971-3564 Fax: (813) 971-4776 18 Yrs/95 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Bonnet, Desiree ARNP Provider ID: 984371 Gender: Female USF Physicians Group 2 Tampa General Cir Fl 5 Tampa, FL 33606 (813) 974-2583 Fax: (813) 259-8770 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Leto, Heather ARNP Provider ID: 1191445 Gender: Female USF Physicians Group 2 Tampa General Cir Tampa, FL 33606 (813) 974-2201 Fax: (813) 259-0620 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Mann, Angela ARNP Provider ID: 1279603 Gender: Female USF Physicians Group 5 Tampa General Cir 3rd Fl Tampa, FL 33606 (800) 505-7769 Fax: (813) 844-4179 18 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM McCray, Taricatory ARNP

Cabral, Laiheng ARNP Provider ID: 1162049 Gender: Female USF Physicians Group 13330 USF Laurel Dr 3rd Fl Tampa, FL 33612 (813) 974-7751 Fax: (813) 974-6956 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 1279594 Gender: Female USF Physicians Group 5 Tampa General Cir 3rd Fl Tampa, FL 33606 (800) 505-7769 Fax: (813) 844-4179 18 Yrs/130 Yrs Tampa General Hospital M-F 8:00 AM - 5:00 PM

Cabral, Laiheng ARNP Provider ID: 1162049 Gender: Female USF Physicians Group 2 Tampa General Cir 6th Fl Tampa, FL 33606 (813) 259-0619 Fax: (813) 259-0620 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Romano-Buckner, Jana ARNP

Leto, Heather ARNP Provider ID: 1191445 Gender: Female USF Physicians Group 13330 USF Laurel Dr Tampa, FL 33612 (813) 259-0619 Fax: (813) 259-0620 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Provider ID: 700300 Gender: Female Pulmonary and Sleep of Tampa Bay 1907 S Alexander St Ste 1 Plant City, FL 33566 (813) 654-8100 Fax: (813) 654-3377 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Pulmonary Disease - cont. Romano-Buckner, Jana ARNP Provider ID: 700300 Gender: Female Pulmonary and Sleep of Tampa Bay 311 Noland Dr Brandon, FL 33511 (813) 654-8100 Fax: (813) 654-3377 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM Romano-Buckner, Jana ARNP Provider ID: 700300 Gender: Female Pulmonary and Sleep of Tampa Bay 4900 N Habana Ave Tampa, FL 33614 (813) 490-9495 Fax: (813) 874-0099 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:00 PM Romano-Buckner, Jana ARNP Provider ID: 714212 Gender: Female Florida Health Sciences Center Inc. 5 Tampa General Cir Tampa, FL 33606 (813) 251-0793 Fax: (813) 844-1988 18 Yrs/130 Yrs Tampa General Hospital Languages: Spanish M-F 7:30 AM - 5:00 PM Stutts, Stacy ARNP Provider ID: 1289510 Gender: Female USF Physicians Group 5 Tampa General Cir 3rd Fl Tampa, FL 33606 (800) 505-7769 Fax: (813) 844-4179 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Pulmonary Medicine Stephens, Shieloh ARNP Provider ID: 1340802 Gender: Male Tampa General Medical Group 12902 USF Magnolia Dr Tampa, FL 33612 (813) 745-3980 Fax: (813) 449-8257 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Radiation Oncology Vazquez, Eduardo PA Provider ID: 408087 Gender: Male Tampa Bay Radiation Oncology 403 S Kings Ave Ste 150 Brandon, FL 33511 (813) 685-2440 Fax: (813) 685-3019 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Vazquez, Eduardo PA Provider ID: 408087 Gender: Male Tampa Bay Radiation Oncology 4031 Upper Creek Dr Sun City Center, FL 33573 (813) 633-2733 Fax: (813) 642-0367 18 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Vazquez, Eduardo PA Provider ID: 408087 Gender: Male Tampa Bay Radiation Oncology 5931 Webb Rd Tampa, FL 33615 (813) 886-9277 Fax: (813) 886-9377 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM

Vazquez, Eduardo PA Provider ID: 408087 Gender: Male Tampa Bay Radiation Oncology 823 S Parsons Ave Brandon, FL 33511 (813) 685-2440 Fax: (813) 685-3019 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM

Reproductive Endocrinology Ziesman, Krista ARNP Provider ID: 1279600 Gender: Female USF Physicians Group 2 Tampa General Cir 4th Fl Tampa, FL 33606 (813) 259-8500 Fax: (813) 259-0882 18 Yrs/130 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM

Speech & Language Pathology Federico, Jeanne SLP Provider ID: 1042345 Gender: Female Therakids Plus Inc 16102 N Florida Ave Lutz, FL 33549 (813) 873-1936 Fax: (813) 873-8837 00 Yrs/130 Yrs M-TH 8:00 AM - 8:00 PM F 8:00 AM - 6:00 PM Galiszewski, Brooke SLP Provider ID: 1414928 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Circle Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Mueller, Pamela SLP Provider ID: 1365921 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (913) 260-9608 00 Yrs/21 Yrs M-F 8:00 AM - 7:00 PM Sanders, Sherra SLP Provider ID: 1152357 Gender: Female Imaris Therapy Services PA 12408 N 56th St Ste 2 Temple Terrace, FL 33617 (813) 374-9414 Fax: (813) 515-5475 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Stipe, Denise SLP Provider ID: 1042352 Gender: Female Therakids Plus Inc 16102 N Florida Ave Lutz, FL 33549 (813) 873-1936 Fax: (813) 873-8837 00 Yrs/130 Yrs M-TH 8:00 AM - 8:00 PM F 8:00 AM - 6:00 PM Thomas Allen, Tequesta SLP Provider ID: 1039695 Gender: Female Imari's Therapy Services PA 12408 N 56th St Ste 2 Temple Terrace, FL 33617 (813) 374-9414 Fax: (813) 515-5475 00 Yrs/130 Yrs M 9:00 AM - 7:00 PM TTH 4:00 AM - 6:00 PM W 9:00 AM - 6:00 PM FSat 10:00 AM - 2:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Speech & Language Pathology - cont. White, Laura SLP Provider ID: 1042312 Gender: Female United Cerebral Palsy of Tampa Bay 2215 E Henry Ave Tampa, FL 33610 (813) 239-1179 Fax: (813) 237-3091 00 Yrs/130 Yrs MTWTHFSatSun 7:30 AM 6:00 PM

Speech Therapy Amurgis, Christie SLP Provider ID: 1056866 Gender: Female Sunshine Speech and Language Center 10501 Rochester Way Tampa, FL 33626 (813) 833-0090 Fax: (813) 852-6373 00 Yrs/18 Yrs M-F 7:00 AM - 7:00 PM Andersen, Bailey SLP Provider ID: 1048413 Gender: Female Sunshine Speech and Language Center 10501 Rochester Way Tampa, FL 33626 (813) 833-0090 Fax: (813) 852-6373 00 Yrs/18 Yrs Languages: Spanish M-F 7:00 AM - 7:00 PM Barth, Jeanne SLP Provider ID: 1036615 Gender: Female Jmb Speech Language Pathology Servi 3709 W Hamilton Ave Ste 2 Tampa, FL 33614 (813) 930-0197 Fax: (813) 930-2426 00 Yrs/130 Yrs Languages: Spanish, Creole M-TH 9:00 AM - 6:00 PM F 9:00 AM - 5:00 PM

Boonyathitisuk, Pisami SLP Provider ID: 1044398 Gender: Female Speech Connection 16539 Lake Brigadoon Cir Tampa, FL 33618 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/21 Yrs Languages: Thai M-F 9:00 AM - 6:00 PM Booth, Kimberly SLP Provider ID: 1042333 Gender: Female Therakids Plus Inc 16102 N Florida Ave Lutz, FL 33549 (813) 873-1936 Fax: (813) 873-8837 00 Yrs/130 Yrs M-TH 8:00 AM - 8:00 PM F 8:00 AM - 6:00 PM Breedlove, Megan SLP Provider ID: 1044288 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM Byrd, Michelle SLP Provider ID: 1044375 Gender: Female Speech Connection 16539 Lake Brigadoon Cir Tampa, FL 33618 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/130 Yrs Languages: Thai M-F 9:00 AM - 6:00 PM

Cobb Dewitt, Mary SLP Provider ID: 1038241 Gender: Female Gorham Therapy Services 3433 Lithia Pnecrst Rd Ste 135 Valrico, FL 33596 (813) 391-8398 Fax: (813) 436-0735 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Daly, Diana SLP Provider ID: 1053963 Gender: Female Diane L Daly PA 6211 Tanager Pl Temple Terrace, FL 33617 (813) 767-2373 Fax: (813) 985-7026 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Genuardi, Sharon SLP Provider ID: 1042335 Gender: Female Therakids Plus Inc 16102 N Florida Ave Lutz, FL 33549 (813) 873-1936 Fax: (813) 873-8837 00 Yrs/130 Yrs M-TH 8:00 AM - 8:00 PM F 8:00 AM - 6:00 PM Grana, Jamira SLP Provider ID: 1038211 Gender: Female Gorham Therapy Services 3433 Lithia Pnecrst Rd Ste 135 Valrico, FL 33596 (813) 391-8398 Fax: (813) 436-0735 00 Yrs/130 Yrs M-F 9:00 AM - 6:30 PM Sat 9:00 AM - 1:00 PM

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Hamor, Marianne SLP Provider ID: 1048420 Gender: Female Sunshine Speech and Language Center 10501 Rochester Way Tampa, FL 33626 (813) 833-0090 Fax: (813) 852-6373 00 Yrs/18 Yrs Languages: Spanish MTWTHFSat 7:00 AM - 7:00 PM Henke, Robyn SLP Provider ID: 1045417 Gender: Female Speech Connection 16539 Lake Brigadoon Cir Tampa, FL 33618 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/21 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM Hull, Kimberly SLP Provider ID: 1035797 Gender: Female Achieveability Therapy Services 288 Crystal Grove Blvd Lutz, FL 33548 (813) 210-1949 Fax: (957) 342-0273 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM Joplin, Tennille SLP Provider ID: 1038188 Gender: Female Gorham Therapy Services 3433 Lithia Pnecrst Rd Ste 135 Valrico, FL 33596 (813) 391-8398 Fax: (813) 436-0735 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 6:00 PM

Last update 08/14/2017

Allied Providers Hillsborough Speech Therapy - cont. Jung, Gina SLP Provider ID: 1093483 Gender: Female United Cerebral Palsy of Tampa Bay 2215 E Henry Ave Tampa, FL 33610 (813) 239-1179 Fax: (813) 237-3091 00 Yrs/21 Yrs M-F 7:30 AM - 6:00 PM Lama, Colleen SLP Provider ID: 1371125 Gender: Female Communication Corner and More Inc 17718 Hunting Bow Cir Lutz, FL 33558 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Leigh, Jennifer SLP Provider ID: 1045363 Gender: Female Total Therapy 7243 US Hwy 301 S Riverview, FL 33578 (813) 663-9828 Fax: (813) 677-5029 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Magers, Deborah SLP Provider ID: 1231418 Gender: Female Decker Therapy Services LLC 4707 W Gandy Blvd Ste 12B Tampa, FL 33611 (813) 380-8230 Fax: (813) 991-9504 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Petrick, Christina SLP Provider ID: 1044407 Gender: Female Speech Connection 16539 Lake Brigadoon Cir Tampa, FL 33618 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/21 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM

Sleem, Sonya SLP Wallace, Davina SLP Provider ID: 1040816 Provider ID: 1049508 Gender: Female Gender: Female Sonya Sleem Therapy Services Sunshine Speech and LLC Language Center 710 Oakfield Dr Unit 127 10501 Rochester Way Brandon, FL 33511 Tampa, FL 33626 (813) 402-0282 (813) 833-0090 Fax: (813) 436-9620 Fax: (813) 852-6373 00 Yrs/130 Yrs 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Languages: Spanish M-F 7:00 AM - 7:00 PM Victores, Rebeca SLP Porreca, Tina SLP Sports Medicine Provider ID: 1046643 Provider ID: 1048076 Gender: Female Gender: Female Collins, Lawrence PA United Cerebral Palsy of Speech Connection Provider ID: 315600 Tampa Bay 1936 W Dr MLK Blvd Ste 204 Gender: Male 2215 E Henry Ave Tampa, FL 33607 USF Physicicans Group Tampa, FL 33610 (813) 579-2212 13601 Bru B Downs Blvd Ste 121 (813) 239-1179 Fax: (813) 345-2896 Tampa, FL 33613 Fax: (813) 237-3091 00 Yrs/21 Yrs (813) 396-9422 00 Yrs/21 Yrs MT 10:00 AM - 7:00 PM Fax: (813) 396-9490 Languages: Spanish W 10:00 AM - 6:00 PM 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM Prabhakaran, Gayle SLP Vizzi, Lindsay SLP Thoracic & Cardiovascular Provider ID: 1056850 Provider ID: 1045425 Surgery Gender: Female Gender: Female Speech Connection Therapy Station Gennara, Thomas PA 16539 Lake Brigadoon Cir 6911 Pistol Range Rd Ste 103A Tampa, FL 33618 Provider ID: 790697 Tampa, FL 33635 (813) 579-2212 Gender: Male (813) 814-5971 Fax: (813) 345-2896 West Florida Cardiology Fax: (813) 814-5972 Network LLC 00 Yrs/21 Yrs 00 Yrs/130 Yrs 270 S Moon Ave Languages: Thai M-F 9:00 AM - 5:30 PM Brandon, FL 33511 M-F 8:00 AM - 5:00 PM (813) 571-9988 Shafii Campbell, Alyssa SLP Vought, Jill SLP Fax: (813) 571-9922 Provider ID: 1050156 18 Yrs/130 Yrs Provider ID: 1045586 Gender: Female M-F 9:00 AM - 5:00 PM Gender: Female Alyssa N Shafii MS Ccc SLP PA Communication Corner and Koliha, Melissa PA More Inc 10601 Ashtead Wood Ct 17718 Hunting Bow Cir Provider ID: 1235228 Tampa, FL 33626 Lutz, FL 33558 Gender: Female (813) 251-4381 (813) 973-1033 USF Physicians Group Fax: (813) 251-6407 Fax: (813) 200-9608 5 Tampa General Cir 8th Fl 00 Yrs/21 Yrs 00 Yrs/130 Yrs Tampa, FL 33606 M-F 8:00 AM - 6:00 PM M-F 7:30 AM - 7:00 PM (813) 844-3228 Fax: (813) 844-7730 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Hillsborough Thoracic & Cardiovascular Surgery - cont. Marchant, Kimberly ARNP Provider ID: 540106 Gender: Female Tampa Transplant Institute Pl 5 Tampa General Cir Ste 725 Tampa, FL 33606 (813) 402-0654 Fax: (813) 402-0661 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Prewett, Jennifer PA Provider ID: 1235230 Gender: Female USF Physicians Group 5 Tampa General Cir 8th Fl Tampa, FL 33606 (813) 844-3228 Fax: (813) 844-7730 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Vascular Surgery Ekers, Mary ARNP Provider ID: 219569 Gender: Female USF Physicicans Group 2 Tampa General Cir 3rd Fl Tampa, FL 33606 (813) 259-0921 Fax: (813) 259-0606 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Manatee Audiology Collison, Lori AUD Provider ID: TPV05743-02 Gender: Female HearUSA 5602 Cortez Rd W Bradenton, FL 34210 (941) 761-3044 Fax: (941) 761-8554 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Desermia, Kristin AUD Provider ID: TPV07784-02 Gender: Female HearUSA 5602 Cortez Rd W Bradenton, FL 34210 (941) 761-3044 Fax: (941) 761-8554 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Parrish, Denise AUD Provider ID: TPV08750-01 Gender: Female Manatee Ear Center 2001 Manatee Ave Ste 104 Bradenton, FL 34208 (941) 745-1518 Fax: (941) 745-1343 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Vecchio, Christine AUD Provider ID: TPV09045-02 Gender: Female HearUSA 5602 Cortez Rd W Bradenton, FL 34210 (941) 761-3044 Fax: (941) 761-8554 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Cardiology Meiring, Maryellen ARNP Provider ID: 1198110 Gender: Female Coastal Cardiovascular Consultants 315 75th St W Bradenton, FL 34209 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Meiring, Maryellen ARNP Provider ID: 1198110 Gender: Female Coastal Cardiovascular Consultants 3904 Cortez Rd W Bradenton, FL 34210 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Meiring, Maryellen ARNP Provider ID: 1198110 Gender: Female Coastal Cardiovascular Consultants 4351 Cortez Rd W Ste 200 Bradenton, FL 34210 (941) 752-2840 Fax: (941) 345-1951 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Family Practice Cowan, Nena ARNP Provider ID: 1313483 Gender: Female Southeast Family Healthcare 1312 Manatee Ave E Bradenton, FL 34208 (941) 751-8100 00 Yrs/130 Yrs

Delaney, Janet ARNP Provider ID: 27565 Gender: Female Southeast Family Healthcare Center 919 53rd Ave E Bradenton, FL 34203 (941) 751-8100 Fax: (941) 751-8127 00 Yrs/130 Yrs MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM Harbison, Kimberly ARNP Provider ID: 1049314 Gender: Female East Manatee Healthcare Center 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8700 Fax: (941) 708-8736 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Hoefferle, Claudia PA Provider ID: 1141114 Gender: Female Healthcare America Drs Manatee 6033 26th St W Bradenton, FL 34207 (941) 752-2025 Fax: (941) 752-3921 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Krueger, Leroy PA Provider ID: 1209085 Gender: Male South East Family Health Mcrhs 919 53rd Ave E Bradenton, FL 34203 (941) 751-8100 Fax: (941) 751-8127 00 Yrs/130 Yrs MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 8:00 PM

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Mitchell, Rita ARNP Provider ID: 1169533 Gender: Female In Home Healthcare LLC 911 70th Dr E Sarasota, FL 34243 (941) 993-5543 Fax: (941) 755-0184 18 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM Persad, Farah PA Provider ID: 1032066 Gender: Female Edgar H Price Jr Family and Childre 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 00 Yrs/130 Yrs MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM Persad, Farah PA Provider ID: 1032066 Gender: Female North County Healthcare Center 1949 Northgate Blvd Bradenton, FL 34208 (941) 373-7844 Fax: (941) 373-7856 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM Persad, Farah PA Provider ID: 1032066 Gender: Female Southeast Family Healthcare Center 919 53rd Ave E Bradenton, FL 34203 (941) 751-8100 Fax: (941) 751-8127 00 Yrs/130 Yrs MTWF 8:00 AM - 5:00 PM TH 8:00 AM - 8:00 PM

Last update 08/14/2017

Allied Providers Manatee Family Practice - cont. Rose, Carey PA Provider ID: 1124772 Gender: Female Bradenton Family Medical Center 4805 26th St W Bradenton, FL 34207 (941) 753-7843 Fax: (941) 753-7845 00 Yrs/130 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 4:30 PM

General Surgery Kasten, Robert PA Provider ID: 1229518 Gender: Male West Flordia Trauma Netwrok LLC 2010 59th St W 2200 Bradenton, FL 34209 (941) 794-5621 Fax: (941) 761-1532 16 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM

Infectious Disease Mays, Michele ARNP Provider ID: 229477 Gender: Female Bach & Godofsky MD PA 6010 Pointe W. Blvd Bradenton, FL 34209 (941) 746-2711 Fax: (941) 746-3433 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Mays, Michele ARNP Provider ID: 229477 Gender: Female Bach & Godofsky, MD PA 2415 University Pkwy Ste 215 Sarasota, FL 34243 (941) 684-4300 Fax: (941) 746-5326 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Internal Medicine Boyette-Peterson, Bonnie ARNP Provider ID: 15299 Gender: Female Manatee Cty Rural Health Service 5108 15th St E Ste 205 Bradenton, FL 34203 (941) 751-2459 Fax: (941) 755-4556 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Rothstein, Marta ARNP Provider ID: 707652 Gender: Female West Florida Physician Network LLC 315 75th St W Bradenton, FL 34209 (941) 792-2211 Fax: (941) 794-6199 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Mental Health Schackman, Cynthia ARNP Provider ID: 1181678 Gender: Female Manatee County Rural Health Service 12271 US Hwy 301 N Parrish, FL 34219 (941) 776-4050 Fax: (941) 776-4057 05 Yrs/130 Yrs MTF 8:00 AM - 5:00 PM W 8:00 AM - 8:00 PM TH 8:00 AM - 1:00 PM

Neurology Clark, Tatiana ARNP Provider ID: 1245850 Gender: Female Pinnacle Medical Group 7005 Cortez Rd W Bradenton, FL 34210 (941) 465-4800 Fax: (877) 446-1404 00 Yrs/130 Yrs Blake Medical Center M-F 8:00 AM - 5:00 PM Raccio, Diane ARNP Provider ID: 924471 Gender: Female West Florida Physician Network LLC 7005 Cortez Rd W Bradenton, FL 34210 (941) 465-4888 Fax: (877) 446-1404 12 Yrs/130 Yrs Blake Medical Center Languages: German, Laotian, Bulgarian M-F 8:00 AM - 5:00 PM

Frazier, Cathy ARNP Provider ID: 1224525 Gender: Female Planned Parenthood-Manatee 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM Lopez-Rosa, Magda ARNP Provider ID: 796157 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs Languages: Spanish M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Nurse Practitioner Mashandure, Mercy ARNP Psychiatric Mental Health Reuter, Ilona ARNP Provider ID: 1069520 Gender: Female Centerstone of Florida Inc 5214 4th Ave Cir E Bradenton, FL 34208 (941) 782-4150 Fax: (941) 782-4642 18 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM

Obstetrics/Gynecology Askren, Holli CNM Provider ID: 955831 Gender: Female Florida Woman Care LLC 2401 University Pkwy Ste 201 Sarasota, FL 34243 (941) 359-8300 Fax: (941) 359-8310 12 Yrs/130 Yrs M-F 9:00 AM - 4:30 PM

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Provider ID: 800492 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs Languages: Spanish, Swahili M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Last update 08/14/2017

Allied Providers Manatee Obstetrics/Gynecology - Redlin, Jacqueline ARNP cont. McGinty, Susanne ARNP Provider ID: 705322 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM McKinnie, Cynthia ARNP Provider ID: 811213 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 6:00 PM T 9:00 AM - 4:00 PM W 9:00 AM - 1:00 PM Reames, Amanda ARNP Provider ID: 1075286 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Valentin, Socorro ARNP

Provider ID: 357586 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Provider ID: 678864 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Shreve, Tanya PA Provider ID: 802457 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Ward, Leslie ARNP Provider ID: 701949 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 2:00 PM T 10:00 AM - 3:00 PM W 1:00 AM - 6:00 PM

Staal, Jacqueline ARNP Provider ID: 801634 Gender: Female Planned Parenthood of SW and Centra 1105 53rd Ave E Ste 201 Bradenton, FL 34203 (941) 567-3800 Fax: (941) 753-3804 00 Yrs/130 Yrs M 10:00 AM - 6:00 PM T 9:00 AM - 4:00 PM W 9:00 AM - 1:00 PM Thomas, Brandy CNM Provider ID: 916198 Gender: Female Florida Woman Care LLC 5323 4th Ave Cir E Bradenton, FL 34208 (941) 745-5115 Fax: (941) 567-1000 12 Yrs/112 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM

Occupational Medicine Halliday, Megan OT Provider ID: 1064677 Gender: Female Childrens Therapy Solutions Inc 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM

Kirchberg, Cynthia OT Provider ID: 1060206 Gender: Female Easter Seals Southwest Florida Inc 350 Braden Ave Sarasota, FL 34243 (941) 355-7637 Fax: (941) 358-3069 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Newingham, Lorin OT Provider ID: 1070099 Gender: Female Childrens Therapy Solutions Inc 3823 E SR 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs MTWTHFSatSun 8:00 AM 8:00 PM Perez, Kristina OT Provider ID: 1250262 Gender: Female Children's Therapy Solutions, Inc 3823 E SR 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM

Pogan, Cara OT Provider ID: 1339598 Gender: Female Childrens Therapy Solutions Occupational Therapy Inc 3823 E State Rd 64 Geimer, Kristie OT Bradenton, FL 34208 Provider ID: 1043220 (941) 945-5111 Gender: Female Easter Seals Southwest Florida Fax: (941) 745-5667 00 Yrs/130 Yrs Inc M-TH 8:00 AM - 6:00 PM 350 Braden Ave F 8:00 AM - 5:00 PM Sarasota, FL 34243 (941) 355-7637 Fax: (941) 358-3069 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

www.wellcare.com/Florida | 685

Last update 08/14/2017

Allied Providers Manatee Occupational Therapy cont. Reinbolt, Elizabeth OT Provider ID: 1241573 Gender: Female Children's Therapy Solutions, Inc 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Thoresen, Lena OT Provider ID: 996404 Gender: Female Childrens Therapy Solutions 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM

Pediatrics Belony, Assoye PA Provider ID: 1207542 Gender: Female Lawton Chiles and Family Healt 1515 26th Ave E Bradenton, FL 34208 (941) 708-8600 Fax: (941) 708-7645 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Eastman, Jessica ARNP Provider ID: 1418156 Gender: Female Ellenton Pediatrics 8425 US Hwy 301 N Parrish, FL 34219 (941) 723-7877 Fax: (941) 723-7844 00 Yrs/21 Yrs M-W 8:00 AM - 5:00 PM TH 8:0 AM - 5:00 PM F 0:80 AM - 5:00 PM

Eddy Gennocro, Erin ARNP Provider ID: 1047896 Gender: Female Manatee Pediatrics 712 39th St W Bradenton, FL 34205 (941) 748-4602 Fax: (941) 747-9230 00 Yrs/21 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM Hernandez, Martha PA Provider ID: 1237596 Gender: Female Palmetto Pediatrics 218 9th St W Palmetto, FL 34221 (941) 721-3900 Fax: (941) 721-7403 00 Yrs/21 Yrs M 8:30 AM - 6:00 PM TWTHF 8:30 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Hernandez, Martha PA Provider ID: 1237596 Gender: Female Palmetto Pediatrics 3425 University Pkwy Ste 103 Sarasota, FL 34243 (941) 355-1777 Fax: (941) 355-7788 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Lambert, Alexandra ARNP Provider ID: 1247640 Gender: Female Federico A Frias MD PA DBA APC Pedi 1862 Rye Rd Ste 101 Bradenton, FL 34212 (941) 755-7000 Fax: (941) 209-7685 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Lambert, Alexandra ARNP Provider ID: 1247640 Gender: Female Federico A Frias MD PA DBA APC Pedi 5255 Office Park Blvd Ste 110 Bradenton, FL 34203 (941) 755-7000 Fax: (941) 755-7088 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Roscher, Elizabeth ARNP Provider ID: 22721 Gender: Female Manasota Pediatrics 3425 University Pkwy Ste 103 Sarasota, FL 34243 (941) 355-1777 Fax: (941) 355-7788 00 Yrs/21 Yrs Languages: Hindi, Gujarati, Telugu M-F 8:30 AM - 5:00 PM

Lucero, Heather ARNP Roscher, Elizabeth ARNP Provider ID: 712083 Gender: Female Provider ID: 22721 APC Pediatrics Gender: Female 1862 Rye Rd Ste G Palmetto Pediatrics Bradenton, FL 34212 218 9th St Dr W (941) 755-7000 Palmetto, FL 34221 Fax: (941) 755-7088 (941) 721-3900 00 Yrs/18 Yrs Fax: (941) 721-7403 Languages: Spanish, Romanian 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Languages: Hindi, Gujarati, Telugu Lucero, Heather ARNP M-F 8:30 AM - 5:00 PM Provider ID: 712083 Soeker, Linda ARNP Gender: Female Provider ID: 1209099 APC Pediatrics PA Gender: Female 5255 Office Park Blvd Ste 110-111 712 39th St W Bradenton, FL 34203 Bradenton, FL 34205 (941) 755-7000 (941) 748-4602 Fax: (941) 755-7088 Fax: (941) 747-9230 00 Yrs/18 Yrs 00 Yrs/21 Yrs Languages: Spanish, Romanian MTWTHFSat 8:00 AM - 8:00 PM M-F 8:00 AM - 5:00 PM Sun 9:00 AM - 5:00 PM McKelvie Zeller, Jessica ARNP Stump, Kay ARNP Provider ID: 375812 Provider ID: 691491 Gender: Female Gender: Female APC Pediatrics Ellenton Pediatrics 1862 Rye Rd Ste 101 8425 US Hwy 301 N Bradenton, FL 34212 Parrish, FL 34219 (941) 755-7000 (941) 723-7877 Fax: (941) 755-7088 Fax: (941) 723-7844 00 Yrs/18 Yrs 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 686

Last update 08/14/2017

Allied Providers Manatee Pediatrics - cont. Stump, Kay ARNP Provider ID: 375812 Gender: Female APC Pediatrics 5255 Office Park Blvd Ste 110-111 Bradenton, FL 34203 (941) 755-7000 Fax: (941) 755-7088 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Physical Therapy Kaminski, Jessica PT Provider ID: 1310806 Gender: Female Childrens Therapy Solutions 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM

Warne, Hannah PT Provider ID: 1335646 Gender: Female Easter Seals of South West Florida 350 Braden Ave Sarasota, FL 34243 (941) 355-7637 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:30 PM

Physician Assistant Lidge, Alecia PA Provider ID: 1069497 Gender: Female Manatee Glens Inc 379 6th Ave W Bradenton, FL 34205 (941) 782-4150 Fax: (941) 782-4101 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Speech & Language Pathology

Humphrey, Chelsey SLP Provider ID: 1359340 Gender: Female Childrens Therapy Solutions Inc 3823 E State Rd 64 Bradenton, FL 34208 (941) 745-5111 Fax: (941) 745-5667 00 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 8:00 AM - 5:00 PM

Speech Therapy Crespo, Shannon SLP Provider ID: 1043224 Gender: Female Easter Seals Southwest Florida Inc 350 Braden Ave Sarasota, FL 34243 (941) 355-7637 Fax: (941) 358-3069 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Nastan, Mary PT Flores, Anita SLP Drew, Kelly SLP Provider ID: 1047890 Provider ID: 1318039 Gender: Female Provider ID: 1043215 Gender: Female Easter Seals Southwest Florida A Center For Life Gender: Female Inc Enhancement Easter Seals Southwest Florida 350 Braden Ave Inc 3588 Parkridge Cir Sarasota, FL 34243 350 Braden Ave Sarasota, FL 34243 (941) 355-7637 Sarasota, FL 34243 (941) 538-8000 Fax: (941) 358-3069 (941) 355-7637 00 Yrs/130 Yrs 00 Yrs/18 Yrs Fax: (941) 358-3069 M-F 8:30 AM - 6:00 PM M 8:00 AM - 4:00 PM 00 Yrs/18 Yrs Galeano, Lilian SLP M-F 8:00 AM - 5:00 PM Scully, Karrin PT Provider ID: 1349376 Murby, Nicole SLP Provider ID: 1064672 Gender: Female Gender: Female Easter Seals Southwest Florida Provider ID: 1043229 Childrens Therapy Solutions Gender: Female 350 Braden Ave Inc Eastern Seals Seaster Seals Sarasota, FL 34243 3823 E SR 64 Southwe (941) 355-7637 Bradenton, FL 34208 350 Braden Ave Fax: (941) 359-1555 (941) 745-5111 Sarasota, FL 34243 00 Yrs/21 Yrs Fax: (941) 745-5667 (941) 355-7637 M-F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs Fax: (941) 358-3069 M-F 8:00 AM - 8:00 PM 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

www.wellcare.com/Florida | 687

Last update 08/14/2017

Allied Providers Pasco Advanced Registered Nurse Practioner Alexander, Sandra ARNP Provider ID: 1332876 Gender: Female Florida Woman Care LLC 8145 Cerebellum Way Ste 102 Trinity, FL 34655 (727) 845-4999 Fax: (866) 777-2195 12 Yrs/130 Yrs MW 9:00 AM - 12:00 PM T 9:00 AM - 5:00 PM

Audiology Desermia, Kristin AUD Provider ID: TPV07784-03 Gender: Female HearUSA 7894 Gall Blvd. Zephyrhills, FL 33541 (813) 788-0603 Fax: (813) 788-9242 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Gladwin, Lydia AUD Provider ID: TPV06848-04 Gender: Female HearUSA 5139 US Hwy 19 New PT Richey, FL 34652 (727) 849-6076 Fax: (727) 848-2830 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Gladwin, Lydia AUD Provider ID: TPV06848-05 Gender: Female HearUSA 7894 Gall Blvd. Zephyrhills, FL 33541 (813) 788-0603 Fax: (813) 788-9242 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Gladwin, Lydia AUD Provider ID: TPV06848-06 Gender: Female HearUSA 8725 Little Rd. New Port Richey, FL 34654 (727) 372-8046 Fax: (727) 849-2608 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM McKeithan, Kyra AUD Provider ID: TPV17513-02 Gender: Female HearUSA 5139 US Hwy 19 New PT Richey, FL 34652 (727) 849-6076 Fax: (727) 848-2830 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM McKeithan, Kyra AUD Provider ID: TPV17513-03 Gender: Female HearUSA 8725 Little Rd. New Port Richey, FL 34654 (727) 372-8046 Fax: (727) 849-2608 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Mills, Jeffrey AUD Provider ID: TPV17193-01 Gender: Male HearUSA 5139 US Hwy 19 New PT Richey, FL 34652 (727) 849-6076 Fax: (727) 848-2830 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Mills, Jeffrey AUD Provider ID: TPV17193-02 Gender: Male HearUSA 8725 Little Rd. New Port Richey, FL 34654 (727) 372-8046 Fax: (727) 849-2608 18 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Oldfield, Christopher AUD Provider ID: TPV17173-06 Gender: Male HearUSA 5139 US Hwy 19 New PT Richey, FL 34652 (727) 849-6076 Fax: (727) 848-2830 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Oldfield, Christopher AUD Provider ID: TPV17173-09 Gender: Male HearUSA 8725 Little Rd. New Port Richey, FL 34654 (727) 372-8046 Fax: (727) 849-2608 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sparkman, Susanne AUD Provider ID: TPV08322-02 Gender: Female HearUSA 5139 US Hwy 19 New PT Richey, FL 34652 (727) 849-6076 Fax: (727) 848-2830 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Vecchio, Christine AUD Provider ID: TPV09045-03 Gender: Female HearUSA 7894 Gall Blvd. Zephyrhills, FL 33541 (813) 788-0603 Fax: (813) 788-9242 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 688

Cardiology Dawson, Heather ARNP Provider ID: 1365628 Gender: Female Baycare Medical Group Inc 6633 Forest Ave Ste 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lenard, Melanie ARNP Provider ID: 1323379 Gender: Female Baycare Medical Group Inc 6633 Forest Ave 300 New Port Richey, FL 34653 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Certified Nurse Midwife Tinny, Jacqueline CNM Provider ID: 421354 Gender: Female Womens Care Florida 2102 Trinity Oaks Blvd Ste 171 New Port Richey, FL 34655 (727) 376-7734 Fax: (727) 408-5336 12 Yrs/130 Yrs Mease Countryside Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM

Dermatology Breen, James PA Provider ID: 916666 Gender: Male Advanced Dermatology Cosmetic Surge 8209 State Rd 54 New Port Richey, FL 34655 (727) 569-1055 Fax: (727) 569-1505 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pasco Dermatology - cont. Chawk, Beverly ARNP Provider ID: 1310200 Gender: Female Advanced Dermatology and Cosmetic S 13908 Lakeshore Blvd Ste 240 Hudson, FL 34667 (727) 863-1312 Fax: (727) 863-7929 00 Yrs/130 Yrs MTTHF 8:00 AM - 5:00 PM W 89:00 AM - 5:00 PM Goff, Michelle PA Provider ID: 917670 Gender: Female 27612 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 991-1457 Fax: (813) 991-1457 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Koehn, Ryan PA Provider ID: 1005389 Gender: Male New Image Dermatology 5534 Gulf Dr Ste 1 New Port Richey, FL 34652 (727) 847-3992 Fax: (727) 848-1118 00 Yrs/130 Yrs M-F 7:30 AM - 4:30 PM Koehn, Ryan PA Provider ID: 1005389 Gender: Male New Image Dermatology 7509 State Rd 52 Ste 150 Bayonet Point, FL 34667 (727) 863-8884 Fax: (727) 863-3964 00 Yrs/130 Yrs M-F 7:30 AM - 4:30 PM

Obradovich, Shelia PA Provider ID: 957260 Gender: Female Advanced Dermatology Cosmetic Surg 13908 Lakeshore Blvd Ste 240 Hudson, FL 34667 (727) 868-1312 Fax: (727) 863-7929 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Shulstad, Raymond ARNP

Obradovich, Shelia PA Provider ID: 957260 Gender: Female Advanced Dermatology Cosmetic Surg 27612 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 991-1457 Fax: (813) 907-2706 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Endocrinology, Diabetes, Metabolism

Obradovich, Shelia PA Provider ID: 957260 Gender: Female Advanced Dermatology Cosmetic Surg 8209 State Rd 54 New Port Richey, FL 34655 (727) 569-1055 Fax: (727) 569-1505 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Shulstad, Raymond ARNP Provider ID: 905860 Gender: Male 13908 Lakeshore Blvd Ste 240 Hudson, FL 34667 (727) 868-1312 Fax: (727) 863-7929 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Provider ID: 905860 Gender: Male 27612 Cashford Cir Ste 102 Wesley Chapel, FL 33544 (813) 991-1457 Fax: (813) 907-2706 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Aquino, Sheila ARNP Provider ID: 795242 Gender: Female Diabetes Care Center Inc 14100 Fivay Rd Ste 250 Hudson, FL 34667 (727) 869-7822 Fax: (727) 862-0934 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 4:00 PM Aquino, Sheila ARNP Provider ID: 795242 Gender: Female Diabetes Care Center Inc 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 869-3688 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 4:00 PM Collins, Sara ARNP Provider ID: 1090270 Gender: Female Diabetes Care Center Inc 14100 Fivay Rd Ste 250 Hudson, FL 34667 (727) 869-7822 Fax: (727) 869-3688 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM

www.wellcare.com/Florida | 689

Collins, Sara ARNP Provider ID: 1090270 Gender: Female Diabetes Care Center Inc 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 869-3688 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM Gonzalez, Joanna PA Provider ID: 1040551 Gender: Female Lucia Gilling MD PA 2252 Twelve Oaks Way Ste 101 Wesley Chapel, FL 33544 (813) 915-6811 Fax: (813) 907-0494 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Pick, Glenna ARNP Provider ID: 930900 Gender: Female Diabetes Care Center, Inc 14100 Fivay Rd Ste 250 Hudson, FL 34667 (727) 869-7822 Fax: (727) 869-3688 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM Pick, Glenna ARNP Provider ID: 930900 Gender: Female Diabetes Care Center, Inc 5422 US Hwy 19 New Port Richey, FL 34652 (727) 869-7822 Fax: (727) 869-3688 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM

Last update 08/14/2017

Allied Providers Pasco Family Practice

Curtis, Lindsay ARNP Provider ID: 949763 Carulli, Denise ARNP Gender: Female Provider ID: 654928 37920 Medical Arts Ct Gender: Female Zephyrhills, FL 33541 Continucare Medical Center (352) 518-2000 Lutz Fax: (352) 567-1974 21507 Vlg Lks Shopping Center 00 Yrs/130 Yrs Dr Languages: Spanish Land O Lakes, FL 34639 MTTHF 7:30 AM - 5:30 PM (813) 949-4224 W 7:30 AM - 1:00 PM Fax: (813) 949-2809 Curtis, Lindsay ARNP 00 Yrs/130 Yrs Provider ID: 949763 M-F 9:00 AM - 5:00 PM Gender: Female Casler, Viva ARNP Lacoochee Family Health Center Provider ID: 297689 38724 Mudcat Grant Blvd Gender: Female Dade City, FL 33523 New Port Richey Family Health Center (352) 518-2000 2114 Seven Spgs Blvd Ste 300 Fax: (352) 567-0218 Trinity, FL 34655 00 Yrs/130 Yrs (352) 518-2000 Languages: Spanish Fax: (727) 645-4251 M 7:00 AM - 4:00 PM 00 Yrs/130 Yrs Geyvandova, Yana ARNP Languages: Spanish M-F 8:00 AM - 5:00 PM Provider ID: 864385 Casler, Viva ARNP Gender: Female Provider ID: 297689 Access Healthcare LLC Gender: Female 7633 Cita Ln Premier Community New Port Richey, FL 34653 Healthcare Group (727) 372-1005 6636 Forest Ave 00 Yrs/130 Yrs New Port Richey, FL 34653 M-F 8:00 AM - 5:00 PM (352) 518-2000 Fax: (727) 645-4251 McCrimmon, Barrie ARNP 00 Yrs/130 Yrs Languages: Spanish Provider ID: 1346332 M-F 8:00 AM - 5:00 PM Gender: Female Pasco Hernando Hma Casler, Viva ARNP Physician Manage Provider ID: 297689 13933 17th St Ste 101 Gender: Female Dade City, FL 33525 Premier Community (352) 567-6763 Healthcare Grp In Fax: (352) 567-2146 37944 Church Ave 18 Yrs/130 Yrs Dade City, FL 33525 M-F 9:00 AM - 5:00 PM (352) 518-2000 Fax: (352) 567-5193 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Olton, Robert PA Provider ID: 966384 Gender: Male 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-1974 00 Yrs/130 Yrs Languages: Spanish MTTHF 7:30 AM - 5:30 PM W 7:30 AM - 1:00 PM Patel, Kirti PA Provider ID: 904881 Gender: Female Wesley Chapel Medical Clinic 5819 Argerian Dr Wesley Chapel, FL 33545 (813) 994-0800 Fax: (813) 994-0866 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Rodriguez, Madali ARNP Provider ID: 232393 Gender: Female Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (813) 788-7930 00 Yrs/21 Yrs Languages: Spanish MTTHF 8:00 AM - 5:00 PM W 10:00 AM - 7:00 PM Walters, Christopher PA Provider ID: 1022506 Gender: Male Ridge Manor Medical Clinic 34498 Cortez Blvd Ridge Manor, FL 33523 (352) 583-4520 Fax: (352) 583-2427 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

www.wellcare.com/Florida | 690

Woodyard, John PA Provider ID: 979758 Gender: Male 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 656-7197 00 Yrs/130 Yrs Languages: Spanish MTTHF 7:30 AM - 5:30 PM W 7:30 AM - 1:00 PM

General Surgery Greenfield, Ashley PA Provider ID: 919727 Gender: Female West Florida Trauma Network LLC 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Johnson, Skyler PA Provider ID: 920432 Gender: Female West Florida Trauma Network LLC 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Knobl, Thomas ARNP Provider ID: 1230838 Gender: Male Bayonet Point Trauma Group 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pasco General Surgery - cont. Sprehe, Stacey PA Provider ID: 1160755 Gender: Female Bayonet Point Trauma Group 7529 Medical Dr Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs CRMC At Bayonet Point M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM

Neurosurgery Lane, Jennifer ARNP Provider ID: 1362320 Gender: Female West Florida Trauma Network 7529 Medical Dr Ste 208 Hudson, FL 34667 (727) 862-6524 Fax: (727) 862-6439 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Nurse Midwife Brown, Delrose CNM Provider ID: 169608 Gender: Female Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (813) 780-4280 Fax: (813) 788-7930 12 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-F 9:00 AM - 5:00 PM Brown, Delrose CNM Provider ID: 169608 Gender: Female Premier Community Healthcare Group 3799 Church Ave Dade City, FL 33525 (352) 518-2006 Fax: (352) 567-5193 12 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-F 9:00 AM - 5:00 PM

Newby, Suzanne PA Provider ID: 1149631 Brown, Delrose CNM Gender: Female Neurosurgery of West Florida Provider ID: 169608 Gender: Female 7529 Medical Dr Premier Community Hudson, FL 34667 Healthcare Group (727) 862-6524 37994 Church Ave Fax: (727) 862-6439 Dade City, FL 33525 00 Yrs/130 Yrs (352) 518-2006 M-F 8:00 AM - 5:00 PM Fax: (352) 567-5193 12 Yrs/130 Yrs Newby, Suzanne PA Florida Hospital Zephyrhills Provider ID: 1149631 Languages: Spanish Gender: Female Neurosurgery of West Florida M-F 9:00 AM - 5:00 PM 9332 SR 54 Ste 400 Brown, Delrose CNM Trinity, FL 34655 Provider ID: 169608 (727) 862-6524 Gender: Female Fax: (727) 862-6439 Premier Community 00 Yrs/130 Yrs Healthcare Group M-F 8:00 AM - 5:00 PM 38030 Daughtery Rd Zephyrhills, FL 33540 (352) 518-2000 Fax: (352) 567-0218 12 Yrs/130 Yrs Florida Hospital Zephyrhills Languages: Spanish M-F 8:00 AM - 5:00 PM

Obstetrics Abraham, Andria ARNP Provider ID: 985710 Gender: Female Womens Care Florida 3743 Maryweather Ln Wesley Chapel, FL 33544 (813) 286-0033 Fax: (813) 282-1806 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:30 PM

Tinny, Jacqueline CNM Provider ID: 421354 Gender: Female Womens Care Florida 2102 Trinity Oaks Blvd Ste 171 New Port Richey, FL 34655 (727) 376-7734 Fax: (727) 408-5336 12 Yrs/130 Yrs Mease Countryside Hospital M-TH 8:00 AM - 5:00 PM F 8:00 AM - 3:00 PM

Obstetrics/Gynecology

Abraham, Andria ARNP Provider ID: 985710 Gender: Female Womens Care Florida LLC 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM Moore, Patricia ARNP Provider ID: 984997 Gender: Female Womens Care Florida LLC 2324 Cypress Cv Wesley Chapel, FL 33544 (813) 876-0914 Fax: (813) 876-9198 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM Moore, Patricia ARNP Provider ID: 984997 Gender: Female Womens Care Florida LLC 3743 Maryweather Ln Wesley Chapel, FL 33544 (813) 973-9728 Fax: (813) 907-7608 12 Yrs/130 Yrs M-TH 8:30 AM - 5:00 PM F 7:30 AM - 4:00 PM

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Ray, Tanya ARNP Provider ID: 1324967 Gender: Female Florida Woman Care LLC 8145 Cerebellum Way Ste 102 Trinity, FL 34655 (727) 845-4999 Fax: (866) 777-2195 12 Yrs/130 Yrs Languages: Spanish, Portuguese M 1:00 AM - 6:00 PM TW 10:00 AM - 8:00 PM Vaughn-Kerns, Karen CNM Provider ID: 174845 Gender: Female Florida Woman Care LLC 2044 Trinity Oaks Blvd Ste 215 New Port Richey, FL 34655 (727) 376-0060 Fax: (727) 375-7308 12 Yrs/130 Yrs Mease Countryside Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM Williams, Michelle Ann CNM Provider ID: 1364928 Gender: Female Florida's Women Acre, LLC 2044 Trinity Oaks Blvd Ste 215 Trinity, FL 34655 (727) 376-0060 Fax: (727) 375-7308 00 Yrs/130 Yrs M-TH 9:00 AM - 5:00 PM F 9:00 AM - 12:30 PM

Last update 08/14/2017

Allied Providers Pasco Occupational Therapy Angelillis, Kimberly OT Provider ID: 1087266 Gender: Female Integrated Therapy Alliance Inc 5807 Argerian Dr Ste 101 Wesley Chapel, FL 33545 (813) 973-9068 Fax: (866) 542-4710 00 Yrs/21 Yrs M-F 12:00 AM - 5:00 PM Bayron, Jennifer OT Provider ID: 1087706 Gender: Female Integrated Therapy Alliance Inc 5807 Argerian Dr Ste 101 Wesley Chapel, FL 33545 (813) 973-9068 Fax: (866) 542-4710 00 Yrs/21 Yrs M-F 12:00 AM - 5:00 PM Beck, Sandra OT Provider ID: 1038445 Gender: Female All Kids Therapy Services, Inc 3407 Clover Blossom Cir Land O Lakes, FL 34638 (813) 245-3098 Fax: (813) 926-5607 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM Ferreyra, Stephanie OT Provider ID: 1418116 Gender: Female Communication Corner and More 2244 Green Hedges Way Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/21 Yrs M-F 8:00 AM - 7:00 PM

Fitzgerald, Jennifer OT Provider ID: 1178591 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 741-3405 Fax: (727) 213-6246 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM Gallea, Elisabeth OT Provider ID: 1352375 Gender: Female Communication Corner and More Inc 2241 Green Hedges Way Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/21 Yrs M-W 8:00 AM - 5:00 PM THF 80:00 AM - 5:00 PM Lamke, Kimberly OT Provider ID: 1043176 Gender: Female Communication Corner and More! Inc 2241 Green Hedges Way Ste 101 Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM Miilu, Erik OT Provider ID: 1349703 Gender: Male Genesis Eldercare Rehabilitation SE 7927 State Rd 52 Hudson, FL 34667 (727) 378-8586 Fax: (727) 378-8587 00 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM

Riley-Naylor, Erin OT Provider ID: 1047503 Gender: Female Communication Corner and More Inc 2241 Green Hedges Way Ste 101 Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM Zdrubecky, Carrie OT Provider ID: 1041310 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 741-3405 Fax: (727) 213-6246 00 Yrs/21 Yrs M-F 8:00 AM - 8:00 PM

Orthopaedic Surgery Murchie, Adam ARNP Provider ID: 241435 Gender: Male Coastal Orthopedics and Sports Medi 5145 Deer Park Dr New Port Richey, FL 34653 (727) 848-1417 Fax: (727) 847-7526 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Rawls, Jonathan PA Provider ID: 540369 Gender: Male Coastal Orthopaedics and Sports Med 5145 Deer Park Dr New Port Richey, FL 34653 (727) 848-1417 Fax: (727) 847-7526 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Rawls, Jonathan PA Provider ID: 540369 Gender: Male Coastal Orthopaedics and Sports Med 7509 State Rd 52 Ste 130 Hudson, FL 34667 (727) 848-1417 Fax: (727) 847-7526 12 Yrs/130 Yrs M-W 9:00 AM - 5:00 PM

Pediatric Cardiology Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 27509 Cashford Cir Wesley Chapel, FL 33544 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Pediatric Gastroenterology Sarnaik, Shawn PA Provider ID: 919473 Gender: Female 4443 Rowan Rd New Port Richey, FL 34653 (813) 987-2911 Fax: (813) 987-2853 00 Yrs/130 Yrs M-F 7:30 AM - 5:00 PM

Pediatric Orthopaedics Carney, Jacquelyn PA Provider ID: 1074572 Gender: Female Cossa 4443 Rowan Rd New Port Richey, FL 34653 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pasco Pediatric Orthopaedics - Clark, Louann ARNP cont. Provider ID: 177150 Cimilluca, Cara PA Provider ID: 424842 Gender: Female Childrens Orthopaedic and Scoliosis 4443 Rowan Rd New Port Richey, FL 34653 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc MT 1:00 AM - 4:00 PM Graham, Adria PA Provider ID: 1340748 Gender: Female Children's Orthopaedic Scoliosis S 4443 Rowan Rd New Port Richey, FL 34653 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Thompson, Cody PA Provider ID: 973391 Gender: Male Childrens Orthopaedic and Scoliosis 4443 Rowan Rd New Port Richey, FL 34653 (813) 879-2663 Fax: (813) 872-0286 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc MT 1:00 AM - 4:00 PM

Pediatrics Clark, Louann ARNP Provider ID: 177150 Gender: Female Premier Community Healthcare Group 14027 5th St Dade City, FL 33525 (352) 518-2000 Fax: (352) 567-1974 00 Yrs/21 Yrs MTHF 8:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 8:00 AM - 12:00 PM

Gender: Female Premier Community Healthcare Group 37920 Medical Arts Ct Zephyrhills, FL 33541 (352) 518-2000 Fax: (813) 783-2745 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

McCormack, Leah ARNP Provider ID: 817631 Gender: Female East Lake Pediatrics 2137 Little Rd Trinity, FL 34655 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Flynn, Lynn ARNP Provider ID: 1106181 Gender: Female A To Z Pediatrics 4804 Rowan Rd New Port Richey, FL 34653 (727) 375-5242 Fax: (727) 375-5198 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM

Riddle, Heather ARNP Provider ID: 978727 Gender: Female Abbrakidabra Kids Clinic 8736 US Hwy 19 Port Richey, FL 34668 (727) 478-8876 Fax: (727) 478-8868 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM

Leal, Jennifer ARNP Provider ID: 449348 Gender: Female East Lake Pediatrics PA 2137 Little Rd New Port Richey, FL 34655 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs Mease Countryside Hospital M-F 8:00 AM - 5:00 PM

Savino, Tarah PA Provider ID: 801424 Gender: Female A To Z Pediatrics 4804 Rowan Rd New Port Richey, FL 34653 (727) 375-5242 Fax: (727) 375-5198 00 Yrs/21 Yrs Languages: Spanish, Hindi M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Madden, Sasha ARNP Provider ID: 1051884 Gender: Female Pediatric Partners of Zephyrhills P 6712 Dairy Rd Zephyrhills, FL 33542 (813) 782-6064 Fax: (813) 782-0984 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Physical Therapy Guida, Meghan PT Provider ID: 1044640 Gender: Female Communication Corner and More Inc 2241 Green Hedges Way Ste 101 Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 7:30 AM - 7:00 PM

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Westervelt, Lindley PT Provider ID: 1223776 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 741-3405 Fax: (727) 213-6246 00 Yrs/18 Yrs M-F 8:00 AM - 8:00 PM

Speech & Language Pathology Abramovitz, Sarah SLP Provider ID: 1324831 Gender: Female Genesis Eldercare Rehabilitation SE 7423 Kauai Loop New Port Richey, FL 34653 (727) 807-6084 Fax: (727) 807-6078 00 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM Blankinship, Louellen SLP Provider ID: 1340768 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 741-3405 Fax: (727) 231-6246 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Galiszewski, Brooke SLP Provider ID: 1414928 Gender: Female Communication Corner and More Inc 2241 Green Hedges Way Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pasco Speech & Language Pathology - cont.

Boonyathitisuk, Pisami SLP

Provider ID: 1044398 Gress, Samantha SLP Gender: Female Provider ID: 1330508 Speech Connection Gender: Female 3152 Little Rd Ste 185 Kernaghan and Moore Speech New Port Richey, FL 34655 And Lang (813) 579-2212 6245 State Rd 54 Fax: (813) 345-2896 New Port Richey, FL 34653 00 Yrs/21 Yrs (727) 376-1111 Languages: Thai Fax: (727) 376-1113 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs Breedlove, Megan SLP M 8:00 AM - 5:00 PM TWTHF 9:00 AM - 5:00 PM Provider ID: 1044288 Gender: Female Mueller, Pamela SLP Communication Corner and Provider ID: 1365921 More Inc Gender: Female 2241 Green Hedges Way Ste 101 Communication Corner and More Inc Wesley Chapel, FL 33544 2241 Green Hedges Way (813) 973-1033 Wesley Chapel, FL 33544 Fax: (813) 200-9608 (813) 973-1033 00 Yrs/130 Yrs Fax: (813) 260-9608 M-F 7:30 AM - 7:00 PM 00 Yrs/21 Yrs Byrd, Michelle SLP M-F 8:00 AM - 7:00 PM Provider ID: 1044375 Reid, Keslynn SLP Gender: Female Provider ID: 1322862 Speech Connection Gender: Female 3152 Little Rd Ste 185 Genesis Eldercare New Port Richey, FL 34655 Rehabilitation SE (813) 579-2212 7423 Kauai Loop Fax: (813) 345-2896 New Port Richey, FL 34653 00 Yrs/130 Yrs (727) 807-6084 Languages: Thai Fax: (727) 807-6078 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs Cichra, Deborah SLP M-F 8:00 AM - 4:00 PM Provider ID: 1037966 Speech Therapy Gender: Female Creative Speech Solutions Beer, Jamie SLP and Thera Provider ID: 1047521 12413 White Bluff Rd Gender: Female Hudson, FL 34669 Leap Into Language Inc (727) 741-3405 3916 Sorrel Vine Dr Fax: (727) 213-6246 Wesley Chapel, FL 33544 00 Yrs/18 Yrs (813) 545-0977 M-F 8:00 AM - 7:00 PM Fax: (866) 431-1912 00 Yrs/21 Yrs M-F 8:30 AM - 6:00 PM

Danner, Erin SLP Provider ID: 1038426 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 741-3405 Fax: (727) 213-6246 00 Yrs/21 Yrs MTWTHFSat 8:00 AM - 8:00 PM Fitzpatrick, Laura SLP Provider ID: 1038376 Gender: Female Kernaghan and Moore 6245 State Rd 54 New Port Richey, FL 34653 (727) 376-1111 Fax: (727) 376-1113 00 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM Gillham, Nicole SLP Provider ID: 1038005 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 731-3405 Fax: (727) 213-6246 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Gillin, Kelly SLP Provider ID: 1038429 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 731-3405 Fax: (727) 213-6246 00 Yrs/21 Yrs M-F 8:00 AM - 7:00 PM Henke, Robyn SLP Provider ID: 1045417 Gender: Female Speech Connection 3152 Little Rd Ste 185 New Port Richey, FL 34655 (727) 631-2466 00 Yrs/21 Yrs Languages: Thai M-F 9:00 AM - 6:00 PM

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Ivanov, Maria SLP Provider ID: 1038372 Gender: Female Kernaghan and Moore 7657 Cita Ln New Port Richey, FL 34653 (727) 376-1111 Fax: (727) 376-1113 00 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM Kernaghan, Kelly SLP Provider ID: 606632 Gender: Female Kernaghan and Moore 7657 Cita Ln New Port Richey, FL 34653 (727) 376-1111 Fax: (727) 376-1113 00 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM Knobloch, Jacquelyn SLP Provider ID: 1037943 Gender: Female Creative Speech Solutions and Thera 12413 White Bluff Rd Hudson, FL 34669 (727) 741-3405 Fax: (727) 213-6246 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Lama, Colleen SLP Provider ID: 1371125 Gender: Female Communication Corner and More Inc 2241 Green Hedges Way Wesley Chapel, FL 33544 (813) 973-1033 Fax: (813) 200-9608 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Moore, Amanda SLP Provider ID: 589712 Gender: Female Kernaghan and Moore 7657 Cita Ln New Port Richey, FL 34653 (727) 376-1111 Fax: (727) 376-1113 00 Yrs/130 Yrs M-F 8:30 AM - 6:00 PM

Last update 08/14/2017

Allied Providers Pasco Speech Therapy - cont.

Pursino, Heather SLP Tager, Madisen SLP Yankeloff, Kristina SLP Provider ID: 1274185 Provider ID: 1140006 Provider ID: 1238205 Orlando, Dana SLP Gender: Female Gender: Female Gender: Female Provider ID: 1183758 Kernaghan Moore Speech and Kernaghan and Moore Speech Creative Speech Solutions & Languag And Lang Therapy Gender: Female 7657 Cita Ln 12413 White Bluff Rd Kernaghan and Moore Speech 7657 Cita Ln And Lang New Port Richey, FL 34653 New Port Richey, FL 34653 Hudson, FL 34669 7657 Cita Ln (727) 376-1111 (727) 376-1111 (727) 741-3405 New Port Richey, FL 34653 Fax: (727) 376-1113 Fax: (727) 376-1113 Fax: (727) 213-6246 (727) 376-1111 00 Yrs/130 Yrs 00 Yrs/130 Yrs 00 Yrs/21 Yrs Fax: (727) 376-1113 M-F 8:00 AM - 6:00 PM M-F 8:00 AM - 6:30 PM M-F 8:00 AM - 8:00 PM 00 Yrs/130 Yrs Reales, Vicky SLP Vizzi, Lindsay SLP M-F 8:30 AM - 6:30 PM Provider ID: 1141156 Provider ID: 1056850 Pennell, Sara SLP Gender: Female Gender: Female Provider ID: 1037996 Kernaghan and Moore Speech Speech Connection And Lang Gender: Female 3152 Little Rd Ste 185 7657 Cita Ln Creative Speech Solutions New Port Richey, FL 34655 and Thera New Port Richey, FL 34653 (727) 631-2466 12413 White Bluff Rd (727) 376-1111 00 Yrs/21 Yrs Hudson, FL 34669 Fax: (727) 376-1113 Languages: Thai (727) 731-3405 00 Yrs/130 Yrs M-F 9:00 AM - 6:00 PM Fax: (727) 213-6246 Languages: Spanish Vought, Jill SLP 00 Yrs/18 Yrs M-F 8:00 AM - 6:30 PM M-F 8:00 AM - 7:00 PM Provider ID: 1050156 Rodriguez Real, Jennifer SLP Gender: Female Petrick, Christina SLP Communication Corner and Provider ID: 1044407 More Inc Provider ID: 1087179 Gender: Female 2241 Green Hedges Way Ste Gender: Female 101 Speech Connection Integrated Therapy Alliance Wesley Chapel, FL 33544 3152 Little Rd Ste 185 Inc (813) 973-1033 New Port Richey, FL 34655 5807 Argerian Dr Ste 101 Fax: (813) 200-9608 (813) 579-2212 Wesley Chapel, FL 33545 00 Yrs/130 Yrs Fax: (813) 345-2896 (813) 973-9068 M-F 7:30 AM - 7:00 PM 00 Yrs/21 Yrs Fax: (866) 542-4710 Languages: Thai 00 Yrs/21 Yrs Willis, Kathleen SLP M-F 9:00 AM - 5:00 PM M-F 12:00 AM - 5:00 PM Provider ID: 1276715 Porreca, Tina SLP Soueidan, Natalie SLP Gender: Female Kernaghan Moore Speech and Provider ID: 1048076 Provider ID: 1087252 Languag Gender: Female Gender: Female 7657 Cita Ln Speech Connection Integrated Therapy Alliance New Port Richey, FL 34653 Inc 3152 Little Rd Ste 185 (727) 376-1111 5807 Argerian Dr Ste 101 New Port Richey, FL 34655 Fax: (727) 376-1113 Wesley Chapel, FL 33545 (727) 631-2466 00 Yrs/130 Yrs (813) 973-9068 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Fax: (866) 542-4710 M-F 9:00 AM - 6:00 PM 00 Yrs/21 Yrs M-F 12:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Pinellas Audiology Oldfield, Christopher AUD Provider ID: TPV17173-02 Gender: Male HearUSA 1430 66th St North The Shoppes At Royal Saint Petersburg, FL 33710 (727) 343-3019 Fax: (727) 345-3738 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Oldfield, Christopher AUD Provider ID: TPV17173-03 Gender: Male HearUSA 30545 US Hwy 19N Palm Harbor, FL 34684 (727) 781-1760 Fax: (727) 786-8477 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Oldfield, Christopher AUD Provider ID: TPV17173-05 Gender: Male HearUSA 5020 East Bay DR Ste 800 Clearwater, FL 33764 (727) 330-9676 Fax: (727) 531-7893 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sparkman, Susanne AUD Provider ID: TPV08322-01 Gender: Female HearUSA 1430 66th St North The Shoppes At Royal Saint Petersburg, FL 33710 (727) 343-3019 Fax: (727) 345-3738 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Stewart, Christian AUD Provider ID: TPV16422-01 Gender: Female HearUSA 1430 66th St North Saint Petersburg, FL 33710 (727) 343-3019 Fax: (727) 345-3738 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Curtis, Mary ARNP Provider ID: 997108 Gender: Female Mpm Specialists LLC 455 Pinellas St Ste 320 Clearwater, FL 33756 (727) 446-2273 Fax: (727) 298-6707 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Cardiac Electrophysiology Dawson, Heather ARNP Felts, Christie ARNP Provider ID: 1256809 Gender: Female Baycare Medical Group 1840 Mease Dr 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hickok, Rebecca ARNP Provider ID: 1256810 Gender: Female Baycare Medical Group Inc 455 Pinellas St Ste 330 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Cardiology Akers, Laura ARNP Provider ID: 689314 Gender: Female West Florida Cardiology Network LLC 6006 49th St N Saint Petersburg, FL 33709 (727) 790-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 1365628 Gender: Female Baycare Medical Group Inc 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Dawson, Heather ARNP Provider ID: 1365628 Gender: Female Baycare Medical Group Inc 455 Pinellas St Ste 330 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Dawson, Heather ARNP Provider ID: 1365628 Gender: Female Baycare Medical Group Inc 646 Virginia St Ste 200 Dunedin, FL 34698 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Elefteriou, Elena PA Provider ID: 765298 Gender: Female Hippocratic Medical Center LLC 1 N Pinellas Ave Tarpon Springs, FL 34689 (346) 774-6996 18 Yrs/130 Yrs M-F 10:00 AM - 5:00 PM

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Farrell, Patricia ARNP Provider ID: 1256807 Gender: Male Baycare Medical Group, Inc. 1840 Mease Dr 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lenard, Melanie ARNP Provider ID: 1323379 Gender: Female Baycare Medical Group Inc 1107 S Myrtle Ave Clearwater, FL 33756 (727) 441-8663 Fax: (727) 441-8859 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lenard, Melanie ARNP Provider ID: 1323379 Gender: Female Baycare Medical Group Inc 1840 Mease Dr 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lenard, Melanie ARNP Provider ID: 1323379 Gender: Female Baycare Medical Group Inc 455 Pinellas St 33 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lenard, Melanie ARNP Provider ID: 1323379 Gender: Female Baycare Medical Group Inc 646 Virginia St 200 Dunedin, FL 34698 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Cardiology - cont. Perry, Alyssa PA Provider ID: 1160747 Gender: Female The Heart Institute 560 Jackson St N Ste 100 Saint Petersburg, FL 33705 (727) 329-1600 Fax: (727) 329-1694 18 Yrs/110 Yrs M-F 9:00 AM - 5:00 PM Vanderheuvel, Kimberly ARNP Provider ID: 1131624 Gender: Female The Heart Institute 6006 49th St N Ste 200 Saint Petersburg, FL 33709 (727) 490-2100 Fax: (727) 544-7389 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Certified Nurse Midwife Ambler, Kathleen CNM Provider ID: 1091353 Gender: Female Women's Care Florida LLC 1600 Dr MLK Jr St N Saint Petersburg, FL 33704 (727) 323-3838 Fax: (813) 282-1806 12 Yrs/130 Yrs Bayfront Medical Center MW 8:00 AM - 5:00 PM T 8:30 AM - 6:30 PM TH 8:00 AM - 6:30 PM F 9:00 AM - 2:00 PM Chenault, Shelley CNM Provider ID: 908578 Gender: Female Womens Care Florida LLC 1840 Mease Dr Safety Harbor, FL 34695 (727) 376-7734 Fax: (727) 372-0644 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Daughtry, Janet CNM Provider ID: 947516 Gender: Female Womens Care Florida 600 8th St S Saint Petersburg, FL 33701 (727) 954-7121 Fax: (727) 954-7122 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Griner, Kimberly CNM Provider ID: 1093011 Gender: Female Women's Care Florida LLC 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Daughtry, Janet CNM Provider ID: 947516 Gender: Female Womens Care Florida 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 456-6200 Fax: (727) 456-6218 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Kepto, Joyce CNM Provider ID: 947085 Gender: Female Womens Care Florida 1600 MLK St N Saint Petersburg, FL 33704 (727) 456-0750 Fax: (727) 456-0751 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Estess, Erica ARNP Provider ID: 1174989 Gender: Female Women's Care Florida, LLC 1600 MLK St N Saint Petersburg, FL 33704 (727) 323-3838 Fax: (727) 456-0751 12 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM

Kepto, Joyce CNM Provider ID: 947085 Gender: Female Womens Care Florida 600 8th St S Saint Petersburg, FL 33701 (727) 954-7121 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Estess, Erica ARNP Provider ID: 1174989 Gender: Female Women's Care Florida, LLC 3055 5th Avneue North Ste A Saint Petersburg, FL 33713 (727) 201-8800 Fax: (727) 201-8801 12 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM Fichtelman-Bosley, Lucinda CNM Provider ID: 718191 Gender: Female Womens Care Florida 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Palomino Malecki, Lisa CNM Provider ID: 965444 Gender: Female Womens Care Florida 625 6th Ave S Ste 350 Saint Petersburg, FL 33701 (727) 456-0080 Fax: (727) 456-0089 12 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM Weingarten, Darlean CNM Provider ID: 685027 Gender: Female Womens Care Florida 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Whittingham, Zerica CNM Provider ID: 444424 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Whittingham, Zerica CNM Provider ID: 444424 Gender: Female Womens Care Florida 7301 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Child Neurology Nazario, Margaret PA Provider ID: 763928 Gender: Female Florida Pediatric Associates LLC 625 6th Ave S Ste 405 Saint Petersburg, FL 33701 (727) 498-8994 Fax: (727) 498-8982 00 Yrs/21 Yrs MTHF 8:30 AM - 5:00 PM T 8:30 AM - 7:00 PM W 8:30 AM - 12:00 PM Sadlowski, Yolanta PA Provider ID: 269545 Gender: Female Florida Pediatric Associates LLC 625 6th Ave S Ste 405 Saint Petersburg, FL 33701 (727) 456-4250 Fax: (727) 346-1044 00 Yrs/21 Yrs Languages: Spanish, Polish M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Dermatology Chawk, Beverly ARNP Provider ID: 1310200 Gender: Female Advanced Dermatology and Cosmetic S 1840 Mease Dr Ste 313 Safety Harbor, FL 34695 (727) 259-7566 Fax: (727) 259-7567 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Chawk, Beverly ARNP Provider ID: 1310200 Gender: Female Advanced Dermatology and Cosmetic S 8250 Bryan Dairy Rd Ste 250 Largo, FL 33777 (727) 393-5300 Fax: (727) 393-5301 00 Yrs/130 Yrs MTTHF 8:00 AM - 5:00 PM W 89:00 AM - 5:00 PM Duquette, Tara PA Provider ID: 984981 Gender: Female Advanced Dermatology and Cosmetic S 4132 Woodlands Pkwy Palm Harbor, FL 34685 (727) 786-5100 Fax: (727) 789-8344 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Rodriguez, Alex PA Provider ID: 1223013 Gender: Male Advanced Dermatology and Cosmetic S 1801 N Belcher Rd Ste B Clearwater, FL 33765 (727) 669-3676 Fax: (727) 669-3669 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Saron, Whitnie ARNP Provider ID: 797947 Gender: Female 5200 Seminole Blvd Saint Petersburg, FL 33708 (727) 392-3376 Fax: (727) 897-5263 02 Yrs/130 Yrs M-TH 8:30 AM - 4:30 PM F 8:00 AM - 2:00 PM Shaner, Timothy PA Provider ID: 1024735 Gender: Male Advanced Dermatology and Cosmetic S 4132 Woodlands Pkwy Palm Harbor, FL 34685 (727) 786-5100 Fax: (727) 789-8344 00 Yrs/130 Yrs Steward Melbourne Hospital M-F 8:00 AM - 5:00 PM Strauss, Lawrence PA Provider ID: 926093 Gender: Male Leavitt Medical Associates of Flori 1840 Mease Dr Ste 313 Safety Harbor, FL 34695 (727) 259-7566 Fax: (727) 259-7567 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Warta, Steven PA Provider ID: 1024093 Gender: Male Advanced Dermatology and Cosmetic S 4132 Woodlands Pkwy Palm Harbor, FL 34685 (727) 786-5100 Fax: (727) 789-8344 00 Yrs/130 Yrs Steward Melbourne Hospital M-F 8:00 AM - 5:00 PM

Webster, Jennifer PA Provider ID: 922826 Gender: Female 620 10th St N Ste 3A Saint Petersburg, FL 33705 (727) 824-7105 Fax: (727) 824-7125 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Endocrinology, Diabetes, Metabolism Aquino, Sheila ARNP Provider ID: 795242 Gender: Female Diabetes Care Center Inc 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 869-7822 Fax: (727) 869-0934 00 Yrs/130 Yrs Languages: Spanish M-F 8:30 AM - 4:00 PM Collins, Sara ARNP Provider ID: 1090270 Gender: Female Diabetes Care Center Inc 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 869-7822 Fax: (727) 869-3688 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM Pick, Glenna ARNP Provider ID: 930900 Gender: Female 2531 Landmark Dr Ste 104 Clearwater, FL 33761 (727) 869-7822 Fax: (727) 869-3688 18 Yrs/130 Yrs M-F 8:30 AM - 4:00 PM

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Family Practice Babbs, Garrett PA Provider ID: 1238459 Gender: Male Community Health Centers At Johnnie 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 00 Yrs/130 Yrs MT 7:30 AM - 8:00 PM WTHF 7:30 AM - 5:00 PM Brown, Amy ARNP Provider ID: 1081748 Gender: Female Community Health Centers of Pinella 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-6701 Fax: (727) 824-8150 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 507-4348 Fax: (727) 524-4410 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Clark-Whitlock, Ann ARNP Provider ID: 953401 Gender: Female Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Corcella, Deborah ARNP Provider ID: 655493 Gender: Female Vj Diella DO LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 734-4454 00 Yrs/130 Yrs MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 12:00 PM Costa, Lori ARNP Provider ID: 1238623 Gender: Female Community Health Centers At Pinella 1721 Main St Dunedin, FL 34698 (727) 824-8181 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Folsom, Martha ARNP Provider ID: 419876 Gender: Female Community Health Centers 1020 Lakeview Rd Clearwater, FL 33756 (727) 461-1439 Fax: (727) 443-7230 00 Yrs/130 Yrs M 8:00 AM - 8:00 PM TWTHF 8:00 AM - 5:00 PM

Folsom, Martha ARNP Provider ID: 419876 Gender: Female Community Health Ctrs of Pinellas 247 S Huey Ave Tarpon Springs, FL 34689 (727) 944-3828 Fax: (727) 939-4679 00 Yrs/130 Yrs MF 8:00 AM - 8:00 PM TWTH 8:00 AM - 5:00 PM Sat 8:00 AM - 12:00 PM Folsom, Martha ARNP Provider ID: 419876 Gender: Female Community Health Ctrs of Pinellas 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 824-8181 Fax: (727) 824-8165 00 Yrs/130 Yrs M 8:00 AM - 8:00 PM TWTHF 8:00 AM - 5:00 PM

Folsom, Martha ARNP Provider ID: 419876 Gender: Female Community Health Ctrs of Pinellas 6237 66th St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 00 Yrs/130 Yrs Folsom, Martha ARNP MF 8:00 AM - 8:00 PM Provider ID: 419876 TWTH 8:00 AM - 5:00 PM Gender: Female Community Health Centers of Sat 8:00 AM - 12:00 PM Largo Gaik, Shane ARNP 12420 130th Ave N Provider ID: 719240 Largo, FL 33774 Gender: Male (727) 587-7729 Community Health Centers Fax: (727) 587-7739 At Pinella 00 Yrs/130 Yrs 12420 130th Ave N M-F 8:00 AM - 5:00 PM Largo, FL 33774 (727) 587-7729 Fax: (727) 587-7729 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. Gaik, Shane ARNP Provider ID: 719240 Gender: Male Community Health Centers At Pinella 1344 22nd St S Saint Petersburg, FL 33712 (727) 821-6701 Fax: (727) 823-7429 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Gaik, Shane ARNP Provider ID: 719240 Gender: Male Community Health Centers At Pinella 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Gaik, Shane ARNP Provider ID: 719240 Gender: Male Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/130 Yrs Languages: Spanish MT 8:00 AM - 8:00 PM W 8:00 AM - 5:00 PM TH 8:00 AM - 6:00 PM F 8:50 AM - 4:30 PM Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Geddes, Jennifer ARNP

Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 942-5467 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Provider ID: 978618 Gender: Female Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Geddes, Jennifer ARNP

Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Provider ID: 978618 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Geddes, Jennifer ARNP Provider ID: 978618 Gender: Female Pinellas County Health Dept 924 58th St S Gulfport, FL 33707 (727) 343-7680 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

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Hendren, Beatrice ARNP Provider ID: 916320 Gender: Female 7500 Park Blvd N Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM Hendren, Debra ARNP Provider ID: 1349712 Gender: Female Community Health Centers of Pinella 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 02 Yrs/130 Yrs M 7:30 AM - 8:00 PM TWTHF 7:30 AM - 7:00 PM Sat 8:00 AM - 4:30 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 524-4410 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Jeffries, Susan ARNP Provider ID: 969513 Gender: Female Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 12 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Jordan, Rosalind ARNP Provider ID: 1161929 Gender: Female Getwell Medical Center 6613 49th St N Pinellas Park, FL 33781 (727) 527-6611 Fax: (727) 527-6604 05 Yrs/130 Yrs M-W 10:00 AM - 6:00 PM Kelly, Christopher PA Provider ID: 473472 Gender: Male Vj Diella DO LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 734-4454 00 Yrs/130 Yrs MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 12:00 PM Moore, Joyce ARNP Provider ID: 1330080 Gender: Female Community Health Centers of Pinella 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Negrete, Latosha ARNP Provider ID: 723074 Gender: Female Vj Diella DO LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 738-5037 00 Yrs/130 Yrs Languages: Spanish MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 12:00 PM

O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM O'Brien, Rhonda ARNP

O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Provider ID: 952343 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 3:00 PM O'Brien, Rhonda ARNP

O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 942-5467 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

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Provider ID: 952343 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 824-6900 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 3:00 PM O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 3:00 PM O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM O'Brien, Rhonda ARNP Provider ID: 952343 Gender: Female Pinellas County Health Dept 924 58th St S Gulfport, FL 33707 (727) 343-7680 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 3:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 05 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 05 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Owens, Henry PA Provider ID: 1071940 Gender: Male Community Health Centers of Pinella 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Reed, Shawn ARNP Provider ID: 472240 Gender: Male Vj Diella DO LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 734-4454 00 Yrs/18 Yrs MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 12:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 05 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM

Reis, Mary ARNP Provider ID: 1226259 Gender: Female Baycare Medical Group Inc 1840 Mease Dr Ste 200 Safety Harbor, FL 34695 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4275 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 507-4348 Fax: (727) 524-4410 05 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Oosterbaan Smith, Laura ARNP Provider ID: 955865 Gender: Female Olivero, Karen PA Pinellas County Health Dept Provider ID: 1087218 310 N Myrtle Ave Gender: Female Clearwater, FL 33755 Community Health Centers of (727) 469-5800 Pinella Fax: (727) 820-4275 1721 Main St 05 Yrs/130 Yrs Dunedin, FL 34698 M-F 9:00 AM - 5:00 PM (727) 824-8181 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Owens, Henry PA Provider ID: 1071940 Gender: Male Community Health Centers of Pinella 1721 Main St Dunedin, FL 34698 (727) 824-8181 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 507-4348 Fax: (727) 524-4410 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33714 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 547-7780 Fax: (727) 547-7793 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Reiter, Suzanne ARNP Provider ID: 996133 Gender: Female Pinellas County Health Dept 924 58th St S Gulfport, FL 33707 (727) 343-7680 00 Yrs/130 Yrs M-F 7:00 AM - 3:00 PM Renshaw, Linda ARNP Provider ID: 624666 Gender: Female CHC At Tarpon Springs 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 824-8166 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Renshaw, Linda ARNP Provider ID: 624666 Gender: Female CHC At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8126 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Renshaw, Linda ARNP Provider ID: 624666 Gender: Female CHC At Pinellas Park 6237 66th St N Pinellas Park, FL 33781 (727) 824-8126 Fax: (727) 824-8166 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Renshaw, Linda ARNP Provider ID: 624666 Gender: Female Johnnie Ruth Clarke 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8126 Fax: (727) 824-8166 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Renshaw, Linda ARNP Provider ID: 624666 Gender: Female Community Health Centers At Pinella 700 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 824-8166 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Riczu, Steven ARNP Provider ID: 522761 Gender: Male Community Health Centers of Pinella 12420 130th Ave N Largo, FL 33774 (727) 587-7729 Fax: (727) 587-7739 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Renshaw, Linda ARNP Riczu, Steven ARNP Provider ID: 624666 Provider ID: 522761 Gender: Female Gender: Male Community Health Centers of Community Health Centers of Clearwa Pinella 707 Druid Rd E 1344 22nd St S Clearwater, FL 33756 Saint Petersburg, FL 33712 (727) 461-1439 (727) 824-8181 Fax: (727) 443-7230 Fax: (727) 824-8166 00 Yrs/130 Yrs 00 Yrs/130 Yrs MTTH 8:00 AM - 8:00 PM M-F 8:00 AM - 5:00 PM WF 8:00 AM - 5:00 PM Riczu, Steven ARNP Sat 8:00 AM - 4:00 PM Provider ID: 522761 Renshaw, Linda ARNP Gender: Male Provider ID: 624666 Community Health Centers of Pinella Gender: Female Community Health Centers of 1721 Main St Pinella Dunedin, FL 34698 1721 Main St (727) 824-8181 Dunedin, FL 34698 00 Yrs/130 Yrs (727) 824-8181 M-F 9:00 AM - 5:00 PM 00 Yrs/130 Yrs Riczu, Steven ARNP M-F 8:00 AM - 5:00 PM Provider ID: 522761 Gender: Male Community Health Centers of Pinella 6237 66th St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At Dunedin 1721 Main St Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 736-1735 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM

Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM

Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At Tarpon 247 S Huey Ave Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 939-4679 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM

Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At St Pete 612 MLK St N Saint Petersburg, FL 33705 (727) 824-8181 Fax: (727) 209-0309 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM

Rollins, Ebony ARNP Provider ID: 970475 Provider ID: 1355814 Gender: Female Gender: Female Pinellas County Health Dept Community Health Centers of 205 MLK St N Pinella Saint Petersburg, FL 33701 1344 22nd St S (727) 824-6900 Saint Petersburg, FL 33712 Fax: (727) 820-4275 (727) 824-8181 00 Yrs/130 Yrs Fax: (727) 823-7429 Languages: Spanish 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM Sangosanya, Tatiana ARNP F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM Provider ID: 970475 Gender: Female Rooney, James ARNP Pinellas County Health Dept Provider ID: 301544 301 Disston Ave Gender: Male Tarpon Springs, FL 34689 Vincent J Dilella DO LLC (727) 942-5457 703 Virginia St Fax: (727) 942-5467 Dunedin, FL 34698 00 Yrs/130 Yrs (727) 734-4000 Languages: Spanish Fax: (727) 734-4454 M-F 9:00 AM - 5:00 PM 05 Yrs/130 Yrs M-TH 8:00 AM - 4:30 PM Sangosanya, Tatiana ARNP F 8:00 AM - 12:00 PM

Rollins, Ebony ARNP Provider ID: 1355814 Gender: Female Community Health Centers At Suncoas 5523 Roosevelt Blvd Clearwater, FL 33760 (727) 824-8181 Fax: (727) 286-6225 00 Yrs/130 Yrs MTH 7:30 AM - 8:00 PM TW 7:30 AM - 7:00 PM F 7:30 AM - 5:00 PM Sat 8:00 AM - 4:00 PM

Rossidis, Heather PA Provider ID: 1226238 Gender: Female Baycare Medical 1201 5th Ave N 402 Saint Petersburg, FL 33705 (727) 446-2273 Fax: (727) 441-4966 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Sangosanya, Tatiana ARNP Provider ID: 970475 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sangosanya, Tatiana ARNP

Provider ID: 970475 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 820-4275 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Family Practice - cont. Sangosanya, Tatiana ARNP Provider ID: 970475 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 3:00 PM Sangosanya, Tatiana ARNP Provider ID: 970475 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 00 Yrs/130 Yrs Languages: Spanish M-F 7:00 AM - 3:00 PM Sangosanya, Tatiana ARNP Provider ID: 970475 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sangosanya, Tatiana ARNP Provider ID: 970475 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 507-4348 Fax: (727) 524-4410 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Sangosanya, Tatiana ARNP Provider ID: 970475 Gender: Female Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Schirripa, Jane ARNP Provider ID: 551153 Gender: Female Vj Diella DO LLC 703 Virginia St Dunedin, FL 34698 (727) 734-4000 Fax: (727) 734-4454 00 Yrs/18 Yrs MTTH 8:00 AM - 4:30 PM WF 8:00 AM - 12:00 PM

Federally Qualified Health Center McCauley, Jodi ARNP Provider ID: 930355 Gender: Female Community Health Centers 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 824-8137 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM McCauley, Jodi ARNP Provider ID: 930355 Gender: Female Community Health Centers 7550 43rd St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Gastroenterology Greene, Brittany PA Provider ID: 1361055 Gender: Female West Central Gastroenterology LLP 1609 Pasadena Ave S Ste 3M Saint Petersburg, FL 33707 (727) 384-2016 Fax: (727) 343-3791 18 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM

General Practice Hudson, Tamika ARNP Provider ID: 1365547 Gender: Female Transplant Surgical Specialists At 1301 2nd Ave SW Ste 315 Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM

General Surgery Armstrong, Ashley PA Provider ID: 436928 Gender: Female Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-6666 Fax: (727) 767-8606 16 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Briscoe, Sarah PA Provider ID: 1418104 Gender: Female Bayfront Hma Physician Management L 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 893-6254 Fax: (727) 553-7158 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Carlee, Christina ARNP Provider ID: 1418094 Gender: Female Bayfront Health Medical Grouptrauma 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 893-6254 Fax: (727) 553-7158 00 Yrs/130 Yrs Bayfront Medical Center M-F 9:00 AM - 5:00 PM Fikry, Driss PA Provider ID: 1419316 Gender: Male Bayfront Hma Physician Management L 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 893-6254 Fax: (727) 553-7158 00 Yrs/130 Yrs Bayfront Medical Center Languages: Spanish, French, Arabic M-F 8:00 AM - 5:00 PM Fuentes, Taniya ARNP Provider ID: 1214379 Gender: Female Community Hospital Family Practice 1301 2nd Ave SW Ste 315 Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Fuentes, Taniya ARNP Provider ID: 1233807 Gender: Female Community Hospital Family Practice 1345 W. Bay Dr Largo, FL 33770 (727) 587-7120 Fax: (727) 585-3290 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas General Surgery - cont. Hennes, Bryan ARNP Provider ID: 1419313 Gender: Male Bayfront Hma Physician Management L 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 893-6254 Fax: (727) 553-7158 00 Yrs/130 Yrs Bayfront Medical Center M-F 8:00 AM - 5:00 PM Lapierre, Lindsay PA Provider ID: 1432625 Gender: Female Bayfront Hma Physician Management L 603 7th St S Ste 500 Saint Petersburg, FL 33701 (727) 893-6254 Fax: (727) 553-7158 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Parker, Jill PA Provider ID: 1207698 Gender: Female Community Hospital Family Practice 1615 Pasadena Ave S Ste 330 Saint Petersburg, FL 33707 (727) 345-2929 Fax: (727) 345-0340 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Tew, Jenna PA Provider ID: 689007 Gender: Female Bay Surgical Specialists PA 1615 Pasadena Ave S Ste 480 Saint Petersburg, FL 33707 (727) 345-2929 Fax: (727) 345-0340 18 Yrs/130 Yrs St Anthonys Hospital M-F 9:00 AM - 5:00 PM

Parker, Jill PA Provider ID: 1229365 Gender: Female Palms Surgical Associates 1615 Pasadena Ave S Ste 330 Saint Petersburg, FL 33707 (727) 345-2929 Fax: (727) 345-0340 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Tew, Jenna PA Provider ID: 689007 Gender: Female Bay Surgical Specialits PA 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs St Anthonys Hospital M-F 9:00 AM - 5:00 PM

Parker, Jill PA Provider ID: 589320 Gender: Female 960 7th Ave N Mazzaferro, Lisa ARNP Saint Petersburg, FL 33705 (727) 821-8101 Provider ID: 1419311 Fax: (727) 825-1357 Gender: Female 18 Yrs/130 Yrs Bayfront Health St Petersburg M-F 8:00 AM - 5:00 PM Traum Sharp, Gloria PA 603 7th St S Ste 500 Saint Petersburg, FL 33701 Provider ID: 1226284 (727) 893-6254 Gender: Female Fax: (727) 553-7158 Baycare Medical Group Inc 00 Yrs/130 Yrs 455 Pinellas St Ste 320 Bayfront Medical Center Clearwater, FL 33756 M-F 9:00 AM - 5:00 PM (727) 446-2273 Fax: (727) 441-4966 Parker, Jill PA 18 Yrs/130 Yrs Provider ID: 1207698 M-F 9:00 AM - 5:00 PM Gender: Female St Croix, Peggy ARNP 960 7th Ave N Saint Petersburg, FL 33705 Provider ID: 1304380 (727) 821-8101 Gender: Female Fax: (727) 825-1357 Transplant Surgical Specialists At 18 Yrs/130 Yrs 1301 2nd Ave SW Ste 315 M-F 8:00 AM - 5:00 PM Largo, FL 33770 (727) 587-7120 Fax: (727) 585-6850 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Gynecological Oncology Yali, Patricia ARNP Provider ID: 1324810 Gender: Female Baycare Medical Group Inc 1005 Pinellas St Clearwater, FL 33756 (727) 446-2111 Fax: (727) 447-2131 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Hematology & Oncology Bremm, Jessica ARNP Provider ID: 1223774 Gender: Female Florida Cancer Specialists Pl 8787 Bryan Dairy Rd Ste 210 Seminole, FL 33777 (727) 397-9641 Fax: (727) 393-4194 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Buckley, Breea PA Provider ID: 1362278 Gender: Female Florida Cancer Specialists Pl 100 Highland Ave N Largo, FL 33770 (727) 683-2900 Fax: (727) 683-2901 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Buckley, Breea PA Provider ID: 1362278 Gender: Female Florida Cancer Specialists Pl 400 Pinellas St Ste 300 Clearwater, FL 33756 (727) 447-8100 Fax: (727) 461-2603 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hart, Katelyn ARNP Provider ID: 1362274 Gender: Female Florida Cancer Specialists Pl 100 Highland Ave N Largo, FL 33770 (727) 683-2900 Fax: (727) 683-2901 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hart, Katelyn ARNP Provider ID: 1362274 Gender: Female Florida Cancer Specialists Pl 1301 2nd Ave SW Ste 290 Largo, FL 33770 (727) 940-9580 Fax: (727) 940-9579 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Hart, Katelyn ARNP Provider ID: 1362274 Gender: Female Florida Cancer Specialists Pl 400 Pinellas St Ste 300 Clearwater, FL 33756 (727) 447-8100 Fax: (727) 461-2603 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Hematology & Oncology Icaza, Elisa ARNP - cont. Provider ID: 324262 Sanchez, Wendy ARNP Provider ID: 1021463 Gender: Female Florida Cancer Specialists 8787 Bryan Dairy Rd Ste 210 Seminole, FL 33777 (727) 397-9641 Fax: (727) 393-4194 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Waters, Madeline ARNP Provider ID: 1366777 Gender: Female Florida Cancer Specialists 8787 Bryan Dairy Rd Ste 210 Largo, FL 33777 (727) 397-9641 Fax: (727) 393-4194 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM Waters, Madeline ARNP Provider ID: 1366777 Gender: Female Florida Cancer Specialists Pl 100 Highland Ave N Largo, FL 33770 (727) 683-2900 Fax: (727) 683-2901 18 Yrs/110 Yrs M-F 8:00 AM - 5:00 PM

Infectious Disease Baptiste, Raoul ARNP Provider ID: 1109360 Gender: Male Help US Help U Inc 1700 22nd St S Saint Petersburg, FL 33712 (727) 223-1070 Fax: (727) 290-4176 18 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM

Gender: Female Advanced Bay Area Medical Associate 1700 66th St N Ste 510 Saint Petersburg, FL 33710 (727) 384-2479 Fax: (727) 384-3573 12 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital M-F 8:30 AM - 5:00 PM Icaza, Elisa ARNP Provider ID: 324262 Gender: Female Advanced Bay Area Medical Associate 8207 113th St Seminole, FL 33772 (727) 397-3991 Fax: (727) 391-4746 12 Yrs/130 Yrs Largo Medical Center Northside Hospital St Petersburg General Hospital M-F 8:30 AM - 4:30 PM

Internal Medicine Amato, Frank ARNP Provider ID: 1241626 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs Languages: Spanish, French, Russian M-F 8:00 AM - 5:00 PM

Amato, Frank ARNP Provider ID: 1241626 Gender: Male Professional Health Care Of Pinella 8133 54th Ave N Saint Petersburg, FL 33709 (727) 541-4458 Fax: (727) 546-6663 18 Yrs/130 Yrs Languages: Spanish, French, Russian M-F 8:00 AM - 5:00 PM Burke, Christina PA Provider ID: 1072561 Gender: Female Comprehensive Care Center 3251 3rd Ave N Ste 125 Saint Petersburg, FL 33713 (727) 498-4969 Fax: (727) 826-0875 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:30 AM - 12:00 PM Burke, Christina PA Provider ID: 1072561 Gender: Female Comprehensive Care Center Inc 2349 Sunset Point Rd Ste 405 Clearwater, FL 33765 (727) 216-6193 Fax: (941) 951-1795 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Davis, Bonnie ARNP Provider ID: 708833 Gender: Female Largo Physician Group, LLC 1345 W. Bay Dr Ste 301 Largo, FL 33770 (727) 581-6984 Fax: (727) 584-7648 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Dixon, Danita ARNP Provider ID: 1303803 Gender: Female Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Dixon, Danita ARNP Provider ID: 1303803 Gender: Female Professional Health Care Of Pinella 8133 54th Ave N Saint Petersburg, FL 33709 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Dzembo, Daria ARNP Provider ID: 1160697 Gender: Female Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Esele, Fitzwilliam ARNP Provider ID: 1274795 Gender: Male Professional Healthcare Of Pinellas 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Internal Medicine - cont. Turnow, Kory ARNP Esele, Fitzwilliam ARNP Provider ID: 1274795 Gender: Male Professional Healthcare Of Pinellas 5500 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 525-5500 Fax: (727) 522-2574 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Esele, Fitzwilliam ARNP Provider ID: 1274795 Gender: Male Professional Healthcare Of Pinellas 8133 54th Ave N Saint Petersburg, FL 33709 (727) 541-4458 Fax: (727) 546-6663 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Reyes, Steven PA Provider ID: 907739 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Turnow, Kory ARNP Provider ID: 1353815 Gender: Male Professional Health Care Of Pinella 1839 Central Ave Saint Petersburg, FL 33713 (727) 322-1054 Fax: (727) 322-2725 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Provider ID: 1353815 Gender: Male Professional Health Care Of Pinella 5500 Dr MLK Jr St N Saint Petersburg, FL 33703 (727) 525-5500 Fax: (727) 522-2574 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Turnow, Kory ARNP Provider ID: 1353815 Gender: Male Professional Health Care Of Pinella 8133 54th Ave N Saint Petersburg, FL 33709 (727) 541-4458 Fax: (727) 546-6663 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Licensed Mental Health Counselor Petry, Harold LMHC Provider ID: 1422865 Gender: Male Metropolitan Charities, Inc 3251 3rd Ave N Saint Petersburg, FL 33713 (727) 321-3854 Fax: (727) 327-7670 00 Yrs/130 Yrs MT 9:00 AM - 5:00 PM W 9:30 AM - 5:00 PM

Nephrology

Kessler Posgai, Dorothy ARNP Rhodes, Eric PA Provider ID: 1132980 Gender: Male Provider ID: 797253 Baycare Medical Group Inc Gender: Female 430 Morton Plant St Ste 325 617 Lakeview Rd Ste A Clearwater, FL 33756 Clearwater, FL 33756 (727) 298-6121 (727) 441-3724 Fax: (727) 298-6151 Fax: (727) 442-2594 18 Yrs/130 Yrs 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Largo Medical Center M-F 9:00 AM - 5:00 PM Staples, Stephanie ARNP Wical, Jessica ARNP Provider ID: 726547 Gender: Female Provider ID: 1093511 Pediatric Physician Services Gender: Female Inc Suncoast Medical Clinic LLC 601 5th St S Ste 5 620 10th St N Saint Petersburg, FL 33701 Saint Petersburg, FL 33705 (727) 767-8181 (727) 824-8274 Fax: (727) 767-8030 Fax: (727) 824-8293 00 Yrs/21 Yrs 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM M-F 8:00 AM - 5:00 PM

Neurology Petti, Erin ARNP Provider ID: 1030319 Gender: Female Pediatric Physicians Services Inc 601 5th St S Ste 510 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM

Neurosurgery

Kessler Posgai, Dorothy ARNP Hunter, Keri PA Provider ID: 1120075 Gender: Female Provider ID: 797253 Bayfront Hma Physician Gender: Female Management 1840 Mease Dr 603 7th St S Ste 500 Safety Harbor, FL 34695 Saint Petersburg, FL 33701 (727) 441-3724 (727) 893-6667 Fax: (727) 442-2594 Fax: (727) 553-7158 18 Yrs/130 Yrs 12 Yrs/130 Yrs Largo Medical Center M-F 8:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM

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Nurse Midwife Bennett, Victoria ARNP Provider ID: 709414 Gender: Female Breath of Life Inc 1900 E Bay Dr Largo, FL 33771 (727) 216-1420 Fax: (727) 216-1418 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Landis-Nussbaum, Debbie CNM Provider ID: 27327 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Nurse Midwife - cont. McCullough, Cynthia CNM Provider ID: 1204967 Gender: Female Breath of Life Inc 1900 E Bay Dr Largo, FL 33771 (727) 216-1420 Fax: (727) 216-1418 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Moore, Cheryl Provider ID: 1119143 Gender: Female Circle of Life Childbirth Practice 1114 Florida Ave Ste C Palm Harbor, FL 34683 (813) 426-2397 Fax: (727) 255-5578 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Moss, Lisa ARNP Provider ID: 1068964 Gender: Female Womens Care Florida LLC 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM Moss, Lisa ARNP Provider ID: 1068964 Gender: Female Womens Care Florida LLC 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM

Nitti, Teresa CNM Provider ID: 1196207 Gender: Female Breath of Life Inc 1900 E Bay Dr Largo, FL 33771 (727) 216-1420 Fax: (727) 216-1418 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Nixon, Everly ARNP Provider ID: 698774 Gender: Female Breath of Life Inc 1900 E Bay Dr Largo, FL 33771 (727) 216-1420 Fax: (727) 216-1418 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Rox, Pamela CNM Provider ID: 966540 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Rox, Pamela CNM Provider ID: 966540 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM

Nurse Practitioner Catalanotto, Chelsea ARNP

Obstetrics Chenault, Shelley CNM Provider ID: 908578 Gender: Female Womens Care Florida LLC 1840 Mease Dr Safety Harbor, FL 34695 (727) 376-7734 Fax: (727) 372-0644 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Daughtry, Janet CNM Provider ID: 947516 Gender: Female Womens Care Florida 600 8th St S Saint Petersburg, FL 33701 (727) 954-7121 Fax: (727) 954-7122 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Daughtry, Janet CNM Provider ID: 947516 Gender: Female Womens Care Florida 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 456-6200 Fax: (727) 456-6218 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Fichtelman-Bosley, Lucinda CNM Provider ID: 718191 Gender: Female Womens Care Florida 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Provider ID: 1213412 Gender: Female Baycare Alliant Hospital 646 Virginia St Ste 200 Dunedin, FL 34698 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Griner, Kimberly CNM Provider ID: 1093011 Gender: Female Women's Care Florida LLC 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Johnson, Amy CNM Provider ID: 161533 Gender: Female OB/GYN Associates 6450 38th Ave N Ste 200 Saint Petersburg, FL 33710 (727) 344-6060 Fax: (727) 347-5586 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Kepto, Joyce CNM Provider ID: 947085 Gender: Female Womens Care Florida 1600 MLK St N Saint Petersburg, FL 33704 (727) 456-0750 Fax: (727) 456-0751 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Kepto, Joyce CNM Provider ID: 947085 Gender: Female Womens Care Florida 600 8th St S Saint Petersburg, FL 33701 (727) 954-7121 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Miller, Jill ARNP Provider ID: 971266 Gender: Female Womens Care Florida 1600 MLK St N Saint Petersburg, FL 33704 (727) 456-0750 Fax: (727) 456-0751 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM

Last update 08/14/2017

Allied Providers Pinellas Obstetrics - cont. Miller, Jill ARNP Provider ID: 971266 Gender: Female Womens Care Florida 3268 66th St N Saint Petersburg, FL 33710 (727) 954-7121 Fax: (727) 954-7122 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Miller, Jill ARNP Provider ID: 971266 Gender: Female Womens Care Florida 600 8th St S Saint Petersburg, FL 33701 (727) 826-0795 00 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Moss, Lisa ARNP Provider ID: 1068964 Gender: Female Womens Care Florida LLC 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM Moss, Lisa ARNP Provider ID: 1068964 Gender: Female Womens Care Florida LLC 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs Morton Plant Hospital M-F 8:30 AM - 4:30 PM

Palomino Malecki, Lisa CNM Provider ID: 965444 Gender: Female Womens Care Florida 625 6th Ave S Ste 350 Saint Petersburg, FL 33701 (727) 456-0080 Fax: (727) 456-0089 12 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM F 8:00 AM - 12:00 PM Rox, Pamela CNM Provider ID: 966540 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Rox, Pamela CNM Provider ID: 966540 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Weingarten, Darlean CNM Provider ID: 685027 Gender: Female Womens Care Florida 700 Central Ave Ste 400 Saint Petersburg, FL 33701 (727) 895-1300 Fax: (727) 823-3494 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Whittingham, Zerica CNM Provider ID: 444424 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Whittingham, Zerica CNM Provider ID: 444424 Gender: Female Womens Care Florida 7301 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Obstetrics/Gynecology

Broom Smith, Nikole ARNP Provider ID: 1355818 Gender: Female Community Health Centers At Dunedin 1721 Main St Tarpon Springs, FL 34689 (727) 824-8181 Fax: (727) 736-1735 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Broom Smith, Nikole ARNP

Bainbridge, Megan CNM Provider ID: 1197989 Gender: Female Planned Parenthood 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 05 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Broom Smith, Nikole ARNP Provider ID: 1355818 Gender: Female Community Health Centers At Bayfron 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 893-6435 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Broom Smith, Nikole ARNP Provider ID: 1355818 Gender: Female Community Health Centers At Clearwa 707 Druid Rd E Clearwater, FL 33756 (727) 824-8181 Fax: (727) 443-7230 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Provider ID: 1355818 Gender: Female Community Health Centers At Largo 12420 130th Ave N Largo, FL 33774 (727) 824-8181 Fax: (727) 587-7739 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Broom Smith, Nikole ARNP Provider ID: 1355818 Gender: Female Community Health Centers At Pinella 7550 43rd St N Pinellas Park, FL 33781 (727) 824-8181 Fax: (727) 541-7984 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Broom Smith, Nikole ARNP Provider ID: 1355818 Gender: Female Community Health Centers At St Pete 612 MLK St N Saint Petersburg, FL 33705 (727) 209-0394 Fax: (727) 209-0309 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Obstetrics/Gynecology - Burke, Elizabeth ARNP Provider ID: 28285 cont.

Jones, Emily ARNP Jones, Emily ARNP Provider ID: 1000447 Provider ID: 1000447 Gender: Female Gender: Female Gender: Female Bayfront Family Health Center Community Health Centers of Community Health Centers of Broom Smith, Nikole ARNP 700 6th St S Pinella Pinella Saint Petersburg, FL 33701 1344 22nd St S 7550 43rd St N Provider ID: 1355818 (727) 893-6198 Saint Petersburg, FL 33712 Pinellas Park, FL 33781 Gender: Female Fax: (727) 553-7295 (727) 824-8181 (727) 824-8181 Community Health Centers 00 Yrs/130 Yrs Fax: (727) 824-8137 Fax: (727) 541-7984 At Suncoas M-F 8:30 AM 5:00 PM 12 Yrs/130 Yrs 12 Yrs/130 Yrs 5523 Roosevelt Blvd M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Clearwater, FL 33760 Dyer, Diana ARNP (727) 824-8181 Provider ID: 797257 Jones, Emily ARNP Keene, Jamie ARNP Fax: (727) 286-6225 Gender: Female Provider ID: 1000447 Provider ID: 499827 12 Yrs/130 Yrs Planned Parenthood of SW Gender: Female Gender: Female M-F 9:00 AM - 5:00 PM and Centra Community Health Centers of Community Health Centers 8950 MLK St N Ste 102 Pinella At Clearwa Broom Smith, Nikole ARNP Saint Petersburg, FL 33702 2960 Roosevelt Blvd 707 Druid Rd E (727) 898-8199 Clearwater, FL 33760 Clearwater, FL 33756 Provider ID: 1355818 Fax: (727) 898-9710 (727) 286-6225 (727) 824-8181 Gender: Female 12 Yrs/130 Yrs Fax: (727) 286-6224 Fax: (727) 443-7230 Community Health Centers M 10:00 AM - 6:00 PM 12 Yrs/130 Yrs 12 Yrs/130 Yrs At Tarpon TTH 11:00 AM - 7:00 PM M-F 8:00 AM - 5:00 PM M-TH 8:00 AM - 8:00 PM 247 S Huey Ave W 9:00 AM 4:00 PM F 8:00 AM - 5:00 PM Tarpon Springs, FL 34689 Jones, Emily ARNP F 9:00 AM 3:00 PM (727) 824-8181 Keene, Jamie ARNP Provider ID: 1000447 Fax: (727) 939-4679 Frazier, Cathy ARNP Gender: Female Provider ID: 499827 12 Yrs/130 Yrs Provider ID: 1224525 Community Health Centers of Gender: Female M-F 9:00 AM - 5:00 PM Gender: Female Pinella Community Health Centers Planned Parenthood-Pinellas 701 6th St S At Pinella Broom Smith, Nikole ARNP 8950 MLK St N Ste 102 Saint Petersburg, FL 33701 7550 43rd St N Saint Petersburg, FL 33702 (727) 824-8181 Pinellas Park, FL 33781 Provider ID: 1355818 (727) 898-8199 Fax: (727) 209-5619 (727) 544-2284 Gender: Female Fax: (727) 898-9710 12 Yrs/130 Yrs Fax: (727) 541-7984 Community Health Centers of 00 Yrs/130 Yrs M-F 8:00 AM 5:00 PM 12 Yrs/130 Yrs Pinella M 9:00 AM 4:30 PM MTTHF 9:00 AM - 5:00 PM 1344 22nd St S Jones, Emily ARNP T 10:00 AM - 6:00 PM W 9:00 AM - 8:00 PM Saint Petersburg, FL 33712 Provider ID: 1000447 W 9:00 AM 3:30 PM (727) 824-8181 Keene, Jamie ARNP Gender: Female TH 9:00 AM - 4:00 PM Fax: (727) 823-7429 Community Health Centers of Provider ID: 499827 12 Yrs/130 Yrs Johnson, Amy CNM Pinella Gender: Female M-F 9:00 AM - 5:00 PM 707 Druid Rd E Johnnie Ruth Clarke Health Clearwater, FL 33756 Center Provider ID: 161533 Burke, Elizabeth ARNP (727) 824-8181 1344 22nd St S Gender: Female Provider ID: 1127119 Fax: (727) 443-7230 Saint Petersburg, FL 33712 OB/GYN Associates Gender: Female 12 Yrs/130 Yrs (727) 821-6701 6450 38th Ave N Ste 200 Bayfront Health Medical M-F 8:00 AM - 5:00 PM 12 Yrs/130 Yrs Group Saint Petersburg, FL 33710 MW 8:00 AM - 8:00 PM 603 7th St S Ste 101 (727) 344-6060 TTHF 8:00 AM - 5:00 PM Saint Petersburg, FL 33701 Fax: (727) 347-5586 (727) 347-8039 12 Yrs/130 Yrs Fax: (727) 341-2359 M-F 8:00 AM - 5:00 PM 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Pinellas Obstetrics/Gynecology - Lavalley, Robin CNM cont. Keene, Jamie ARNP Provider ID: 499827 Gender: Female Johnnie Ruth Clarke Health Center 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Keene, Jamie ARNP Provider ID: 499827 Gender: Female Johnnie Ruth Clarke Health Center 701 6th St S Saint Petersburg, FL 33701 (727) 824-8181 Fax: (727) 209-5619 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Landis-Nussbaum, Debbie CNM Provider ID: 27327 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Lavalley, Robin CNM Provider ID: 965912 Gender: Female Womens Care Florida 401 Corbett St Ste 400 Clearwater, FL 33756 (727) 462-2229 Fax: (727) 447-5610 12 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM

Provider ID: 965912 Gender: Female Womens Care Florida 7601 Seminole Blvd Seminole, FL 33772 (727) 399-9922 Fax: (727) 399-8377 12 Yrs/130 Yrs M-F 8:30 AM - 4:30 PM Mashandure, Mercy ARNP Provider ID: 800492 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (872) 789-8819 Fax: (872) 898-9710 00 Yrs/130 Yrs Languages: Spanish, Swahili M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM McCauley, Jodi ARNP Provider ID: 930355 Gender: Female Community Health Centers 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 824-8137 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM McCauley, Jodi ARNP Provider ID: 930355 Gender: Female Community Health Centers 7550 43rd St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

McGinty, Susanne ARNP Provider ID: 705322 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (872) 789-8819 Fax: (872) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM McKinnie, Cynthia ARNP Provider ID: 811213 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

Redlin, Jacqueline ARNP Provider ID: 357586 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Shreve, Tanya PA Provider ID: 802457 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Staal, Jacqueline ARNP

Reames, Amanda ARNP Provider ID: 1075286 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (872) 789-8819 Fax: (872) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

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Provider ID: 801634 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-8199 00 Yrs/130 Yrs M 10:00 AM - 6:00 PM TTH 11:00 AM - 7:00 PM W 9:00 AM - 4:00 PM F 9:00 AM - 3:00 PM

Last update 08/14/2017

Allied Providers Pinellas Obstetrics/Gynecology - Valentin, Socorro ARNP cont. Tillquist, Jackson ARNP Provider ID: 1312027 Gender: Male Baycare Medical Group Inc 455 Pinellas St Ste 33 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 720-7425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Turpin, Sharon CNM Provider ID: 216143 Gender: Female Commuinity Health Centers At Pinell 2960 Roosevelt Blvd Clearwater, FL 33760 (727) 286-6225 Fax: (727) 286-6224 13 Yrs/59 Yrs M-F 9:00 AM - 5:00 PM Turpin, Sharon CNM Provider ID: 216143 Gender: Female Commuinity Health Centers At Pinell 7550 43rd St N Pinellas Park, FL 33781 (727) 544-2284 Fax: (727) 541-7984 13 Yrs/59 Yrs M-F 9:00 AM - 5:00 PM Turpin, Sharon CNM Provider ID: 216143 Gender: Female Johnnie Ruth Clarke Health Center 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 13 Yrs/59 Yrs M-F 9:00 AM - 5:00 PM

Provider ID: 678864 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Ward, Leslie ARNP Provider ID: 701949 Gender: Female Planned Parenthood of SW and Centra 8950 MLK St N Ste 102 Saint Petersburg, FL 33702 (727) 898-8199 Fax: (727) 898-9710 00 Yrs/130 Yrs M 9:00 AM - 4:30 PM T 10:00 AM - 6:00 PM WF 9:00 AM - 3:00 PM TH 11:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Wilkinson, Donna ARNP Provider ID: 965475 Gender: Female Womens Care Florida 3268 66th St N Saint Petersburg, FL 33710 (727) 954-7121 Fax: (727) 954-7122 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Wilkinson, Donna ARNP Provider ID: 965475 Gender: Female Womens Care Florida 603 7th St S Ste 300 Saint Petersburg, FL 33701 (727) 456-6200 Fax: (727) 456-6218 12 Yrs/130 Yrs Languages: Spanish M-TH 8:00 AM - 5:00 PM F 8:00 AM - 4:00 PM Willard, Cindylee CNM Provider ID: 179186 Gender: Female 807 N Myrtle Ave Clearwater, FL 33756 (727) 467-2551 Fax: (727) 467-2550 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Willard, Cindylee CNM Provider ID: 179186 Gender: Female CHC At Clearwater 1020 Lakeview Rd Clearwater, FL 33756 (727) 461-1439 Fax: (727) 443-7230 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Willard, Cindylee CNM Provider ID: 179186 Gender: Female Johnnie Ruth Clarke Health Center 1310 22nd Ave S Saint Petersburg, FL 33705 (727) 821-6701 Fax: (727) 823-7429 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Occupational Therapy Burks, Nicole OT Provider ID: 1247668 Gender: Female Heart 4 Kids Therapy, LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 Fax: (727) 350-9665 00 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 9:00 AM - 5:00 PM Jensen, Summer OT Provider ID: 1053486 Gender: Female Educated Play Inc 8673 15th Way N Saint Petersburg, FL 33702 (727) 423-0060 Fax: (727) 369-8803 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Kotolski, Amanda OT Provider ID: 357364 Gender: Female Ak Therapy Inc 6061 Bhia Del Mar Blvd Ste 207 Saint Petersburg, FL 33715 (727) 637-6137 Fax: (727) 388-9640 00 Yrs/21 Yrs M-TH 8:30 AM - 5:00 PM F 8:30 AM - 12:00 PM Riveros, Ashley OT Provider ID: 1040552 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Occupational Therapy cont. Sims, Mary OT Provider ID: 1417948 Gender: Female Heart 4 Kids Therapy LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 00 Yrs/21 Yrs MT 8:00 AM - 6:00 PM WTH 8:00 AM - 6:30 PM Velett, Kristen OT Provider ID: 1107289 Gender: Female Heart 4 Kids Therapy LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 Fax: (727) 350-9665 00 Yrs/21 Yrs M-TH 8:00 AM - 6:00 PM F 9:00 AM - 5:00 PM

Orthopaedic Surgery Croteau, Sean PA Provider ID: 1054984 Gender: Male Bayfront Physician Specialty Serivi 603 7th St S Ste 450 Saint Petersburg, FL 33701 (727) 527-5272 Fax: (866) 846-6542 12 Yrs/130 Yrs M-F 9:00 AM - 4:00 PM

Dent, Leah PA Mirsky, Stephanie ARNP Provider ID: 516242 Gender: Female Provider ID: 1353015 Pinellas Medical Associates PA Gender: Female 5880 49th St N Ste 104 Pediatrix Medical Group of Saint Petersburg, FL 33709 Florida (727) 528-6100 601 5 St S Ste 711 Fax: (727) 528-7895 Saint Petersburg, FL 33701 18 Yrs/130 Yrs (727) 322-4830 M-F 8:00 AM - 5:00 PM Fax: (855) 527-5510 00 Yrs/18 Yrs Pain Management M-F 9:00 AM - 5:00 PM

Oshrine, Kathleen ARNP

Spieker, Janet ARNP Provider ID: 452554 Gender: Female Suncoast Medicl Clinic LLC 620 10th St N Saint Petersburg, FL 33705 (727) 824-8385 Fax: (727) 824-8388 00 Yrs/130 Yrs M-F 9:00 AM - 4:30 PM

Pavlock, Amanda ARNP

Pediatric Allergy & Immunology Duff, Carla ARNP Provider ID: 655044 Gender: Female USF Physicians Group 601 5th St S Saint Petersburg, FL 33701 (727) 767-4150 Fax: (727) 767-8532 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM

Dent, Leah PA Pediatric Cardiology Provider ID: 516242 Gender: Female Mirsky, Stephanie ARNP Pinellas Medical Associates PA 2299 9th Ave N Ste 1A Provider ID: 1353015 Saint Petersburg, FL 33713 Gender: Female (727) 528-6100 Pediatrix Medical Group of Fax: (727) 528-7895 Florida 18 Yrs/130 Yrs 3253 McMullen Booth Rd Ste M-F 9:00 AM - 5:00 PM 100 Clearwater, FL 33761 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 626 6th Ave S Ste 120 Saint Petersburg, FL 33701 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Oshrine, Kathleen ARNP Provider ID: 1312672 Gender: Female Pediatrix Medical Group of Florida 3253 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Oshrine, Kathleen ARNP Provider ID: 1312672 Gender: Female Pediatrix Medical Group of Florida 601 5th St S Ste 711 Saint Petersburg, FL 33701 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

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Provider ID: 1312672 Gender: Female Pediatrix Medical Group of Florida 840 MLK St N Ste 100 Saint Petersburg, FL 33705 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Provider ID: 1356296 Gender: Female Pediatrix Medical Gorup of Florida 3253 N McMln Bth Rd Ste 100 Clearwater, FL 33761 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Pavlock, Amanda ARNP Provider ID: 1356296 Gender: Female Pediatrix Medical Group of Florida 625 6th Ave S Ste 120 Saint Petersburg, FL 33705 (727) 322-4830 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Wilson, Heather ARNP Provider ID: 764776 Gender: Female Pediatric Physician Services 601 5th St S 2nd Fl Saint Petersburg, FL 33701 (727) 767-3333 Fax: (727) 767-8990 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Pediatric Gastroenterology Deltoro, Kristin ARNP Provider ID: 924776 Gender: Female 601 5th St S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/18 Yrs M-F 7:30 AM - 5:00 PM Gursky, Beverly ARNP Provider ID: 722439 Gender: Female Pediatric Gastroenterology Hepatolo 601 5th St S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/21 Yrs MT 7:00 AM - 5:30 PM WTH 7:00 AM - 7:30 PM F 7:00 AM - 5:00 PM Johnson, Michele ARNP Provider ID: 924783 Gender: Female 601 5th St S Ste 605 Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/18 Yrs M-F 7:30 AM - 5:00 PM Sherman, Shanna ARNP Provider ID: 925774 Gender: Female 601 5th St S Saint Petersburg, FL 33701 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/18 Yrs M-F 7:30 AM - 5:00 PM

Pediatric Hematology/ Oncology Horner, Kelsey ARNP Provider ID: 1310502 Gender: Female Pediatric Physician Services Inc 601 5th St S Ste 302 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Lukas, Claudia PA Provider ID: 997313 Gender: Female Pediatric Physicians Services Inc 601 5th St S Ste 3 Saint Petersburg, FL 33701 (727) 767-4176 Fax: (727) 767-4379 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM

Pediatric Neurosurgery

Pediatric Orthopaedics Carney, Jacquelyn PA Provider ID: 1074572 Gender: Female Cossa 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM Cimilluca, Cara PA Provider ID: 424842 Gender: Female Childrens Orthopaedic and Scoliosis 3850 Tampa Rd Palm Harbor, FL 34684 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc MT 9:00 AM - 12:00 PM

Navarre, Nicole ARNP Provider ID: 1359320 Gender: Female Pediatric Physician Services Inc 601 5th St S Ste 511 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Cimilluca, Cara PA Provider ID: 424842 Gender: Female Childrens Orthopaedic and Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM

Young, Carrie ARNP Provider ID: 783757 Gender: Female Pediatric Physician Services Inc 601 5th St S Ste 5 Saint Petersburg, FL 33701 (727) 767-8181 Fax: (727) 767-8030 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Graham, Adria PA Provider ID: 1340748 Gender: Female Children's Orthopaedic Scoliosis S 3850 Tampa Rd Palm Harbor, FL 34684 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

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Graham, Adria PA Provider ID: 1340748 Gender: Female Children's Orthopaedic Scoliosis S 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Hunter, Lara PA Provider ID: 1063089 Gender: Female 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Shepard, Ashleigh PA Provider ID: 1335739 Gender: Female Childrens Orthopaedic and Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Thompson, Cody PA Provider ID: 973391 Gender: Male Childrens Orthopaedic and Scoliosis 625 6th Ave S Ste 450 Saint Petersburg, FL 33701 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Pediatric Rheumatology Brothers, Mary ARNP Provider ID: 753164 Gender: Female Pediatric Physician Services, Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-7438 Fax: (727) 767-8170 00 Yrs/21 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:00 PM

Pediatric Surgery Benson, Matthew PA Provider ID: 786411 Gender: Male 601 5th St S 3rd Fl Saint Petersburg, FL 33701 (727) 767-4170 Fax: (727) 767-4346 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Davis, Jennifer PA Provider ID: 240875 Gender: Female Pediatric Physician Services Inc 601 5th St S Saint Petersburg, FL 33701 (727) 767-6666 Fax: (727) 767-8606 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Pediatrics Dougherty, Aimee ARNP Provider ID: 1328341 Gender: Female USF Physicians Group 140 7th Ave S Saint Petersburg, FL 33701 (727) 873-4422 Fax: (727) 873-4193 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM

Freed, Heather ARNP Provider ID: 816978 Gender: Female Petersburg Pediatrics Pinellas 7500 Park Blvd N Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 7:00 PM

Freed, Heather ARNP Provider ID: 816978 Gender: Female St Petersburg Pediatrics 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 939-9578 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 7:00 PM

Freed, Heather ARNP Provider ID: 816978 Gender: Female St Petersburg Pediatrics 1012 4th St S Saint Petersburg, FL 33701 (727) 894-2231 Fax: (727) 895-8602 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:30 AM - 5:30 PM

Kennel Besselieu, Allison ARNP Provider ID: 1187418 Gender: Female USF Physicians Group 880 6th St S Ste 460 Saint Petersburg, FL 33701 (727) 767-8230 Fax: (727) 767-7786 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM

Freed, Heather ARNP Provider ID: 816978 Gender: Female St Petersburg Pediatrics 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 7:00 PM Freed, Heather ARNP Provider ID: 816978 Gender: Female St Petersburg Pediatrics 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM

Kober, Terry PA Provider ID: 1235197 Gender: Female Mariano D Cibran, MD Corp DBA St Pe 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 00 Yrs/21 Yrs MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 2:00 PM Sat 9:00 AM - 12:00 PM Leal, Jennifer ARNP Provider ID: 449348 Gender: Female East Lake Pediatrics PA 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 772-1452 Fax: (727) 772-1453 00 Yrs/18 Yrs Mease Countryside Hospital M-F 8:00 AM - 6:00 PM

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Mallett, Lesley ARNP Provider ID: 916979 Gender: Female 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 392-9578 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM McCormack, Leah ARNP Provider ID: 817631 Gender: Female East Lake Pediatrics 4150 Woodlands Pkwy Ste B Palm Harbor, FL 34685 (727) 372-6760 Fax: (727) 372-6808 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM McHugh, Sara ARNP Provider ID: 916586 Gender: Female 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 392-9578 00 Yrs/18 Yrs Languages: Vietnamese M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Seminole 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 939-9578 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM

Last update 08/14/2017

Allied Providers Pinellas Pediatrics - cont. Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Disston 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Largo 3475 E Bay Dr Largo, FL 33771 (727) 535-9700 Fax: (727) 539-7301 00 Yrs/18 Yrs M-F 8:30 AM - 5:30 PM Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Largo Mall 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs MTWTHFSat 8:30 AM - 5:30 PM Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Northside 2137 16th St N Saint Petersburg, FL 33704 (727) 822-1896 Fax: (727) 821-0932 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM

Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Pinellas P 7500 Park Blvd N Pinellas Park, FL 33781 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM Migliore, Heidi ARNP Provider ID: 486487 Gender: Female St Petersburg Pediatrics Seville 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs M-F 8:30 AM - 5:30 PM Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 2137 16th St N Saint Petersburg, FL 33704 (813) 871-5437 Fax: (727) 821-0932 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM

Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 2701 54th Ave S Saint Petersburg, FL 33712 (727) 867-5788 Fax: (727) 867-3255 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 3475 E Bay Dr Largo, FL 33771 (727) 535-9700 Fax: (727) 539-7301 00 Yrs/18 Yrs M-F 8:30 AM - 5:30 PM Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 4105 49th St N Saint Petersburg, FL 33709 (727) 528-6900 Fax: (727) 526-0753 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 7050 Seminole Blvd Seminole, FL 33772 (727) 392-8033 Fax: (727) 939-9578 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Shine, Leetoria ARNP Provider ID: 547577 Gender: Female St Petersburg Pediatrics 7500 Park Blvd Saint Petersburg, FL 33704 (727) 544-5437 Fax: (727) 547-7961 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM

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Strickland, Kimberly ARNP Provider ID: 372084 Gender: Female Community Health Centers of Pinella 1721 Main St Dunedin, FL 34698 (727) 824-8181 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Strickland, Kimberly ARNP Provider ID: 372084 Gender: Female Community Health Ctrs of Pinellas 1020 Lakeview Rd Clearwater, FL 33756 (727) 461-4139 Fax: (727) 461-1692 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Strickland, Kimberly ARNP Provider ID: 372084 Gender: Female Community Health Ctrs of Pinellas 12420 130th Ave N Largo, FL 33774 (727) 587-7729 Fax: (727) 587-7739 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Strickland, Kimberly ARNP Provider ID: 372084 Gender: Female Community Health Ctrs of Pinellas 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8181 Fax: (727) 823-7429 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Pediatrics - cont. Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 12420 130th Ave N Largo, FL 33774 (727) 588-4040 Fax: (727) 588-4010 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 205 MLK St N Saint Petersburg, FL 33701 (727) 824-6900 Fax: (727) 820-4285 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 301 Disston Ave Tarpon Springs, FL 34689 (727) 942-5457 Fax: (727) 942-5467 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 310 N Myrtle Ave Clearwater, FL 33755 (727) 469-5800 Fax: (727) 298-2842 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 5500 16th St N Saint Petersburg, FL 33703 (727) 570-3025 Fax: (727) 570-3026 00 Yrs/21 Yrs M-F 7:00 AM - 3:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 6305 118th Ave Largo, FL 33773 (727) 538-7410 00 Yrs/21 Yrs M-F 7:00 AM - 3:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 6350 76th Ave N Pinellas Park, FL 33781 (727) 547-7780 Fax: (727) 547-7793 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 850 34th St S Saint Petersburg, FL 33711 (727) 893-5452 00 Yrs/21 Yrs M-F 7:00 AM - 3:00 PM Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 8751 Ulmerton Rd Largo, FL 33771 (727) 524-4410 Fax: (727) 507-4348 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Thoenes, Melanie ARNP Provider ID: 300519 Gender: Female Pinellas County Health Dept 924 58th St S Saint Petersburg, FL 33707 (727) 343-7680 00 Yrs/21 Yrs M-F 7:00 AM - 3:00 PM Warren, Ana ARNP Provider ID: 1315767 Gender: Female Pediatric Physician Services, Inc. 601 5th St S Ste 502 Saint Petersburg, FL 33701 (727) 767-3636 Fax: (727) 767-3638 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Wesnofske, Cassandra ARNP Provider ID: 916152 Gender: Female 12170 Seminole Blvd Largo, FL 33778 (727) 586-5355 Fax: (727) 586-6997 00 Yrs/18 Yrs M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM

Physical Therapy Kokemohr, Deann PT Provider ID: 1045645 Gender: Female Body In Motion Therapy 9300 4th St N Ste A Saint Petersburg, FL 33702 (727) 575-7966 Fax: (727) 575-7969 00 Yrs/130 Yrs MW 8:00 AM - 5:00 PM TTH 10:00 AM - 7:00 PM F 8:00 AM - 2:00 PM Sat 10:00 AM - 2:00 PM

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Kraynak, Jodi PT Provider ID: 1414965 Gender: Female Heart 4 Kids Therapy LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Lee, Lauri PT Provider ID: 1058929 Gender: Female Educated Play Inc 8673 15th Way N Saint Petersburg, FL 33702 (727) 423-0060 Fax: (727) 369-8803 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Lester, Lawrence PT Provider ID: 1039199 Gender: Male International Health Clinic 2878 Roosevelt Blvd Clearwater, FL 33760 (727) 507-8555 Fax: (727) 532-3981 00 Yrs/130 Yrs Languages: Spanish, Chinese M-F 7:30 AM - 6:00 PM Sat 9:00 AM - 12:00 PM McCormack, Maire PT Provider ID: 19184 Gender: Female Educated Play Inc 8673 15th Way N Saint Petersburg, FL 33702 (727) 423-0060 Fax: (727) 369-8803 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Physician Assistant Saglibene, Mark MD Provider ID: 1226262 Gender: Male Baycare Medical Group Inc 455 Pinellas St 330 Clearwater, FL 33756 (727) 724-8611 Fax: (727) 724-0425 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Plastic & Reconstructive Surgery Pringle, Aleisha ARNP Provider ID: 811939 Gender: Female Pediatric Physicians Inc 601 5th St S Ste 3 Saint Petersburg, FL 33701 (727) 767-3916 Fax: (727) 767-8917 00 Yrs/130 Yrs Johns Hopkins All Childrens Hospital Inc M-F 8:00 AM - 5:00 PM

Speech & Language Pathology Clifton, Andrea SLP Provider ID: 1359356 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Craven, Emily SLP Provider ID: 1359363 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM

Douglas, Marissa SLP Provider ID: 1349667 Gender: Female Heart 4 Kids Therapy LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 00 Yrs/21 Yrs M-TH 8:00 AM - 6:00 PM F 0:90 AM - 5:00 PM Kurtz, Molly SLP Provider ID: 1321338 Gender: Female Therachoice, Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Reed, Danielle SLP Provider ID: 1286780 Gender: Female Therachoice, Inc 111 2nd Ave NE 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Zeitler, Christine SLP Provider ID: 1264011 Gender: Female Heart 4 Kids Therapy, LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 Fax: (727) 350-9665 00 Yrs/21 Yrs M-TH 8:00 AM - 6:00 PM F 9:00 AM - 5:00 PM

Speech Therapy Boonyathitisuk, Pisami SLP Provider ID: 1044398 Gender: Female Speech Connection 2519 N McMullen Booth Rd Ste 150-174 Clearwater, FL 33761 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/21 Yrs Languages: Thai M-F 9:00 AM - 5:00 PM Bowers, Janaya SLP Provider ID: 1120103 Gender: Female Stepping Stones Assessment and Therapy 3905 Tampa Rd Unit 284 Oldsmar, FL 34677 (727) 485-4660 Fax: (727) 789-9204 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Byrd, Michelle SLP Provider ID: 1044375 Gender: Female Speech Connection 2519 N McMullen Booth Rd Ste 150-174 Clearwater, FL 33761 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/130 Yrs Languages: Thai M-F 9:00 AM - 5:00 PM Coleman, Laci SLP Provider ID: 1060192 Gender: Female Heart 4 Kids Therapy LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 Fax: (727) 350-9665 00 Yrs/18 Yrs Languages: Spanish M-TH 8:00 AM - 6:00 PM F 9:00 AM - 5:00 PM

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Cummings, Kristin SLP Provider ID: 1040556 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM Diaz, Elanda SLP Provider ID: 1040543 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM Henke, Robyn SLP Provider ID: 1045417 Gender: Female Speech Connection 2519 N McMln Bth Rd Ste 150 174 Clearwater, FL 33761 (727) 631-2466 00 Yrs/21 Yrs Languages: Thai M-F 9:00 AM - 6:00 PM Le, Sharon SLP Provider ID: 1040554 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Speech Therapy - cont. Mason, Karen SLP Provider ID: 1060185 Gender: Female Mason Speech Therapy 1631 Golf View Dr Bellair, FL 33756 (941) 204-7352 Fax: (727) 215-1465 02 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Miller, Julia SLP Provider ID: 1048827 Gender: Female Stepping Stones Assessment and Therapy 3905 Tampa Rd Unit 284 Oldsmar, FL 34677 (727) 485-4600 Fax: (727) 789-9204 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Miller, Rachel SLP Provider ID: 1195333 Gender: Female Heart 4 Kids Therapy LLC 31840 US Hwy 19 N Palm Harbor, FL 34684 (727) 202-9200 Fax: (727) 350-9665 00 Yrs/130 Yrs M-TH 8:00 AM - 6:00 PM F 9:00 AM - 5:00 PM Petrick, Christina SLP Provider ID: 1044407 Gender: Female Speech Connection 2519 N McMullen Booth Rd Ste 150-174 Clearwater, FL 33761 (813) 579-2212 Fax: (813) 345-2896 00 Yrs/21 Yrs Languages: Thai M-F 9:00 AM - 5:00 PM

Porreca, Tina SLP Provider ID: 1048076 Gender: Female Speech Connection 926 16th St N Ste 3 Saint Petersburg, FL 33705 (727) 631-2466 00 Yrs/21 Yrs MT 10:00 AM - 7:00 PM Rutland, Kristen SLP Provider ID: 1268351 Gender: Female Therachoice, Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Shuster, Paige SLP Provider ID: 706161 Gender: Female Sweet Talk LLC 805 Duval Ct Safety Harbor, FL 34695 (727) 418-9925 Fax: (727) 559-1156 00 Yrs/130 Yrs M-TH 9:00 AM - 4:00 PM F 9:00 AM - 3:00 PM Steffel, Christine SLP Provider ID: 1048825 Gender: Female Stepping Stones Assessment and Therapy 3905 Tampa Rd Unit 284 Oldsmar, FL 34677 (727) 485-4600 Fax: (727) 789-9204 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Stokes, Sarianna SLP Provider ID: 1040566 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM

Trimble, Chelsy SLP Provider ID: 1040569 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM Vargas, Tania SLP Provider ID: 1040561 Gender: Female Therachoice Inc 111 2nd Ave NE Ste 900 Saint Petersburg, FL 33701 (813) 690-1327 Fax: (727) 213-6233 00 Yrs/130 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 5:00 PM Vizzi, Lindsay SLP Provider ID: 1056850 Gender: Female Speech Connection 2519 N McMullen Booth Rd Ste 150-174 Clearwater, FL 33761 (727) 631-2466 00 Yrs/21 Yrs Languages: Thai M-F 9:00 AM - 6:00 PM

Thoracic & Cardiovascular Surgery Bowersock, Angela PA Provider ID: 1168755 Gender: Female Bayfront Health Medical Group 601 7th St S Ste 530 Saint Petersburg, FL 33701 (727) 553-7450 Fax: (727) 553-7421 18 Yrs/130 Yrs M-F 8:00 AM - 4:00 PM

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Chamberlain, Brian PA Provider ID: 225992 Gender: Male 455 Pinellas St Ste 320 Clearwater, FL 33756 (727) 446-2273 Fax: (727) 441-4966 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Davenport, Misti ARNP Provider ID: 1302592 Gender: Female Cwest Florida Cardiology Network LL 270 S Moon Ave Brandon, FL 33511 (813) 571-9988 Fax: (813) 571-9922 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Dixon, Gloria PA Provider ID: 1346793 Gender: Female Baycare Medical Group Inc 455 Pinellas St Ste 320 Clearwater, FL 33756 (727) 446-2273 Fax: (727) 441-4966 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Gennara, Thomas PA Provider ID: 790697 Gender: Male 6006 49th St N Ste 310 Saint Petersburg, FL 33709 (813) 571-9988 Fax: (813) 571-9922 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Leek, Joshua PA Provider ID: 1245940 Gender: Male Cardiac Surgical Associates 6006 49th St N Ste 310 Saint Petersburg, FL 33709 (727) 527-9779 Fax: (727) 522-0415 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Pinellas Thoracic & Cardiovascular Surgery - cont. Leek, Joshua PA Provider ID: 1245940 Gender: Male Cardiac Surgical Associates of Larg 1345 W. Bay Dr Ste 304 Largo, FL 33770 (727) 587-7100 Fax: (727) 585-3290 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Steeves, Andrea PA Provider ID: 1126142 Gender: Female Cardiac Surgical Associates of Larg 1345 W. Bay Dr Ste 304 Largo, FL 33770 (727) 587-7100 Fax: (727) 585-3290 18 Yrs/130 Yrs Largo Medical Center Indian Rocks M-F 9:00 AM - 5:00 PM

Vascular Surgery Morningstar, Tracy PA Provider ID: 1349671 Gender: Female Bay Surgical Specialists PA 900 Carillon Pkwy Ste 301 Saint Petersburg, FL 33716 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs M 8:00 AM - 12:00 PM Morningstar, Tracy PA Provider ID: 1349671 Gender: Female Bay Surgical Specialists PA 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs MW 8:00 AM - 12:00 PM T 1:00 AM - 5:00 PM

Turner, Nancy ARNP Provider ID: 1323378 Gender: Female Baycare Medical Group Inc 455 Pinellas St 240 Clearwater, FL 33756 (727) 446-2273 Fax: (727) 441-4966 18 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Thoracic Surgery Parker, Jill PA Provider ID: 589320 Gender: Female 960 7th Ave N Saint Petersburg, FL 33705 (727) 821-8101 Fax: (727) 825-1357 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Polk Audiology Barlow, Kevin AUD Provider ID: TPV03093-01 Gender: Male Winter Haven Audiology 510 S 1st Winter Haven, FL 33880 (863) 293-6507 Fax: (863) 291-0737 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Oldfield, Christopher AUD

Child Neurology Oneil, Amanda ARNP Provider ID: 1070499 Gender: Female Capernaum Medical Center For Kids P 5129 S Lakeland Dr Ste 1 and 2 Lakeland, FL 33813 (863) 232-4323 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Dermatology

Albares, Jamie ARNP Provider ID: TPV17173-01 Provider ID: 535909 Gender: Male Gender: Female HearUSA 1421 Town Center DR Ste B 102 Lakeland Dermatology 202 Lake Miriam Dr Lakeland, FL 33803 Lakeland, FL 33813 (863) 581-8105 (863) 647-2333 Fax: (863) 688-0432 Fax: (863) 644-6729 21 Yrs/99 Yrs 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Vecchio, Christine AUD Ferrell, Bobbie ARNP Provider ID: TPV09045-01 Provider ID: 778048 Gender: Female Gender: Female HearUSA 1421 Town Center DR Ste B 102 Lakeland Dermatology 202 Lake Miriam Dr Ste 1 Lakeland, FL 33803 Lakeland, FL 33813 (863) 581-8105 (863) 647-2333 Fax: (863) 688-0432 Fax: (863) 644-6729 21 Yrs/99 Yrs 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM

Cardiology

Elliott, Julie ARNP Provider ID: 1176404 Gender: Female Comprehensive Cardiovascular Specia 320 1st St N Winter Haven, FL 33881 (863) 512-5092 Fax: (863) 508-6326 18 Yrs/130 Yrs Winter Haven Hospital M-F 9:00 AM - 5:00 PM

Rodriguez, Alex PA Provider ID: 1223013 Gender: Male Advanced Dermatology and Cosmetic S 202 Lake Miriam Dr Ste S-1 Lakeland, FL 33813 (863) 647-2333 Fax: (863) 393-1995 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Ear, Nose & Throat Cornish, Victoria ARNP Provider ID: 27205 Gender: Female Central Florida ENT Associates PA 515 E Garden St Lakeland, FL 33805 (863) 683-5454 Fax: (863) 683-4652 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Family Practice Andre, Philippe PA Provider ID: 1176162 Gender: Male Jay Care Medical Center 950 1st St S Winter Haven, FL 33880 (863) 295-5604 Fax: (863) 295-5398 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Barberet, Leigh ARNP Provider ID: 187888 Gender: Female Central Fla Healthcare 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Barberet, Leigh ARNP Provider ID: 187888 Gender: Female Central Fla Healthcare 1514 1st St N Winter Haven, FL 33881 (836) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

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Barberet, Leigh ARNP Provider ID: 187888 Gender: Female Central Fla Healthcare 204 E Palmetto St Wauchula, FL 33873 (863) 773-2111 Fax: (863) 773-3946 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Barberet, Leigh ARNP Provider ID: 187888 Gender: Female Central Fla Healthcare 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3252 00 Yrs/130 Yrs M-F 7:30 AM - 5:30 PM Barberet, Leigh ARNP Provider ID: 187888 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Breitenbach, Renee ARNP Provider ID: 1160678 Gender: Female Florida Department of Health Of Pol 1700 Baker Ave Haines City, FL 33844 (863) 519-7900 Fax: (863) 519-7696 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Polk Family Practice - cont.

Knight, Amelia ARNP Provider ID: 1272029 Breitenbach, Renee ARNP Gender: Female Central Florida Health Care Winter Provider ID: 1160678 201 Magnolia Ave SW Gender: Female Florida Department of Health Winter Haven, FL 33880 (863) 292-4280 Of Pol Fax: (863) 292-4293 1805 Hobbs Rd 00 Yrs/130 Yrs Auburndale, FL 33823 M-TH 7:30 AM - 6:00 PM (863) 965-5400 F 7:30 AM - 5:30 PM Fax: (863) 965-3739 00 Yrs/130 Yrs Knight, Amelia ARNP M-F 8:00 AM - 5:00 PM Provider ID: 1272029 Breitenbach, Renee ARNP Gender: Female Central Florida Health Care, Inc. L Provider ID: 1160678 1129 N Missouri Ave Gender: Female Florida Department of Health Lakeland, FL 33805 (863) 413-8600 Of Pol Fax: (863) 413-8651 3241 Lakeland Hills Blvd 00 Yrs/130 Yrs Lakeland, FL 33805 M-TH 7:30 AM - 6:00 PM (863) 413-2620 F 7:30 AM - 5:30 PM Fax: (863) 499-2612 00 Yrs/130 Yrs Knight, Amelia ARNP M-F 9:00 AM - 5:00 PM Provider ID: 1272029 Gender: Female Breitenbach, Renee ARNP Central Florida Health Care, Inc. L Provider ID: 1160678 225 Lincoln Ave Gender: Female Florida Department of Health Lake Wales, FL 33853 (863) 678-4360 Of Pol Fax: (863) 678-4399 835 W Central Ave 00 Yrs/130 Yrs Lake Wales, FL 33853 M-TH 7:30 AM - 6:00 PM (863) 519-7910 F 7:30 AM - 5:30 PM Fax: (863) 421-3210 00 Yrs/130 Yrs Knight, Amelia ARNP M-F 8:00 AM - 5:00 PM Provider ID: 1272029 Gender: Female Garrido Jr, Eduardo PA Central Florida Health Care, Provider ID: 1156699 Inc. L Gender: Male 601 S Florida Ave Aviva Healthcare, Inc. Lakeland, FL 33801 339 Cypress Pkwy Ste 110 (863) 688-0841 Kissimmee, FL 34759 Fax: (863) 616-9709 (407) 343-0542 00 Yrs/130 Yrs Fax: (407) 353-0553 M-TH 7:30 AM - 6:00 PM 00 Yrs/130 Yrs F 7:30 AM - 5:30 PM Languages: Spanish M 10:00 AM - 30:0 PM T 11:30 AM - 5:30 PM W 10:00 AM - 5:00 PM

Knight, Amelia ARNP Provider ID: 1272029 Gender: Female Central Florida Health Care, Inc. L 916 Old Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Knight, Amelia ARNP Provider ID: 1272029 Gender: Female Central Florida Health Care, Inc. M 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Knight, Amelia ARNP Provider ID: 1272029 Gender: Female Central Florida Health Care, Inc. M 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Knight, Amelia ARNP Provider ID: 1272029 Gender: Female Central Florida Health Care, Inc. W 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM

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Love, Kelly ARNP Provider ID: 815280 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Metts, Huey ARNP Provider ID: 1074534 Gender: Male Central Florida Health Care Inc 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 18 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM Metts, Huey ARNP Provider ID: 1074534 Gender: Male Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 18 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Metts, Huey ARNP Provider ID: 1074534 Gender: Male Central Florida Health Care Inc 916 Dundee Rd Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 18 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM

Last update 08/14/2017

Allied Providers Polk Family Practice - cont. Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 106 NW 9th St Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8651 00 Yrs/130 Yrs M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM Sat 8:00 AM - 5:00 PM Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 225 Lincoln Ave Dundee, FL 33838 (863) 678-4360 Fax: (863) 678-4399 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Sirak, Laura ARNP Provider ID: 1310184 Gender: Female Central Florida Health Care Inc 916 Dundee Rd Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Victorine, Suzanne ARNP Provider ID: 472244 Gender: Female Central Florida Health Care 106 NW 9th Ave Mulberry, FL 33860 (863) 425-6200 Fax: (862) 425-6219 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Victorine, Suzanne ARNP Provider ID: 472244 Gender: Female Central Florida Health Care Inc 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-3545 00 Yrs/130 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM Sat 7:30 AM - 12:00 PM

Victorine, Suzanne ARNP Provider ID: 472244 Gender: Female Central Florida Health Care Inc 1129 N Missouri Ave Lakeland, FL 33805 (863) 413-8600 Fax: (863) 413-8650 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Victorine, Suzanne ARNP Provider ID: 472244 Gender: Female Central Florida Health Care Inc 916 Hwy 542 Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3258 00 Yrs/130 Yrs M-TH 7:30 AM - 5:30 PM F 7:30 AM - 5:00 PM Sat 7:30 AM - 12:00 PM Wells, Lindsey PA Provider ID: 1195275 Gender: Female Lakeland Physicians And Associates 1818 Harden Blvd Ste 120 Lakeland, FL 33803 (863) 210-5640 Fax: (863) 210-5716 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Wright, Melissa ARNP Provider ID: 1122359 Gender: Female Central Florida Health Care, Inc. 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

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Wright, Melissa ARNP Provider ID: 1122359 Gender: Female Central Florida Health Care, Inc. 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Wright, Melissa ARNP Provider ID: 1122359 Gender: Female Central Florida Health Care, Inc. 305 W Central Ave Lake Wales, FL 33853 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Gastroenterology Severino, Alba ARNP Provider ID: 1270923 Gender: Female Gastroenterology Associates of Osce 339 Cypress Pkwy Ste 230 Kissimmee, FL 34759 (407) 846-6747 Fax: (407) 846-6186 18 Yrs/130 Yrs M 8:00 AM - 1:00 PM

General Surgery Castro, Maria ARNP Provider ID: 801150 Gender: Female Lakeland Regional Surgical Associat 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 03 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Polk General Surgery - cont. Owens, Rose ARNP Provider ID: 916111 Gender: Female Lakeland Regional Surgery Associate 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Powrzanas, Trey ARNP Provider ID: 1174969 Gender: Male Lakeland Regional Health 130 Pablo St Lakeland, FL 33803 (863) 687-1259 Fax: (863) 284-1786 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Reiss, Jared PA Provider ID: 1261717 Gender: Male Florida Vien Care Specialists, LLC 22411 US Hwy 27 Ste A Lake Wales, FL 33859 (321) 252-0327 Fax: (863) 215-7085 02 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Infectious Disease Drake, Carol ARNP Provider ID: 26314 Gender: Female Polk County Health Department 2050 Havendale Blvd NW Winter Haven, FL 33881 (863) 297-3037 Fax: (863) 297-3039 00 Yrs/130 Yrs

Drake, Carol ARNP Provider ID: 26314 Gender: Female Seen At Polk County Health Dept 1255 Brice Blvd Bartow, FL 33830 (863) 519-8233 Fax: (863) 519-8304 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Ellermeyerstapleton, Mary Tyree, Mary PA Kathryn ARNP Provider ID: 315575 Provider ID: 1214381 Gender: Female Gender: Female Jay Care Medical Center Florida Department of Health 950 1st St S Ste 101 In Pol Winter Haven, FL 33880 835 W Central Ave (863) 295-5604 Lake Wales, FL 33853 Fax: (863) 295-5898 (863) 519-7910 18 Yrs/130 Yrs Fax: (863) 519-7696 M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Velez, Ana ARNP Internal Medicine Provider ID: 1001393 Estrada, Paul ARNP Gender: Female Ellermeyerstapleton, Mary Provider ID: 1356301 1045 E County Rd 540A 540A Kathryn ARNP Gender: Male Lakeland, FL 33813 Provider ID: 1214381 American Care of Tampa (863) 644-3585 Gender: Female 1005 N Lake Parker Ave Fax: (863) 644-3171 Florida Department of Health Lakeland, FL 33805 12 Yrs/130 Yrs In Pol (863) 583-4053 Lakeland Reg Medical Center 1700 Baker Ave Fax: (863) 248-8288 M-F 8:00 AM - 5:00 PM Haines City, FL 33844 12 Yrs/130 Yrs (863) 421-3204 Languages: Spanish Velez, Ana ARNP Fax: (863) 519-7696 M-F 8:00 AM - 5:00 PM Provider ID: 1001393 18 Yrs/130 Yrs Gender: Female M-F 8:00 AM - 5:00 PM Holcomb, Lisa ARNP Advanced Internal Medicine Care Ellermeyerstapleton, Mary Provider ID: 1251768 5425 S Florida Ave Kathryn ARNP Gender: Female Lakeland, FL 33813 Provider ID: 1214381 Central Florida Health Care, (863) 644-3585 Gender: Female Inc Fax: (863) 644-3171 Florida Department of Health 1514 1st St N 12 Yrs/130 Yrs In Pol Winter Haven, FL 33881 Lakeland Reg Medical Center 1805 Hobbs Rd (863) 292-4280 M-F 9:00 AM - 5:00 PM Auburndale, FL 33823 Fax: (863) 292-4293 (863) 965-5400 Interventional Cardiology 00 Yrs/130 Yrs Fax: (863) 965-3739 M-F 9:00 AM - 5:00 PM 18 Yrs/130 Yrs Yantorni, Lauren ARNP M-F 8:00 AM - 5:00 PM Tyree, Mary PA Provider ID: 315575 Provider ID: 1344855 Ellermeyerstapleton, Mary Gender: Female Gender: Female Kathryn ARNP 175 US Hwy 17 N Heart and Vascular Institute Provider ID: 1214381 Bartow, FL 33830 of Flo Gender: Female (863) 533-8215 1110 Druid Cir Ste A Florida Department of Health Fax: (863) 533-8221 Lake Wales, FL 33853 In Pol 18 Yrs/130 Yrs (863) 424-3278 3241 Lakeland Hills Blvd M-F 8:00 AM 5:00 PM 18 Yrs/130 Yrs Lakeland, FL 33805 M-F 8:00 AM - 5:00 PM (863) 413-2620 Fax: (863) 519-7696 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Polk Interventional Cardiology Horrell, Cindy Jo ARNP - cont. Provider ID: 303804 Yantorni, Lauren ARNP Provider ID: 1344855 Gender: Female Heart and Vascular Institute of Flo 400 Ave K SE Ste 9 Winter Haven, FL 33880 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM Yantorni, Lauren ARNP Provider ID: 1344855 Gender: Female Heart and Vascular Institute of Flo 405 Lionel Way Davenport, FL 33837 (863) 424-3278 18 Yrs/130 Yrs M-F 8:30 AM - 5:00 PM

Licensed Mental Health Counselor Lopez, Marianne LMHC Provider ID: 1423185 Gender: Female Beacon Behavioral Health 280 Patterson Rd Ste 1 Haines City, FL 33844 (407) 927-9619 00 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM

Medical Oncology Horrell, Cindy Jo ARNP Provider ID: 303804 Gender: Female Lakeland Regional Caner Center 300 Parkview Pl Lakeland, FL 33805 (863) 603-6577 Fax: (863) 603-6502 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Gender: Female Lakeland Regional Caner Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 18 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Neonatal Perinatal Medicine Petrino, Layne ARNP Provider ID: 754395 Gender: Female 40100 Hwy 27 Davenport, FL 33837 (863) 419-2399 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Powell, Traci ARNP Provider ID: 717031 Gender: Female 40100 Hwy 27 Davenport, FL 33837 (863) 419-2399 00 Yrs/130 Yrs Nemours Childrens Hospital M-F 8:00 AM - 5:00 PM

Neurosurgery Bryant, Melissa ARNP Provider ID: 230273 Gender: Female 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1100 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Bryant, Melissa ARNP Provider ID: 230273 Gender: Female Lakeland Regional Medical Center 1325 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6542 Fax: (863) 603-6529 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Dalton, Natalie ARNP Provider ID: 1289504 Gender: Female USF Physicians Group 1325 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6542 Fax: (863) 603-6529 18 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM

Fee, Krysta CNM Provider ID: 1151978 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 Fax: (863) 577-1949 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Nurse Midwife

Hatcher, Tammy ARNP

Bailey, Glenda CNM Provider ID: 499670 Gender: Female Heart of Florida OB/GYN Associates 220 Ave O SE Winter Haven, FL 33880 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs MT 9:00 AM - 5:00 PM

Provider ID: 1146824 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (813) 686-0082 Fax: (863) 577-1975 00 Yrs/130 Yrs MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 7:00 PM

Bailey, Glenda CNM Provider ID: 499670 Gender: Female Heart of Florida OB/GYN Associates 2221 North Blvd W Davenport, FL 33837 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Lorenz, Kelly CNM Provider ID: 1073751 Gender: Female Central Florida Health Care Inc 1514 1st St N Winter Haven, FL 33881 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM

Bailey, Glenda CNM Provider ID: 499670 Gender: Female Heart of Florida OB/GYN Associates 421 Linden Ln Lake Wales, FL 33853 (863) 421-7600 Fax: (863) 421-7551 12 Yrs/130 Yrs MT 9:00 AM - 5:00 PM

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Lorenz, Kelly CNM Provider ID: 1073751 Gender: Female Central Florida Health Care, Inc. 916 Dundee Rd Dundee, FL 33838 (863) 419-3330 Fax: (863) 419-3249 00 Yrs/130 Yrs Languages: Spanish M-TH 7:30 AM - 6:00 PM F 7:30 AM - 5:30 PM

Last update 08/14/2017

Allied Providers Polk Nurse Midwife - cont. Power, Marianne CNM Provider ID: 1109892 Gender: Female Lakeland Midwifery Care Inc 1923 S Florida Ave Lakeland, FL 33803 (863) 683-4663 Fax: (888) 853-9293 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Reneau, Carolyn CNM Provider ID: 179351 Gender: Female 502 E Hinson Ave Haines City, FL 33844 (863) 940-2908 18 Yrs/130 Yrs Languages: Thai M-F 8:00 AM - 5:00 PM Russell, Laura ARNP Provider ID: 1228759 Gender: Female Central Florida Health Care Winter 1129 N Missouri Ave Lakeland, FL 33805 (863) 292-4280 Fax: (863) 292-4293 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Russell, Laura ARNP Provider ID: 1228759 Gender: Female Central Florida Health Care Frostpr 109 W Wall St Frostproof, FL 33843 (863) 635-4891 Fax: (863) 635-7613 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Russell, Laura ARNP Provider ID: 1228759 Gender: Female Central Florida Health Care Lake Wa 225 Lincoln Ave Lake Wales, FL 33853 (863) 678-4360 Fax: (863) 678-4399 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Mathew, Jeena ARNP Provider ID: 1328328 Gender: Female Polk County Health Department 1805 Hobbs Rd Auburndale, FL 33823 (863) 519-7900 Fax: (563) 519-7696 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Russell, Laura ARNP Provider ID: 1228759 Gender: Female Central Florida Health Care Mulberr 106 NW 9th St Mulberry, FL 33860 (863) 425-6200 Fax: (863) 425-6219 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM

Mathew, Jeena ARNP Provider ID: 1328328 Gender: Female Polk County Health Department 3421 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2623 Fax: (863) 499-2612 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Nurse Practitioner Laracuente, Minedy ARNP Provider ID: 1355806 Gender: Female Florida Woman Care LLC 353 Cypress Pkwy Kissimmee, FL 34759 (407) 333-0496 Fax: (407) 931-4395 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Mathew, Jeena ARNP Provider ID: 1328328 Gender: Female Polk County Health Department 1700 Baker Ave Haines City, FL 33844 (863) 519-7900 Fax: (863) 519-7696 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Mathew, Jeena ARNP Provider ID: 1328328 Gender: Female Polk County Health Department 835 W Central Ave Lake Wales, FL 33853 (863) 519-7900 Fax: (863) 519-7696 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Puig, Katherine ARNP Provider ID: 1368339 Gender: Female Florida Woman Care LLC 353 Cypress Pkwy Kissimmee, FL 34759 (407) 333-0496 Fax: (407) 931-4395 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Nurse Practitioner Acute Care Crovo, Shana ARNP Provider ID: 1366783 Gender: Female Vascular Center of Orlando PA 121 Webb Dr Ste 300 Davenport, FL 33837 (863) 291-6313 Fax: (863) 421-4687 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Obstetrics/Gynecology Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Anderson, Mary ARNP Provider ID: 654485 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Bainbridge, Megan CNM Provider ID: 1197989 Gender: Female Planned Parenthood 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 05 Yrs/130 Yrs M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM

Last update 08/14/2017

Allied Providers Polk Obstetrics/Gynecology - Barany, Pamela CNM cont. Provider ID: 373917 Baker, Kimona CNM Provider ID: 689133 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 686-0082 Fax: (863) 577-1975 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Ballo, Amanda ARNP Provider ID: 707609 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Barany, Pamela CNM Provider ID: 373917 Gender: Female Exodus Womens Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM

Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs St Josephs Hospital M-F 8:00 AM - 5:30 PM Boyette, Suzette ARNP Provider ID: 927134 Gender: Female Celebration Obstetrics & Gynecology 2209 North Blvd W Ste C Davenport, FL 33837 (407) 566-2229 Fax: (407) 566-2499 12 Yrs/130 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM Bryant-Barnett, Paula ARNP Provider ID: 693909 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2273 Fax: (813) 654-1384 12 Yrs/130 Yrs Brandon Regional Hospital M-F 8:00 AM - 5:30 PM

Dyer, Diana ARNP Provider ID: 797257 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 12 Yrs/130 Yrs M 12:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 9:00 AM - 2:00 PM TH 12:00 AM - 7:00 PM F 11:00 AM - 4:00 PM Dyer, Diana ARNP Provider ID: 797257 Gender: Female Planned Parenthood of SW and Centra 908 Spring Lake Sq Winter Haven, FL 33881 (863) 299-7494 Fax: (863) 299-3485 12 Yrs/130 Yrs MT 12:00 AM - 7:00 PM W 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM

Lopez-Rosa, Magda ARNP Provider ID: 796157 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs Languages: Spanish M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM Mashandure, Mercy ARNP Provider ID: 800492 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs Languages: Spanish, Swahili M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM

Frazier, Cathy ARNP Provider ID: 1224525 Gender: Female Planned Parenthood-Lakeland 2250 E Edgewood Dr McGinty, Susanne ARNP Lakeland, FL 33803 (863) 665-5735 Provider ID: 705322 Fax: (863) 665-4422 Gender: Female 00 Yrs/130 Yrs Planned Parenthood of SW M 9:00 AM - 5:00 PM and Centra T 12:00 AM - 7:00 PM 2250 E Edgewood Dr W 9:00 AM - 3:00 PM Lakeland, FL 33803 (863) 665-5735 Hendry, Jill CNM Fax: (863) 665-4422 Provider ID: 174907 00 Yrs/130 Yrs Gender: Female M 9:00 AM - 5:00 PM Schc Womens Care of T 11:30 AM - 7:00 PM Lakeland W 8:30 AM - 4:30 PM 1729 Lakeland Hills Blvd TH 8:00 AM - 2:00 PM Lakeland, FL 33805 (863) 686-0082 Fax: (863) 577-1975 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Polk Obstetrics/Gynecology - Moraga, Juanita ARNP cont. Provider ID: 568610 McKinnie, Cynthia ARNP Provider ID: 811213 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM Messier Besser, Irene CNM Provider ID: 755126 Gender: Female Exodus Womens Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Messier Besser, Irene CNM Provider ID: 755126 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B2 Lakeland, FL 33803 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Moraga, Juanita ARNP Provider ID: 568610 Gender: Female Exodus Womens Center Inc 1525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-2229 Fax: (813) 654-1384 12 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM

Olivencia Lozada, Melinda Reames, Amanda ARNP ARNP Provider ID: 1230843 Gender: Female Provider ID: 1075286 Gender: Female Exodus Womens Center Inc Gender: Female Florida Department of Health Planned Parenthood of SW 215 Imperial Blvd Ste B2 In Pol Lakeland, FL 33803 and Centra 835 W Central Ave (863) 687-2229 2250 E Edgewood Dr Lake Wales, FL 33853 Fax: (813) 654-1384 Lakeland, FL 33803 (863) 421-3204 12 Yrs/130 Yrs (863) 665-5735 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Fax: (863) 665-4422 M-F 8:00 AM - 5:00 PM 00 Yrs/130 Yrs Olivencia Lozada, Melinda M 9:00 AM - 5:00 PM Paine, Lisa ARNP ARNP T 11:30 AM - 7:00 PM Provider ID: 1160677 Provider ID: 1230843 W 8:30 AM - 4:30 PM Gender: Female Gender: Female TH 8:00 AM - 2:00 PM Florida Department of Health Florida Department of Health In Pol In Pol Redlin, Jacqueline ARNP 3241 Lakeland Hills Blvd 1255 Brice Blvd Lakeland, FL 33805 Bartow, FL 33830 Provider ID: 357586 (863) 413-2620 (863) 519-8233 Gender: Female Fax: (863) 499-2612 00 Yrs/130 Yrs Planned Parenthood of SW 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM and Centra M-F 9:00 AM - 5:00 PM 2250 E Edgewood Dr Olivencia Lozada, Melinda Lakeland, FL 33803 ARNP Purvis, Susan ARNP (863) 665-5735 Provider ID: 1230843 Provider ID: 934899 Fax: (863) 665-4422 Gender: Female Gender: Female 00 Yrs/130 Yrs Florida Department of Health 215 Imperial Blvd M 9:00 AM - 5:00 PM In Pol Lakeland, FL 33803 T 11:30 AM - 7:00 PM 1700 Baker Ave (863) 687-2229 W 8:30 AM - 4:30 PM Haines City, FL 33844 Fax: (813) 654-1384 TH 8:00 AM - 2:00 PM (863) 421-3204 12 Yrs/130 Yrs 00 Yrs/130 Yrs M-F 8:00 AM - 5:30 PM Shreve, Tanya PA M-F 8:00 AM - 5:00 PM Provider ID: 802457 Purvis, Susan ARNP Gender: Female Olivencia Lozada, Melinda Provider ID: 934918 Planned Parenthood of SW ARNP Gender: Female and Centra Provider ID: 1230843 215 Imperial Blvd 2250 E Edgewood Dr Gender: Female Lakeland, FL 33803 Lakeland, FL 33803 Florida Department of Health (863) 687-2229 (863) 665-5735 In Pol Fax: (813) 654-1384 Fax: (863) 665-4422 1805 Hobbs Rd 12 Yrs/130 Yrs 00 Yrs/130 Yrs Auburndale, FL 33823 M-F 8:00 AM - 5:30 PM M 9:00 AM - 5:00 PM (863) 965-5400 T 11:30 AM - 7:00 PM 00 Yrs/130 Yrs W 8:30 AM - 4:30 PM M-F 8:00 AM - 5:00 PM TH 8:00 AM - 2:00 PM Olivencia Lozada, Melinda ARNP Provider ID: 1230843 Gender: Female Florida Department of Health In Pol 3241 Lakeland Hills Blvd Lakeland, FL 33805 (863) 413-2620 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Polk Obstetrics/Gynecology - Staal, Jacqueline ARNP cont. Siron, Judith ARNP Provider ID: 801527 Gender: Female Celebration Obstetrics & Gynecology 2209 North Blvd W Ste C Davenport, FL 33837 (863) 424-4321 Fax: (407) 566-2499 12 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Small, Sheri CNM Provider ID: 438638 Gender: Female Schc Womens Care of Lakeland 1729 Lakeland Hills Blvd Lakeland, FL 33805 (863) 940-2908 Fax: (863) 577-1975 12 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Staal, Jacqueline ARNP Provider ID: 801634 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs M 12:00 AM - 5:00 PM T 1:00 AM - 7:00 PM W 9:00 AM - 2:00 PM TH 12:00 AM - 7:00 PM F 11:00 AM - 4:00 PM

Provider ID: 801634 Gender: Female Planned Parenthood of SW and Centra 908 Spring Lake Sq Winter Haven, FL 33881 (863) 665-5735 Fax: (863) 299-3485 00 Yrs/130 Yrs MT 12:00 AM - 7:00 PM W 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Women's Center 1525 Lakeland Hills Blvd Lakeland, FL 33805 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Strong, Shannon ARNP Provider ID: 1025779 Gender: Female Exodus Womens Center 215 Imperial Blvd Ste B-2 Lakeland, FL 33803 (813) 684-2273 Fax: (813) 654-1384 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Valentin, Socorro ARNP Provider ID: 678864 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM

Ward, Leslie ARNP Provider ID: 701949 Gender: Female Planned Parenthood of SW and Centra 2250 E Edgewood Dr Lakeland, FL 33803 (863) 665-5735 Fax: (863) 665-4422 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM T 11:30 AM - 7:00 PM W 8:30 AM - 4:30 PM TH 8:00 AM - 2:00 PM

Occupational Therapy Bass, Kristina OT Provider ID: 1278586 Gender: Female Achievement Academy Inc 716 E Bella Vista St Lakeland, FL 33805 (863) 683-6504 Fax: (863) 688-9292 00 Yrs/18 Yrs M-F 8:30 AM - 3:30 PM Castelli, Jennifer OT Provider ID: 554391 Gender: Female The Hand Rehabilitation Center of F 2000 E Edgewood Dr Ste 114 Lakeland, FL 33803 (863) 606-5948 Fax: (863) 937-9224 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Castelli, Jennifer OT Provider ID: 554391 Gender: Female The Hand Rehabilitation Center of F 250 3rd St NW Ste 202 Lakeland, FL 33805 (863) 662-3935 Fax: (863) 662-3936 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Ditaranto, Heather OT Provider ID: 1349679 Gender: Female Achievement Academy Inc. 2211 28th St NW Winter Haven, FL 33881 (863) 683-6504 Fax: (863) 688-9292 00 Yrs/18 Yrs M-F 8:00 AM - 3:30 PM Ditaranto, Heather OT Provider ID: 1349679 Gender: Female Achievement Academy Inc. 716 E Bella Vista St Lakeland, FL 33805 (863) 683-6504 Fax: (863) 688-9292 00 Yrs/18 Yrs M-F 8:30 AM - 3:30 PM Gomez, Ivette OT Provider ID: 1041527 Gender: Female Small Steps Pediatric Therapy 2201 North Blvd W Davenport, FL 33837 (407) 847-7344 Fax: (407) 483-0206 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:30 PM Lane, Kim OT Provider ID: 1143700 Gender: Female Our Childrens Academy 555 Burns Ave Lake Wales, FL 33853 (863) 679-3338 Fax: (888) 871-0887 00 Yrs/21 Yrs M-F 8:00 AM - 3:00 PM Sanchez Ortiz, Margarita OT Provider ID: 1041901 Gender: Female Therapy World 820 Cypress Pkwy Ste B Kissimmee, FL 34759 (407) 913-1010 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Polk Occupational Therapy cont. Vazquez, Maribel OT Provider ID: 1041921 Gender: Female Therapy World 820 Cypress Pkwy Ste B Kissimmee, FL 34759 (407) 913-1010 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Orthopaedic Surgery Galasso, Jed PA Provider ID: 1256854 Gender: Male Lakeland Regional Health Systems In 3030 Harden Blvd Lakeland, FL 33803 (863) 687-1250 Fax: (863) 687-1258 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Spinney, Elizabeth PA Provider ID: 1275497 Gender: Female Lakeland Regional HealthOrtho 3030 Harden Blvd Lakeland, FL 33803 (863) 687-1250 Fax: (863) 687-1258 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Pediatric Cardiology Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 808 E Main St Lakeland, FL 33801 (813) 971-6909 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

McDonald, Bobbielee PA Pavlock, Amanda ARNP Provider ID: 1092993 Gender: Female Provider ID: 1356296 Lakeland Regional Orthopedic Gender: Female Associ Pediatrix Medical Gorup of 3030 Harden Blvd Florida Bartow, FL 33803 808 E Main St (863) 687-1250 Lakeland, FL 33801 Fax: (863) 687-1258 (813) 971-6909 18 Yrs/130 Yrs Fax: (855) 527-5510 M-F 8:00 AM - 5:00 PM 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Sawyer, Keri ARNP Pediatric Provider ID: 1236656 Gender: Male Gastroenterology Lakeland RegionalOrthopaedic Tenn, Alicia ARNP 3030 Harden Blvd Provider ID: 509163 Lakeland, FL 33803 Gender: Female (863) 687-1250 Pediatric Gastroenterology Fax: (863) 687-1258 3310 Lakeland Hills Blvd 00 Yrs/130 Yrs Lakeland, FL 33805 M-F 8:00 AM - 5:00 PM (813) 870-4948 Fax: (813) 554-8044 00 Yrs/21 Yrs M-F 7:30 AM - 5:00 PM Sat 9:00 AM - 1:00 PM

Pediatric Pulmonology Adkinson, Jason ARNP Provider ID: 1310293 Gender: Male USF Physicians Group 200 N Kentucky Ave Ste 114 Lakeland, FL 33801 (813) 259-8767 Fax: (813) 259-8770 00 Yrs/18 Yrs Tampa General Hospital M-F 9:00 AM - 5:00 PM Cravatta, Vanessa ARNP Provider ID: 955995 Gender: Female Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Leinbach, Mary ARNP Provider ID: 954504 Gender: Female Orlando Pediatric Pulmonary And Sle 2104 Lakeland Hills Blvd Lakeland, FL 33805 (407) 898-2767 Fax: (407) 898-9443 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Pediatrics Brown, Rachel ARNP Provider ID: 1144323 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM

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Brown, Rachel ARNP Provider ID: 1144323 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 00 Yrs/18 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM Bryant, June ARNP Provider ID: 995307 Gender: Female Total Pediatric Healthcare PA 930 Marcum Rd Ste 12 Lakeland, FL 33809 (813) 655-5106 Fax: (813) 655-4460 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Dollison, Indya ARNP Provider ID: 1260049 Gender: Female Central Florida Health Care Inc 201 Magnolia Ave SW Winter Haven, FL 33880 (863) 688-0841 Fax: (863) 616-9709 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Farmer, Stacey PA Provider ID: 1246356 Gender: Female Nemours Primary Care Kinder Care 435 2nd St NE Winter Haven, FL 33881 (863) 299-4567 Fax: (863) 299-9750 00 Yrs/18 Yrs Nemours Childrens Hospital M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Polk Pediatrics - cont. Gray, Lelia ARNP Provider ID: 1112764 Gender: Female Nemours Children Primary Care, Kind 435 2nd St NE Winter Haven, FL 33881 (863) 299-4567 Fax: (863) 297-9750 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Grimes, Amy PA Provider ID: 324702 Gender: Female Heartland Pediatrics of Lake Wales 1356 State Rd 60 E Lake Wales, FL 33853 (863) 679-8888 Fax: (863) 676-2851 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM Jones, Courtney ARNP Provider ID: 621704 Gender: Female Bond Clinic PA 45 Elbert Dr Winter Haven, FL 33880 (863) 293-1191 Fax: (863) 293-3635 00 Yrs/18 Yrs Winter Haven Hospital Languages: Spanish M-F 9:00 AM - 5:00 PM Mueller-Barker, Denise ARNP Provider ID: 1000931 Gender: Female Heartland Pediatrics of Lake Wales 1354 State Rd 60 E Lake Wales, FL 33853 (863) 679-8888 Fax: (863) 676-2851 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM

Mulinda, Simon ARNP Provider ID: 955945 Gender: Male Pediatrics and Family Medicine of B 519 Buena Vista St Lakeland, FL 33805 (863) 337-4994 Fax: (863) 337-4997 00 Yrs/130 Yrs Languages: French M-F 8:00 AM - 5:00 PM

Rupert, Brooke ARNP Provider ID: 1265966 Gender: Female Lakeside Pediactrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/21 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM

Rowland, Christine ARNP

Snow, Rodney ARNP Provider ID: 220851 Gender: Male Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 619-8441 Fax: (863) 687-8969 00 Yrs/18 Yrs Languages: Spanish M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM

Provider ID: 1233476 Gender: Female Pediatric Partners of Winter 550 Pope Ave NW 100 Winter Haven, FL 33881 (863) 293-2144 Fax: (863) 533-8723 00 Yrs/18 Yrs M-F 8:00 AM - 5:00 PM Rumph, Melissa ARNP Provider ID: 1236407 Gender: Female Pediatric Partners of Winter 550 Pope Ave NW 100 Winter Haven, FL 33881 (863) 293-2144 Fax: (863) 293-3732 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Rupert, Brooke ARNP Provider ID: 1265966 Gender: Female Lakeside Pediactrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/21 Yrs M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM

Thomas, Janelle ARNP Provider ID: 16415 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM Venezia, Angela ARNP Provider ID: 1247763 Gender: Female Pediatrics of Central Florida PA 820 Cypress Pkwy Ste A Kissimmee, FL 34759 (407) 933-5985 Fax: (407) 933-8696 00 Yrs/21 Yrs Osceola Regional Medical Center M-F 9:00 AM - 5:00 PM

Snow, Rodney ARNP Provider ID: 220853 Gender: Male Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 619-8441 Fax: (863) 687-8969 00 Yrs/18 Yrs Languages: Spanish M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM

Wagoner, Mary ARNP Provider ID: 913193 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM

Thomas, Janelle ARNP Provider ID: 1010234 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM

Wagoner, Mary ARNP Provider ID: 913193 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM

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Last update 08/14/2017

Allied Providers Polk Pediatrics - cont. Wallace, Cynthia ARNP Provider ID: 913195 Gender: Female Lakeside Pediatrics 2929 Lakeland Hills Blvd Lakeland, FL 33805 (863) 688-3550 Fax: (863) 684-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 4:30 PM Sat 8:00 AM - 12:00 PM Wallace, Cynthia ARNP Provider ID: 913195 Gender: Female Lakeside Pediatrics 5950 S Florida Ave Lakeland, FL 33813 (863) 688-3550 Fax: (863) 687-8969 00 Yrs/18 Yrs Lakeland Reg Medical Center M-TH 8:00 AM - 7:00 PM F 8:00 AM - 4:30 PM Sat 11:00 AM - 2:00 PM

Physical Therapy Ballard, Michelle PT Provider ID: 1212525 Gender: Female Our Childrens Academy 555 Burns Ave Lake Wales, FL 33853 (863) 678-3338 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Hanson, Tina PT Provider ID: 1004153 Gender: Female Our Childrens Rehab Center Inc 150 Ave B SE Winter Haven, FL 33880 (863) 294-1429 Fax: (863) 294-9826 00 Yrs/21 Yrs MW 8:00 AM - 6:00 PM TTHF 8:00 AM - 4:30 PM

Kane, Susan PT Westervelt, Lindley PT Provider ID: 1148714 Provider ID: 1140008 Gender: Female Gender: Female Leading Edge Physical Therapy Therapy World LLC and S 820 Cypress Pkwy 4406 S Florida Ave Ste 16 Kissimmee, FL 34759 Lakeland, FL 33813 (407) 913-1010 (863) 688-1800 Fax: (407) 992-8697 Fax: (863) 688-1824 00 Yrs/21 Yrs 12 Yrs/130 Yrs Languages: Spanish Languages: Spanish M-F 9:00 AM - 6:00 PM M-TH 7:00 AM - 6:00 PM Radiation Therapy F 7:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM Miller, Cheryl SLP Singleton, Ulysses PT Provider ID: 1015685 Provider ID: 1408921 Gender: Female Gender: Male Our Childrens Rehab Center Kevin S Burkevich LLC Inc 106 Center St 150 Ave B SE Dundee, FL 33838 Winter Haven, FL 33880 (610) 554-6245 (863) 294-1429 Fax: (863) 439-2257 Fax: (863) 294-9826 00 Yrs/130 Yrs 00 Yrs/21 Yrs M-F 9:00 AM - 7:00 PM MW 8:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM TTHF 8:00 AM - 4:30 PM Vogel, Kenneth PT Provider ID: 1258906 Gender: Male Therapy World LLC 820 Cypress Pkwy Ste B Kissimmee, FL 34759 (407) 913-1010 Fax: (407) 992-8697 00 Yrs/21 Yrs M-F 9:00 AM - 6:00 PM Vogel, Kenneth PT Provider ID: 1341550 Gender: Male Kids First Therapy Center Inc 1068 Cypress Pkwy Kissimmee, FL 34759 (407) 655-1068 Fax: (877) 942-7626 00 Yrs/21 Yrs M-F 9:00 AM - 7:00 PM

Speech & Language Pathology Adams SLP Provider ID: 1223743 Our Childrens Academy 555 Burns Ave Lake Wales, FL 33853 (863) 678-3338 00 Yrs/130 Yrs M 8:00 AM - 4:00 PM Lopez, Sharon SLP Provider ID: 1241666 Gender: Female Therapy World 820 Cypress Pkwy Ste B Kissimmee, FL 34759 (407) 913-1010 Fax: (407) 992-8697 00 Yrs/21 Yrs Languages: Spanish M-F 8:30 AM - 6:00 PM

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Marrero, Zayra SLP Provider ID: 1343062 Gender: Female Kids First Therapy Center Inc 1068 Cypress Pkwy Kissimmee, FL 34759 (407) 655-1068 Fax: (877) 942-7626 00 Yrs/21 Yrs M-F 9:00 AM - 7:00 PM

Speech Therapy Ayala, Indira SLP Provider ID: 1041532 Gender: Female Small Steps Pediatric Therapy 2201 North Blvd W Davenport, FL 33837 (407) 847-7344 Fax: (407) 483-0206 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:30 PM Brewer, Staci Beth SLP Provider ID: 1041905 Gender: Female Therapy World 820 Cypress Pkwy Ste B Kissimmee, FL 34759 (407) 913-1010 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Collins, Sharon SLP Provider ID: 1298709 Gender: Female Achievement Academy Inc 2211 28th St NW Bartow, FL 33830 (863) 683-6504 Fax: (863) 688-9292 00 Yrs/18 Yrs M-F 8:30 AM - 3:30 PM Collins, Sharon SLP Provider ID: 1298709 Gender: Female Achievement Academy Inc 695 E Summerlin St Bartow, FL 33830 (863) 683-6504 Fax: (863) 688-9292 00 Yrs/18 Yrs M-F 8:30 AM - 3:30 PM

Last update 08/14/2017

Allied Providers Polk Speech Therapy - cont. Collins, Sharon SLP Provider ID: 1298709 Gender: Female Achievement Academy Inc 716 E Bella Vista St Lakeland, FL 33805 (863) 683-6504 Fax: (863) 614-1381 00 Yrs/18 Yrs M-F 8:30 AM - 3:30 PM Comkowyez, Sharon SLP Provider ID: 1052831 Gender: Female Our Childrens Rehab Center Inc 150 Ave B SE Winter Haven, FL 33880 (863) 294-1429 Fax: (863) 294-9826 00 Yrs/21 Yrs Languages: Spanish MW 8:00 AM - 6:00 PM TTHF 8:00 AM - 4:30 PM Copple, Debra SLP Provider ID: 1005542 Gender: Female Kanga Dyslexia and Therapy Services 123 E Central Ave Ste 3 Lake Wales, FL 33853 (863) 409-2994 Fax: (863) 676-3630 00 Yrs/21 Yrs MTTH 8:00 AM - 5:00 PM W 8:00 AM - 5:30 PM F 8:00 AM - 4:00 PM Gier, Terry SLP Provider ID: 1050628 Gender: Female Our Childrens Rehab Center Inc 150 Ave B SE Winter Haven, FL 33880 (863) 294-1429 Fax: (863) 298-0299 00 Yrs/21 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM

Gonzalez Soldevilla, Hilda SLP Provider ID: 571957 Gender: Female Therapy World 820 Cypress Pkwy Ste B Kissimmee, FL 34759 (407) 913-1010 00 Yrs/21 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Kirkland, Mary SLP Provider ID: 1044093 Gender: Female Our Childrens Rehab Center Inc 150 Ave B SE Winter Haven, FL 33880 (863) 294-1429 Fax: (863) 294-9826 00 Yrs/21 Yrs MW 8:00 AM - 6:00 PM TTHF 8:00 AM - 4:30 PM

Surgical Oncology Liptak, Amy ARNP Provider ID: 920956 Gender: Female Lakeland Regional Cancer Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 904-1961 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Urology

Almerico, Jessica ARNP Provider ID: 696045 Gender: Female Baycare Medical Group 199 Ave B NW Ste 310 Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 16 Yrs/130 Yrs Miller MS Ccc/SLP, Cheryl SLP M-F 9:00 AM - 5:00 PM Provider ID: 199226 Gender: Female 8 Templederry Ave Haines City, FL 33844 (863) 514-0778 Fax: (863) 875-7842 00 Yrs/21 Yrs M-F 7:00 AM - 3:00 PM Rhines Ogara, Shelly SLP Provider ID: 1218000 Gender: Female Our Childrens Rehab Center 150 Ave B SE Winter Haven, FL 33880 (863) 268-2903 Fax: (863) 268-2906 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM

Almerico, Jessica ARNP Provider ID: 696045 Gender: Female Baycare Medical Group 200 Ave F NE Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Ancaya, Francisco PA Provider ID: 568977 Gender: Male Baycare Medical Group 199 Ave B NW Ste 310 Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM

Spencer, Shelly SLP Provider ID: 1209162 Gender: Female Our Childrens Academy 555 Burns Ave Lake Wales, FL 33853 (863) 678-3338 00 Yrs/130 Yrs M-F 8:00 AM - 3:30 PM

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Ancaya, Francisco PA Provider ID: 568977 Gender: Male Baycare Medical Group 200 Ave F NE Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 16 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Hughes, Jennifer PA Provider ID: 687784 Gender: Female 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 603-6576 00 Yrs/130 Yrs M-F 9:00 AM - 5:00 PM Perry, Robert PA Provider ID: 915350 Gender: Male Baycare Medical Group 199 Ave B NW Ste 310 Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 18 Yrs/130 Yrs Winter Haven Hospital M-F 8:30 AM - 4:30 PM Ranon, Shena ARNP Provider ID: 782733 Gender: Female Baycare Medical Group 199 Ave B NW Ste 310 Winter Haven, FL 33881 (863) 292-4652 Fax: (863) 292-4653 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Reifenstein, Chris PA Provider ID: 1085355 Gender: Male Lakeland Regional Cancer Center 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 904-1961 18 Yrs/130 Yrs Lakeland Reg Medical Center M-F 8:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Polk Urology - cont. Vargas, Catherine ARNP Provider ID: 1361049 Gender: Female Lakeland Regional Health Systems 3525 Lakeland Hills Blvd Lakeland, FL 33805 (863) 603-6565 Fax: (863) 904-1961 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Vargas, Catherine ARNP Provider ID: 1361049 Gender: Female Lakeland Regional Medical Center 1324 Lakeland Hills Blvd Lakeland, FL 33805 (863) 687-1321 Fax: (863) 284-1730 18 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

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Last update 08/14/2017

Allied Providers Sarasota Audiology Collison, Lori AUD Provider ID: TPV05743-01 Gender: Female HearUSA 2650 S. Tamiami Trail Sarasota, FL 34239 (941) 953-4855 Fax: (941) 951-2445 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Palmeri, Janine AUD Provider ID: TPV03048-01 Gender: Female HearUSA 2650 S. Tamiami Trail Sarasota, FL 34239 (941) 953-4855 Fax: (941) 951-2445 21 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Certified Nurse Midwife Cantwell, Carol CNM Provider ID: 1355830 Gender: Female Florida Woman Care LLC 1950 Arlington St Ste 203 Sarasota, FL 34239 (941) 379-6331 Fax: (941) 379-5343 00 Yrs/130 Yrs MWF 8:30 AM - 5:00 PM TTH 8:30 AM - 8:00 PM

Family Practice Collingwood, Susan ARNP Provider ID: 1344429 Gender: Female Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2869 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM Collins, Emily ARNP Provider ID: 1061636 Gender: Female North County Healthcare Center 1949 Northgate Blvd Sarasota, FL 34234 (941) 373-7844 Fax: (941) 373-7856 00 Yrs/130 Yrs MTWTHFSat 8:00 AM - 8:00 PM Sun 9:00 AM - 5:00 PM Egan, Patricia ARNP Provider ID: 986831 Gender: Female 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2869 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Ferris, Karen ARNP Provider ID: 1349817 Gender: Female Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2869 00 Yrs/130 Yrs M-F 7:30 AM - 6:00 PM King, Nadine ARNP Provider ID: 1323391 Gender: Female Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-2900 Fax: (941) 861-2869 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Parker, Vicki ARNP Provider ID: 217192 Gender: Female Sarasita Cnty Health Ringling 6950 Outreach Way North Port, FL 34287 (941) 548-0100 Fax: (941) 548-0121 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Parker, Vicki ARNP Provider ID: 217192 Gender: Female Cantwell, Carol CNM Sarasota Cnty Health Dept Fendt, Meeru PA Provider ID: 1355830 2200 Ringling Blvd Provider ID: 1185602 Gender: Female Sarasota, FL 34237 Gender: Female Florida Womancare LLC (941) 861-2900 2345 Bobcat Village Center Rd South County Medical Center Fax: (941) 861-2868 579 S Indiana Ave Ste 201 00 Yrs/130 Yrs Englewood, FL 34223 North Port, FL 34288 Languages: Spanish (941) 460-1341 (941) 379-6331 M-F 8:00 AM - 5:00 PM Fax: (941) 776-4013 Fax: (941) 973-5342 00 Yrs/130 Yrs 00 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM M-W 8:30 AM - 4:30 PM

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Parker, Vicki ARNP Provider ID: 217192 Gender: Female Sarasota Cnty Health Dept 7820 Tamiami Trl S Ste B-2 Venice, FL 34293 (941) 862-3300 Fax: (941) 861-2868 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

General Practice Fawks, David ARNP Provider ID: 1349581 Gender: Male Senior Friendship Centers, Inc. 2350 Scenic Dr Venice, FL 34293 (941) 584-0042 Fax: (941) 496-8627 40 Yrs/130 Yrs M-TH 8:00 AM - 4:00 PM F 9:00 AM - 12:00 PM Gibson, Mary ARNP Provider ID: 1353026 Gender: Female Senior Friendship Centers 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 40 Yrs/130 Yrs M-TH 8:00 AM - 4:00 PM F 8:00 AM - 12:00 PM

Gynecology O'Flynn, Sonja ARNP Provider ID: 1182497 Gender: Female Senior Friendship Centers, Inc. 1900 Brother Geenen Way Sarasota, FL 34236 (941) 556-3220 Fax: (941) 955-8214 50 Yrs/110 Yrs M-TH 8:00 AM - 4:00 PM

Last update 08/14/2017

Allied Providers Sarasota Infectious Disease

Internal Medicine

Blix, Andrew ARNP Arnold, Chelsea ARNP Provider ID: 1344413 Provider ID: 1168745 Gender: Male Gender: Female Infectious Diseases Associates Sarasota Co Health Dept 1425 S Osprey Ave Ste 1 2200 Ringling Blvd Sarasota, FL 34239 Sarasota, FL 34237 (941) 366-9060 (941) 861-2900 Fax: (941) 552-1588 Fax: (941) 861-2719 12 Yrs/130 Yrs 00 Yrs/130 Yrs Sarasota Memorial Hospital M-F 7:30 AM - 6:00 PM M-F 8:00 AM - 5:00 PM Boyette-Peterson, Bonnie ARNP Doepker, Leslie ARNP Provider ID: 15299 Provider ID: 1344411 Gender: Female Gender: Female Infectious Diseases Associates Sarasota County Health Department1 1425 S Osprey Ave Ste 1 1750 17th St Sarasota, FL 34239 Sarasota, FL 34234 (941) 366-9060 (941) 861-1400 Fax: (941) 552-1588 Fax: (941) 373-7676 16 Yrs/130 Yrs 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 4:30 PM Boyette-Peterson, Bonnie Langone, Marie ARNP ARNP Provider ID: 1115051 Provider ID: 15299 Gender: Female Infectious Diseases Associates Gender: Female Sarasota County Health 1425 S Osprey Ave STE1 Department1 Sarasota, FL 34239 2200 Ringling Blvd (941) 366-9060 Sarasota, FL 34237 Fax: (941) 552-1588 (941) 861-2900 16 Yrs/130 Yrs Fax: (941) 861-2719 M-F 8:30 AM - 5:00 PM 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Ouhri, Jasmina PA Provider ID: 1198231 Boyette-Peterson, Bonnie Gender: Female ARNP Infectious Diseases Associates Provider ID: 15299 1425 S Osprey Ave Ste 1 Gender: Female Sarasota, FL 34239 Sarasota County Health (941) 366-9060 Department1 Fax: (941) 552-1588 6950 Outreach Way 12 Yrs/130 Yrs North Port, FL 34287 M-F 8:00 AM - 5:00 PM (941) 548-0100 Fax: (941) 548-0120 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Boyette-Peterson, Bonnie ARNP Provider ID: 15299 Gender: Female Sarasota County Health Department1 7820 Tamiami Trl S Venice, FL 34293 (941) 861-3300 Fax: (941) 861-3384 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Burke, Christina PA Provider ID: 1072561 Gender: Female Comprehensive Care Center 1231 N Tuttle Ave Sarasota, FL 34237 (941) 366-0461 Fax: (941) 951-1795 18 Yrs/130 Yrs M-W 8:00 AM - 5:00 PM TH 8:00 AM - 7:00 PM F 8:30 AM - 12:00 PM Burke, Christina PA Provider ID: 1072561 Gender: Female Comprehensive Care Center 14243 Tamiami Trl North Port, FL 34287 (941) 366-0134 Fax: (941) 951-1795 18 Yrs/130 Yrs MWTHF 9:00 AM - 5:00 PM T 9:00 AM - 4:30 PM Dankanich, Ivan ARNP Provider ID: 1344567 Gender: Male Sarasota County Health Department 6950 Outreach Way North Port, FL 34287 (941) 861-3820 Fax: (941) 861-2719 00 Yrs/21 Yrs M-F 7:00 AM - 6:30 PM

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Henry, Myrtle ARNP Provider ID: 1258896 Gender: Female Florida Department of Health In Sar 6950 Outreach Way North Port, FL 34287 (941) 861-2900 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Jones, Jennifer ARNP Provider ID: 1222185 Gender: Female Florida Department of Health In Sar 6950 Outreach Way North Port, FL 34285 (941) 861-2900 00 Yrs/130 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Michael, Melanie ARNP Provider ID: 556884 Gender: Female Sarasota County Health Department 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 Fax: (941) 861-2719 18 Yrs/130 Yrs M-TH 8:00 AM - 5:00 PM

Licensed Mental Health Counselor Gussin, Lisa LMHC Provider ID: 1349740 Gender: Female Healing Transitions Creative Counse 3333 Clark Rd Ste 170 Sarasota, FL 34231 (941) 888-2081 Fax: (888) 700-6760 02 Yrs/130 Yrs M-F 8:30 AM - 7:00 PM

Last update 08/14/2017

Allied Providers Sarasota Licensed Mental Health Counselor - cont. Miller, Linda LMHC Provider ID: 1349392 Gender: Female Linda K Miller, LMHC 3205 Southgate Cir Sarasota, FL 34239 (941) 730-5666 Fax: (941) 351-6437 18 Yrs/130 Yrs M 10:00 AM - 6:00 PM TW 9:00 AM - 7:30 PM TH 11:00 AM - 7:00 PM F 9:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM

Hillesheim, Angela ARNP Provider ID: 1333876 Gender: Female Nephrology Associates of Sarasota 6960 Professional Pkwy E Ste 4 and Ste 5 Sarasota, FL 34240 (941) 917-6585 Fax: (941) 917-6514 18 Yrs/130 Yrs M 1:30 AM - 4:30 PM T 0:00 AM - 0:0 PM

Nurse Midwife Hollifield, Cheryl ARNP

Sterling, Jocelyn LMHC Provider ID: 1352213 Gender: Female Healing Transitions Creative Counse 3333 Clark Rd Ste 170 Sarasota, FL 34231 (941) 888-2081 Fax: (888) 700-6760 02 Yrs/130 Yrs M-F 8:30 AM - 7:00 PM Walker, Larry LMHC Provider ID: 1340832 Gender: Male Healing Transitions Inc 3333 Clark Rd Ste 170 Sarasota, FL 34231 (941) 888-2081 Fax: (888) 700-6760 12 Yrs/130 Yrs M-F 8:00 AM - 8:00 PM Sat 10:00 AM - 2:00 PM

Nephrology Hillesheim, Angela ARNP Provider ID: 1333876 Gender: Female Nephrology Associates of Sarasota 1921 Waldemere St Ste 413 Sarasota, FL 34239 (941) 917-6585 Fax: (941) 917-6514 18 Yrs/130 Yrs M-F 9:00 AM - 4:30 PM

Provider ID: 1145918 Gender: Female Birthways Midwifery Care, Inc 4222 McIntosh Ln Sarasota, FL 34232 (941) 366-2229 Fax: (941) 706-1534 18 Yrs/130 Yrs M 9:00 AM - 6:00 PM TWTH 9:00 AM - 5:00 PM F 10:00 AM - 3:00 PM

Nurse Practitioner Family Frazier, Cathy ARNP Medicine Provider ID: 1224525 Gonzalez, Maribel ARNP Provider ID: 1414957 Gender: Female Community Aids Network 1231 N Tuttle Ave Sarasota, FL 34237 (941) 366-0134 Fax: (941) 951-1795 18 Yrs/130 Yrs M-F 9:00 AM - 3:00 PM

Obstetrics/Gynecology Bainbridge, Megan CNM Provider ID: 1197989 Gender: Female Planned Parenthood 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 05 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM

Hummon, Ivy CNM Provider ID: 994511 Dyer, Diana ARNP Gender: Female Provider ID: 797257 Fruit of The Womb Midwifery Gender: Female Care Planned Parenthood of SW 440 E Dearborn St and Centra Englewood, FL 34223 736 Central Ave (413) 519-2568 Sarasota, FL 34236 Fax: (941) 240-1779 (941) 953-4060 12 Yrs/130 Yrs Fax: (941) 366-1899 M-F 9:00 AM - 5:00 PM 12 Yrs/130 Yrs M 9:00 AM - 5:00 PM Nurse Practitioner TW 11:00 AM - 7:00 PM TH 9:00 AM - 4:00 PM Sanchez, Lajuan ARNP F 9:00 AM - 3:00 PM Provider ID: 1364296 Gender: Female Florida Department of Health In Sar 2200 Ringling Blvd Sarasota, FL 34237 (941) 861-2900 00 Yrs/130 Yrs M-F 7:00 AM - 6:30 PM

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Gender: Female Planned Parenthood-Sarasota 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 2:00 PM Hall, Kathryn ARNP Provider ID: 1192079 Gender: Female Planned Parenthood of Southwest and 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:30 PM T 12:00 AM - 6:30 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM Lopez-Rosa, Magda ARNP Provider ID: 796157 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs Languages: Spanish MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM Lytle, Sharon CNM Provider ID: 1246331 Gender: Female Florida Woman CareUniversity Park 389 Commercial Ct Unit D1 Venice, FL 34292 (941) 359-8300 Fax: (941) 359-8319 12 Yrs/130 Yrs Sarasota Memorial Hospital M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Sarasota Obstetrics/Gynecology - Reames, Amanda ARNP cont. Mashandure, Mercy ARNP Provider ID: 800492 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs Languages: Spanish, Swahili MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM McGinty, Susanne ARNP Provider ID: 705322 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM McKinnie, Cynthia ARNP Provider ID: 811213 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM

Provider ID: 1075286 Gender: Female Planned Parenthood of Southwest and 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM Redlin, Jacqueline ARNP Provider ID: 357586 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (407) 246-1788 Fax: (407) 246-8466 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM Shreve, Tanya PA Provider ID: 802457 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM

Staal, Jacqueline ARNP Provider ID: 801634 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs M 9:00 AM - 5:00 PM TW 11:00 AM - 7:00 PM TH 9:00 AM - 4:00 PM F 9:00 AM - 3:00 PM Thomas, Brandy CNM Provider ID: 916198 Gender: Female Florida Woman Care LLC 5741 Bee Ridge Rd Ste 350 Sarasota, FL 34233 (941) 745-5115 Fax: (941) 567-1000 12 Yrs/112 Yrs M 8:00 AM - 12:00 PM T 1:00 AM - 5:00 PM Ward, Leslie ARNP Provider ID: 701949 Gender: Female Planned Parenthood of SW and Centra 736 Central Ave Sarasota, FL 34236 (941) 953-4060 Fax: (941) 366-1899 00 Yrs/130 Yrs MW 11:00 AM - 6:00 PM T 9:00 AM - 4:00 PM TH 9:00 AM - 3:00 PM F 9:00 AM - 2:00 PM

Occupational Therapy Albright, Cheryl OT Provider ID: 1183754 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM

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Albright, Cheryl OT Provider ID: 1183754 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Bohan, Kristen OT Provider ID: 1042316 Gender: Female Kristen A E Bohan Inc 7333 International Pl Sarasota, FL 34240 (941) 545-3744 Fax: (888) 411-9677 00 Yrs/21 Yrs M-F 8:00 AM - 5:00 PM Frease, Linda OT Provider ID: 1044763 Gender: Female Instride Therapy Inc 1629 Ranch Rd Nokomis, FL 34275 (941) 412-9333 Fax: (941) 483-3653 00 Yrs/130 Yrs M 8:00 AM - 12:00 PM Kiellach, Jennifer OT Provider ID: 1040890 Gender: Female Sensory Solutions Sarasota LLC 22 Sarasota Center Blvd Sarasota, FL 34240 (941) 377-9361 Fax: (800) 370-8553 00 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Marsh, Nancy OT Provider ID: 1048033 Gender: Female Childrens Therapy Works 63 Sara Center Blvd Ste 101 Sarasota, FL 34240 (941) 379-3725 Fax: (941) 377-1131 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Sarasota Occupational Therapy cont. Milton, Melissa OT Provider ID: 1207071 Gender: Female Sensory Solutions, LLC of Sarasota 22 Sarasota Center Blvd Sarasota, FL 34240 (941) 377-9361 00 Yrs/21 Yrs M-F 9:00 AM - 6:00 PM Robertson, Sharon SLP Provider ID: 448885 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM Robertson, Sharon SLP Provider ID: 448885 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 426-0324 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM

Orthopaedic Surgery Cofer, Kristen PA Provider ID: 754538 Gender: Female Sarasota Orthopedic Associates 2750 Bahia Vista St Ste 100 Sarasota, FL 34239 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Premier Surgery Center of Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM

Cofer, Kristen PA Provider ID: 754538 Gender: Female Sarasota Orthopedic Associates 438 Commercial Ct Ste 100 Venice, FL 34292 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Premier Surgery Center of Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM Cofer, Kristen PA Provider ID: 754538 Gender: Female Sarasota Orthopedic Associates 6230 University Pkwy Ste 203 Sarasota, FL 34240 (941) 951-2663 Fax: (941) 552-3312 00 Yrs/18 Yrs Premier Surgery Center of Sarasota Sarasota Memorial Hospital M-F 8:00 AM - 5:00 PM

Pediatric Cardiology Mirsky, Stephanie ARNP Provider ID: 1353015 Gender: Female Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (877) 537-4787 Fax: (855) 527-5510 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM Oshrine, Kathleen ARNP Provider ID: 1312672 Gender: Female Pediatrix Medical Group of Florida 5741 Bee Ridge Rd Ste 540 Sarasota, FL 34233 (727) 322-4831 Fax: (855) 527-5510 00 Yrs/21 Yrs M-F 8:30 AM - 5:00 PM

Pediatric Gastroenterology Deltoro, Kristin ARNP Provider ID: 924776 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/18 Yrs M-F 7:30 AM - 5:00 PM Gursky, Beverly ARNP Provider ID: 722439 Gender: Female Pediatric Gastroenterology Hepatolo 5881 Rand Blvd Sarasota, FL 34238 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM Sherman, Shanna ARNP Provider ID: 925774 Gender: Female 5881 Rand Blvd Sarasota, FL 34238 (727) 822-4300 Fax: (727) 456-1399 00 Yrs/18 Yrs M-F 7:30 AM - 5:00 PM

Pediatric Orthopaedics Carney, Jacquelyn PA Provider ID: 1074572 Gender: Female Cossa 5881 Rand Blvd Sarasota, FL 34238 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs Johns Hopkins All Childrens Hospital Inc Languages: Spanish M-F 9:00 AM - 5:00 PM

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Graham, Adria PA Provider ID: 1340748 Gender: Female Children's Orthopaedic Scoliosis S 5881 Rand Blvd Sarasota, FL 34238 (727) 898-2663 Fax: (727) 568-6836 00 Yrs/18 Yrs M-F 9:00 AM - 5:00 PM

Pediatrics Bernard, Lisa ARNP Provider ID: 1174055 Gender: Female Sarasota Children's Clinic 3920 Bee Ridge Rd Ste C Sarasota, FL 34233 (941) 923-3667 Fax: (941) 924-3246 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM Bryant, Valerie ARNP Provider ID: 1028125 Gender: Female Nevenka Horvat MD Inc 3333 Clark Rd Ste 160 Sarasota, FL 34231 (941) 923-1809 Fax: (941) 927-6945 00 Yrs/18 Yrs M 9:00 AM - 6:00 PM TW 9:00 AM - 4:30 PM TH 10:00 AM - 6:00 PM F 9:00 AM - 4:00 PM Shiffner, Beth PA Provider ID: 554090 Gender: Female Gulf Coast Pediatrics 405 Commercial Ct Ste D Venice, FL 34292 (941) 412-1515 Fax: (941) 412-1525 00 Yrs/18 Yrs Sarasota Memorial Hospital MT 8:30 AM - 7:00 PM W 8:30 AM - 12:00 PM THF 8:30 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Sarasota Pediatrics - cont. Shiffner, Beth PA Provider ID: 554090 Gender: Female Gulf Coast Pediatrics 5664 Bee Ridge Rd Ste 202 Sarasota, FL 34233 (941) 377-6406 Fax: (941) 377-6407 00 Yrs/18 Yrs Sarasota Memorial Hospital MTHF 8:30 AM - 5:00 PM T 8:30 AM - 7:00 PM W 8:30 AM - 12:00 PM Wolfson, James PA Provider ID: 224377 Gender: Male Pediatrics of Sarasota 1951 Northgate Blvd Sarasota, FL 34234 (941) 355-0687 Fax: (941) 358-0417 00 Yrs/18 Yrs Languages: Spanish, French, Urdu M-F 9:00 AM - 5:00 PM

Physical Therapy Cascio, Cynthia PT Provider ID: 1053468 Gender: Female Childrens Therapy Works 63 Sara Center Blvd Ste 101 Sarasota, FL 34240 (941) 379-3725 Fax: (941) 377-1131 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Cecil, Adam PT Provider ID: 1242803 Gender: Male Back In Motion, Sarasota Physical T 3920 Bee Ridge Rd E/G Sarasota, FL 34233 (941) 925-2700 Fax: (941) 925-7744 05 Yrs/130 Yrs M-F 7:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM

Fugleberg, Keefe PT Provider ID: 1333862 Gender: Male Fyzical 1599 Main St Sarasota, FL 34236 (941) 951-0170 Fax: (941) 993-1088 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Lissone, Said PT Provider ID: 1331668 Gender: Male Fyzical 1599 Main St Sarasota, FL 34236 (941) 951-0170 Fax: (941) 993-1088 12 Yrs/130 Yrs M-F 8:00 AM - 6:00 PM Nastan, Mary PT Provider ID: 1044748 Gender: Female Instride Therapy Inc 1629 Ranch Rd Nokomis, FL 34275 (941) 412-9333 Fax: (941) 483-3653 00 Yrs/130 Yrs M 8:00 AM - 12:00 PM Nastan, Mary PT Provider ID: 486498 Gender: Female Childrens Therapy Works 63 Sara Center Blvd Ste 101 Sarasota, FL 34240 (941) 379-3725 Fax: (941) 377-1131 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Randall, Kelly PT Provider ID: 1041947 Gender: Female Physical Therapy Pl 3920 Bee Ridge Rd Bldg E Ste G Sarasota, FL 34277 (941) 925-2700 Fax: (941) 925-7744 12 Yrs/130 Yrs MTWTHFSat 8:00 AM - 6:00 PM

Watson, Maxine PT Provider ID: 1129157 Gender: Female Back In Motion, Sarasota Physical T 3920 Bee Ridge Rd Unit G Sarasota, FL 34233 (941) 925-2700 Fax: (941) 925-7744 00 Yrs/130 Yrs Languages: Spanish, German M-F 7:00 AM - 6:00 PM Sat 7:00 AM - 12:00 PM Watson, Maxine PT Provider ID: 1160687 Gender: Female Back In Motion, Sarasota Physical T 3920 Bee Ridge Rd Bldg E Unit G Sarasota, FL 34233 (941) 925-2700 Fax: (941) 925-7744 05 Yrs/130 Yrs M-F 7:00 AM - 6:00 PM Sat 7:00 AM - 12:00 PM

Pulmonary Disease Haight, Tish ARNP Provider ID: 1156686 Gender: Female Lung Associates of Sarasota LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Kienzle, Jeffrey PA Provider ID: 1162576 Gender: Male Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 12 Yrs/130 Yrs Sarasota Memorial Hospital MWTHF 8:00 AM - 5:00 PM T 8:00 AM - 4:30 PM

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Sylvain, Emily ARNP Provider ID: 1330084 Gender: Female Lung Associates of Sarasota, LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM Voutour, Deborah ARNP Provider ID: 1159535 Gender: Female Lung Associates of Sarasota LLC 1921 Waldemere St Ste 705 Sarasota, FL 34239 (941) 366-5864 Fax: (941) 365-4276 12 Yrs/130 Yrs M-F 8:00 AM - 5:00 PM

Speech & Language Pathology Clifton, Andrea SLP Provider ID: 1359356 Gender: Female Therachoice Inc 1345 Main St Ste F4 Sarasota, FL 34236 (941) 295-7733 Fax: (941) 847-1034 00 Yrs/21 Yrs M-F 8:00 AM - 6:00 PM Craven, Emily SLP Provider ID: 1359363 Gender: Female Therachoice Inc 1345 Main St Ste F4 Sarasota, FL 34236 (941) 295-7733 Fax: (941) 847-1034 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Allied Providers Sarasota Speech & Language Pathology - cont. Dilallo, Mary SLP Provider ID: 1055007 Gender: Female Instride Therapy Inc 1629 Ranch Rd Nokomis, FL 34275 (941) 412-9333 Fax: (941) 783-3653 02 Yrs/130 Yrs M 2:30 AM - 5:30 PM Hart, Katherine SLP Provider ID: 1044768 Gender: Female Instride Therapy Inc 1629 Ranch Rd Nokomis, FL 34275 (941) 412-9333 Fax: (941) 483-3653 00 Yrs/130 Yrs M-W 8:00 AM - 5:00 PM TH 8:00 AM - 8:00 PM F 8:00 AM - 3:00 PM Hart, Katherine SLP Provider ID: 1048038 Gender: Female Childrens Therapy Works 63 Sara Center Blvd Ste 101 Sarasota, FL 34240 (941) 379-3725 Fax: (941) 377-1131 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Semel Parkhurst, Barbara SLP

Smith, Mary SLP Provider ID: 1099943 Gender: Female Children's Therapy Works 63 Sara Center Blvd Ste 101 Sarasota, FL 34240 (941) 379-3725 Fax: (941) 377-1131 00 Yrs/18 Yrs M 8:30 AM - 6:00 PM TTHF 8:00 AM - 6:00 PM W 8:00 AM - 7:00 PM

Johnson, Lee Diahn SLP

Zarling Felts, Jaclyn SLP

Richardson, Maree SLP

Provider ID: 1431453 Gender: Female Sensory Solutions 22 Sarasota Center Blvd Sarasota, FL 34240 (941) 377-9361 Fax: (800) 370-8553 00 Yrs/21 Yrs M-F 9:00 AM - 5:00 PM

Speech Therapy Carter, Anna SLP Provider ID: 1040834 Gender: Female Kids Clear Speech 684 Sugarwood Trl Venice, FL 34292 (941) 445-0812 Fax: (888) 971-3952 00 Yrs/18 Yrs M 9:00 AM - 5:00 PM T 9:00 AM - 6:30 PM Johnson, Lee Diahn SLP

Provider ID: 1057498 Gender: Female Childrens Therapy Works 63 Sara Center Blvd Ste 101 Sarasota, FL 34240 (941) 379-3725 Fax: (941) 377-1131 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM

Provider ID: 1041518 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM

Provider ID: 1041518 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 426-0324 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM

Provider ID: 1174265 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 378-0611 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Richardson, Maree SLP Provider ID: 1174265 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 426-0324 00 Yrs/18 Yrs M-F 8:30 AM - 5:00 PM Stublen, Greta SLP Provider ID: 681236 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM

www.wellcare.com/Florida | 742

Stublen, Greta SLP Provider ID: 681236 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 426-0324 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM Vodopija, Linda SLP Provider ID: 528514 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM Vodopija, Linda SLP Provider ID: 528514 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 426-0324 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM Williams, Kim SLP Provider ID: 528345 Gender: Female The Florida Center For Early Childh 4620 17th St Sarasota, FL 34235 (941) 371-8820 Fax: (941) 377-3194 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM

Last update 08/14/2017

Allied Providers Sarasota Speech Therapy - cont. Williams, Kim SLP Provider ID: 528345 Gender: Female The Florida Center For Early Childh 6929 Outreach Way North Port, FL 34287 (941) 371-8820 Fax: (941) 426-0324 00 Yrs/18 Yrs M-F 8:00 AM - 5:30 PM

Urology Belilovskiy, Elina ARNP Provider ID: 1224573 Gender: Female 21st Century Oncology LLC DBA Rtr U 14575 Tamiami Trl North Port, FL 34287 (941) 485-3351 Fax: (941) 485-7677 16 Yrs/130 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM Belilovskiy, Elina ARNP Provider ID: 1224573 Gender: Female 21st Century Oncology, LLC Dbd Rtr 842 Sunset Lake Blvd Ste 403 Bldg B Venice, FL 34292 (941) 485-3351 Fax: (941) 485-7677 16 Yrs/130 Yrs Languages: Russian M-F 8:00 AM - 5:00 PM

www.wellcare.com/Florida | 743

Last update 08/14/2017

Pharmacy Hardee Retail CVS Provider ID: TPV1962672105-0 301 S 6th Ave Wauchula, FL 33873 (863) 767-1195 Fax: (863) 767-1960 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Heartland Pharmacy Provider ID: TPV1689717548-0 116 Heartland Way Wauchula, FL 33873 (863) 767-8920 Fax: (863) 773-3172 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Walmart Pharmacy Provider ID: TPV1689691990-0 1480 US Hwy 17 N Wauchula, FL 33873 (863) 773-5900 Fax: (863) 773-6167 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Wauchula Pharmacy Provider ID: TPV1215230875-0 518 S 6th Ave Wauchula, FL 33873 (863) 774-3536 Fax: (863) 774-3538 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 3:00 PM

www.wellcare.com/Florida | 744

Last update 08/14/2017

Pharmacy Highlands Retail Avon Pharmacy Provider ID: TPV1326389867-0 1577 US Hwy 27 N Avon Park, FL 33825 (863) 453-3884 Fax: (863) 453-3885 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Central Florida Health Care Pharmacy Provider ID: TPV1720020746-0 950 CR 17-A W. Avon Park, FL 33825 (863) 452-3040 Fax: (863) 452-3047 00 Yrs/99 Yrs Languages: Spanish M-TH 9:00 AM - 5:00 PM F 8:00 AM - 5:00 PM CVS Provider ID: TPV1275637167-0 2728 US Hwy 27 S Sebring, FL 33870 (863) 385-2525 Fax: (863) 385-4355 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1679677561-0 5 US 27 S Lake Placid, FL 33852 (863) 465-4810 Fax: (863) 465-4844 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1851495741-0 1105 W Main St Avon Park, FL 33825 (863) 453-7505 Fax: (863) 453-3482 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Gilbert Drugs Provider ID: TPV1265523963-0 2190 Lakeview Dr Sebring, FL 33870 (863) 385-0741 Fax: (863) 386-0012 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 2:00 PM Heartland Pharmacy Provider ID: TPV1891838496-0 6360 US Hwy 27 N Sebring, FL 33870 (863) 385-5588 Fax: (863) 385-1378 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

K M Drugs Provider ID: TPV1912144353-0 133 Tower St Lake Placid, FL 33852 (863) 260-0100 Fax: (863) 260-0164 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Sebring Pharmacy Provider ID: TPV1639408685-0 3023 US Hwy 27 N Sebring, FL 33870 (863) 471-0007 Fax: (863) 658-2417 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Heartland Pharmacy Lake Placid Provider ID: TPV1811233430-0 342 E Royal Palm St Lake Placid, FL 33852 (863) 659-1780 Fax: (863) 659-1786 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM

Shamrock Pharmacy Provider ID: TPV1083004378-0 5 N Main Ave Lake Placid, FL 33852 (863) 659-4744 Fax: (888) 741-7969 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

Highlands Pharmacy Provider ID: TPV1255706024-0 7217 US Hwy 27 N Sebring, FL 33870 (863) 304-8146 Fax: (863) 304-8171 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Walmart Pharmacy Provider ID: TPV1508883711-0 3525 US Hwy 27 N Sebring, FL 33870 (863) 385-3373 Fax: (863) 385-2405 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Jares Pharmacy Provider ID: TPV1982918397-0 1542 Lakeview Dr Ste 1 Sebring, FL 33870 (863) 304-8792 Fax: (863) 304-8846 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM

Walmart Pharmacy Provider ID: TPV1851573588-0 1041 US Hwy 27 N Avon Park, FL 33825 (863) 453-4177 Fax: (863) 452-5259 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 745

Winn-Dixie Pharmacy Provider ID: TPV1578985255-0 3250 US 27 South Sebring, FL 33870 (863) 471-1268 Fax: (863) 471-0833 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM

Last update 08/14/2017

Pharmacy Hillsborough Retail 5 Star Pharmacy Provider ID: TPV1295049591-0 13757 N Nebraska Ave Tampa, FL 33613 (813) 971-5557 Fax: (813) 971-5558 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM

American Care of Tampa IncNtampa Provider ID: TPV1801067517-0 11211 North Nebraska Ave Tampa, FL 33612 (813) 514-2333 Fax: (813) 482-0015 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 11:00 PM

Acme Pharmacy Provider ID: TPV1184069924-0 1548 E Fowler Ave Tampa, FL 33612 (813) 971-6565 Fax: (813) 971-7550 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 7:00 PM Sat-Sun 10:00 AM - 3:00 PM

American Care of Tampa Inc W Provider ID: TPV1861796435-0 8726 W Waters Ave Tampa, FL 33615 (813) 712-1726 Fax: (813) 925-4640 00 Yrs/99 Yrs Languages: Spanish MTWTHFSat 8:00 AM - 11:00 PM

Advance Pharmacy Service Provider ID: TPV1922429562-0 5124 N Armenia Ave Tampa, FL 33603 (813) 350-9999 Fax: (813) 350-9990 00 Yrs/99 Yrs Languages: Spanish M-F 10:00 AM - 6:00 PM

Apollo Beach Pharmacy Provider ID: TPV1942697016-0 264 Apollo Beach Blvd Apollo Beach, FL 33572 (813) 606-4577 Fax: (813) 606-4588 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 3:00 PM

Advanced Medical Pharmacy Inc Provider ID: TPV1639470362-0 3614 W Kennedy Blvd Ste C Tampa, FL 33609 (813) 374-2065 Fax: (813) 374-8884 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 4:00 PM

Bay Discount Pharmacy Provider ID: TPV1417275694-0 8802 Rocky Creek Dr Ste 105 Tampa, FL 33615 (813) 885-4000 Fax: (813) 885-4008 00 Yrs/99 Yrs Languages: Spanish, French M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 3:00 PM

All Childrens Hospital OP Pharmac Provider ID: TPV1992710503-0 12220 Bruce B Downs Blvd Tampa, FL 33612 (813) 631-5006 Fax: (813) 631-5094 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Baycare Pharmacy Provider ID: TPV1982039731-0 3003 W Dr MLK Jr Blvd Tampa, FL 33607 (813) 357-0630 Fax: (813) 357-0631 00 Yrs/99 Yrs Languages: Spanish M-F 10:00 AM - 6:00 PM

Bearss Pharmacy Provider ID: TPV1457358616-0 3606 Madaca Ln Tampa, FL 33618 (813) 341-1555 Fax: (813) 341-1556 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM Benzer Pharmacy Provider ID: TPV1164805016-0 105 S Moon Ave Brandon, FL 33511 (813) 689-7800 Fax: (813) 654-6395 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM Benzer Pharmacy Provider ID: TPV1316315393-0 6056 Van Dyke Rd Lutz, FL 33558 (813) 968-9100 Fax: (813) 968-9200 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Benzer Pharmacy Provider ID: TPV1669785168-0 11509 E MLK Jr Blvd Mango, FL 33550 (813) 661-2263 Fax: (813) 662-2263 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM Benzer Pharmacy Provider ID: TPV1689044141-0 14306-D North Dale Maybry Hwy Tampa, FL 33618 (813) 963-6800 Fax: (813) 963-6889 00 Yrs/99 Yrs M-F 8:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM

www.wellcare.com/Florida | 746

Benzer Pharmacy Provider ID: TPV1780005389-0 2812 W MLK Jr Blvd Tampa, FL 33607 (813) 443-4796 Fax: (813) 374-9522 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Benzer Pharmacy Provider ID: TPV1811133424-0 5908 Breckenridge Pkwy Tampa, FL 33610 (813) 644-7277 Fax: (813) 875-4000 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Best Deal RX Pharmacy Provider ID: TPV1609173525-0 4160 N Armenia Ave Ste C Tampa, FL 33607 (813) 644-6845 Fax: (813) 644-6850 00 Yrs/99 Yrs Languages: Spanish, French, Italian, German M-F 8:00 AM - 6:00 PM Sat 8:00 AM - 1:00 PM Bills Prescription Center Provider ID: TPV1568532679-0 202 E Brandon Blvd Brandon, FL 33511 (813) 689-3521 Fax: (813) 681-8475 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Bioscrip Infusion Services Provider ID: TPV1457658486-0 5505 Johns Rd Ste 700 Tampa, FL 33634 (813) 549-5499 Fax: (813) 549-5490 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Brandon Community Health Center Provider ID: TPV1326410952-0 313 S. Lakewood Dr Brandon, FL 33511 (813) 349-7859 Fax: (813) 349-7869 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Brandon Pharmacy Provider ID: TPV1013382662-0 1035 Professional Park DR Brandon, FL 33511 (813) 684-4444 Fax: (813) 684-3444 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM

Careplus Pharmacy Provider ID: TPV1760793111-0 701 W Dr M L K Jr Blvd Ste 1 Tampa, FL 33603 (813) 849-0991 Fax: (813) 849-0992 00 Yrs/99 Yrs Languages: Spanish, French M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM Carrollwood Pharmacy Provider ID: TPV1053331850-0 11775 N Dale Mabry Hwy Tampa, FL 33618 (813) 961-8798 Fax: (813) 962-0092 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Ccm Pharmacy, LLC Provider ID: TPV1417322033-0 6821 W Hillsborough Ave Ste 6 Tampa, FL 33634 (813) 559-1010 Fax: (813) 559-1200 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Busch Pharmacy LLC Provider ID: TPV1609038926-0 Sat 9:00 AM - 3:00 PM 6751 N Armenia Ave Ste 4 Chen Neighborhood Medical Tampa, FL 33604 E Tampa (813) 990-8300 Provider ID: TPV1619401338-0 Fax: (813) 990-8380 3128 E. Hillsborough Ave. 00 Yrs/99 Yrs Tampa, FL 33610 Languages: Spanish (813) 579-1769 M-F 9:00 AM - 5:00 PM Fax: (813) 579-1769 Sat 9:00 AM - 1:00 PM 00 Yrs/99 Yrs Caremark Specialty Pharmacy Languages: Spanish M-F 8:00 AM - 5:00 PM Provider ID: TPV1417938820-0 7930 Woodland Center Blvd Choice Pharmacy Ste 500 Provider ID: TPV1346443116-0 Tampa, FL 33614 5913 N Armenia Ave (813) 881-0949 Tampa, FL 33603 Fax: (813) 882-5572 (813) 870-6426 00 Yrs/99 Yrs Fax: (813) 870-6429 M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM Bulls Country Pharmacy Provider ID: TPV1568613180-0 4103 USF Cedar Cir Tampa, FL 33620 (813) 974-2071 Fax: (813) 974-4383 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM

Choice Pharmacy Provider ID: TPV1972743573-0 401 S Parsons Ave Ste C Brandon, FL 33511 (813) 685-4707 Fax: (813) 685-4722 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM City Care Pharmacy Provider ID: TPV1649584434-0 5557 S 78th St Tampa, FL 33619 (813) 402-0444 Fax: (813) 402-0445 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM

CVS Provider ID: TPV1083636625-0 3625 W Gandy Blvd Tampa, FL 33611 (813) 835-9414 Fax: (813) 402-4753 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM CVS Provider ID: TPV1083718951-0 403 N Alexander St Plant City, FL 33563 (813) 659-4687 Fax: (813) 707-1778 00 Yrs/99 Yrs

City Pharmacy Provider ID: TPV1982678918-0 3302 E Dr Martin Luther King J Tampa, FL 33610 (813) 248-5405 Fax: (813) 248-5408 00 Yrs/99 Yrs Languages: German M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

CVS Provider ID: TPV1104920016-0 5632 Gunn Hwy Tampa, FL 33624 (813) 963-5355 Fax: (813) 269-0004 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Coram Healthcare Corp of Florida Provider ID: TPV1417907627-0 8508 Benjamin Rd Ste C Tampa, FL 33634 (813) 884-6987 Fax: (813) 886-3357 00 Yrs/99 Yrs M-F 8:00 AM - 6:00 PM

CVS Provider ID: TPV1114172590-0 4401 W Gandy Blvd Tampa, FL 33611 (813) 837-8382 Fax: (813) 839-2858 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Crestmark Pharmacy Services LLC Provider ID: TPV1598158701-0 1860 Highland Oaks Blvd Lutz, FL 33559 (813) 428-6963 Fax: (813) 803-7503 00 Yrs/99 Yrs MTWTHFSat 9:00 AM - 6:00 PM Sun 11:00 AM - 6:00 PM

CVS Provider ID: TPV1164526133-0 4120 Henderson Blvd Tampa, FL 33629 (813) 281-5353 Fax: (813) 281-5356 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 747

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. CVS Provider ID: TPV1205930120-0 2109 State Rd 60 E Valrico, FL 33594 (813) 684-0583 Fax: (813) 657-9798 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1205933793-0 625 W Dr Martin Luther King Jr Tampa, FL 33603 (813) 232-2925 Fax: (813) 232-2976 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1245334226-0 9202 N Florida Ave Tampa, FL 33612 (813) 935-1134 Fax: (813) 930-6914 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1255435129-0 715 W Brandon Blvd Brandon, FL 33511 (813) 653-4109 Fax: (813) 655-0929 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1255435228-0 2502 W Hillsborough Ave Tampa, FL 33614 (813) 877-5881 Fax: (813) 870-1317 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1265537013-0 715 Dr MLK Jr Blvd W Seffner, FL 33584 (813) 681-4431 Fax: (813) 654-6930 00 Yrs/99 Yrs CVS Provider ID: TPV1275637183-0 11212 N Dale Mabry Hwy Tampa, FL 33618 (813) 968-1457 Fax: (813) 969-4367 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1295839157-0 1904 W Lumsden Rd Brandon, FL 33511 (813) 651-3118 Fax: (813) 655-9316 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1295839165-0 8809 New Tampa Blvd Tampa, FL 33647 (813) 632-8989 Fax: (813) 632-4918 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1316041239-0 5357 Ehrlich Rd Tampa, FL 33625 (813) 968-4003 Fax: (813) 960-3410 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1316042146-0 5905 US Hwy 301 S Riverview, FL 33578 (813) 740-8463 Fax: (813) 740-8540 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1386748200-0 11670 Countryway Blvd Tampa, FL 33626 (813) 818-0287 Fax: (813) 925-8208 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1316969918-0 1544 N Dale Mabry Hwy Tampa, FL 33607 (813) 262-0245 Fax: (813) 830-7896 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

CVS Provider ID: TPV1386748291-0 10623 Gibsonton Dr Riverview, FL 33578 (813) 677-4435 Fax: (813) 677-4063 00 Yrs/99 Yrs

CVS Provider ID: TPV1346344322-0 2302 James L Redman Pkwy Plant City, FL 33563 (813) 752-3139 Fax: (813) 754-0780 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1356445225-0 2725 N Macdill Ave Tampa, FL 33607 (813) 873-0259 Fax: (813) 873-9549 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1366636441-0 10150 Bloomingdale Ave Riverview, FL 33578 (813) 387-1162 Fax: (813) 387-1172 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat-Sun 9:00 AM - 6:00 PM

www.wellcare.com/Florida | 748

CVS Provider ID: TPV1417051384-0 813 W Bearss Ave Tampa, FL 33613 (813) 908-0360 Fax: (813) 908-6820 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1417127648-0 6202 Commerce Palms Dr Tampa, FL 33647 (813) 971-2459 Fax: (813) 971-2980 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1427152404-0 110 Bullard Pkwy Temple Terrace, FL 33617 (813) 988-5214 Fax: (813) 983-0846 00 Yrs/99 Yrs

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. CVS Provider ID: TPV1447272083-0 6295 W Waters Ave Tampa, FL 33634 (813) 885-1792 Fax: (813) 261-2883 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM CVS Provider ID: TPV1457455438-0 102 S Dale Mabry Hwy Tampa, FL 33609 (813) 877-8227 Fax: (813) 873-2907 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS CVS Provider ID: TPV1609970680-0 Provider ID: TPV1740202365-0 7351 W Hillsborough Ave 187 Brandon Town Center Dr Tampa, FL 33634 Brandon, FL 33511 (813) 884-2506 (813) 654-4843 Fax: (813) 885-1493 Fax: (813) 261-3431 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 6:00 PM Sun 11:00 AM - 5:00 PM

CVS Provider ID: TPV1891989935-0 11627 W Hillsborough Ave Tampa, FL 33635 (813) 749-5962 Fax: (813) 749-5972 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

CVS Provider ID: TPV1639273543-0 909 E Lumsden Rd Brandon, FL 33511 (813) 684-8684 Fax: (813) 684-1454 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1902900871-0 15499 N Dale Mabry Hwy Tampa, FL 33618 (813) 264-6803 Fax: (813) 264-4961 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1740384601-0 5502 E Fowler Ave Temple Terrace, FL 33617 (813) 984-1560 Fax: (813) 899-0660 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat-Sun 9:00 AM - 9:00 PM

CVS Provider ID: TPV1770505398-0 CVS Provider ID: TPV1912226044-0 15240 N Dale Mabry Hwy 8603 W. Hillsborough Ave CVS Tampa, FL 33618 Tampa, FL 33615 Provider ID: TPV1477657443-0 (813) 962-6133 (813) 882-4029 8801 W Linebaugh Ave Fax: (813) 280-7040 Fax: (813) 885-4862 Tampa, FL 33626 00 Yrs/99 Yrs 00 Yrs/99 Yrs (813) 926-3756 M-F 9:00 AM - 7:00 PM Fax: (813) 926-5305 Sat 9:00 AM - 5:00 PM CVS 00 Yrs/99 Yrs Sun 11:00 AM - 5:00 PM Provider ID: TPV1922102839-0 M-F 8:00 AM - 9:00 PM CVS 6202 N US Hwy 41 CVS Sat 9:00 AM - 6:00 PM Provider ID: TPV1700980778-0 Apollo Beach, FL 33572 Provider ID: TPV1801990783-0 Sun 10:00 AM - 6:00 PM 1010 Bloomingdale Ave (813) 645-4605 2322 Land O Lakes Blvd Valrico, FL 33596 Fax: (813) 645-1436 CVS Lutz, FL 33549 00 Yrs/99 Yrs Provider ID: TPV1487848560-0 (813) 684-0283 (813) 949-3641 Fax: (813) 661-8532 M-F 8:00 AM - 10:00 PM 1040 Dale Mabry Hwy Fax: (813) 948-3931 00 Yrs/99 Yrs Sat 8:00 AM - 6:00 PM Lutz, FL 33548 00 Yrs/99 Yrs M-F 8:00 AM 9:00 PM Sun 10:00 AM - 6:00 PM (813) 435-2934 M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Fax: (813) 435-2944 Sat 9:00 AM - 6:00 PM CVS Sun 10:00 AM - 6:00 PM 00 Yrs/99 Yrs Sun 10:00 AM - 6:00 PM Provider ID: TPV1932203882-0 M-F 9:00 AM - 7:00 PM CVS 611 S Howard Ave CVS Sat 9:00 AM - 5:00 PM Provider ID: TPV1720182694-0 Tampa, FL 33606 Provider ID: TPV1881798759-0 Sun 11:00 AM - 5:00 PM 6701 N Dale Mabry Hwy (813) 259-9911 4001 E Busch Blvd Tampa, FL 33614 Fax: (813) 258-0306 CVS Tampa, FL 33617 00 Yrs/99 Yrs Provider ID: TPV1598869463-0 (813) 873-0472 (813) 914-7645 Fax: (813) 873-0463 3102 W Gandy Blvd Fax: (813) 914-7607 CVS 00 Yrs/99 Yrs Tampa, FL 33611 00 Yrs/99 Yrs Provider ID: TPV1952405813-0 (813) 902-1833 M-F 8:00 AM - 10:00 PM 105 S Pebble Beach Blvd Fax: (813) 831-1394 Sat 9:00 AM - 6:00 PM Sun City Center, FL 33573 00 Yrs/99 Yrs Sun 10:00 AM - 6:00 PM (813) 633-8082 M-F 8:00 AM - 9:00 PM Fax: (813) 633-3613 Sat 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1700980679-0 2911 E Fowler Ave Tampa, FL 33612 (813) 975-1998 Fax: (813) 615-0486 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat-Sun 9:00 AM - 9:00 PM

www.wellcare.com/Florida | 749

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont.

Exactus Pharmacy Solutions Inc CVS Provider ID: TPV1073733408-0 Provider ID: TPV1992809800-0 4110 George Rd Ste 100 10013 McMullen Rd Tampa, FL 33634 Riverview, FL 33569 (866) 458-9246 (813) 677-4551 Fax: (866) 458-9245 Fax: (813) 741-1289 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: French, Chinese, M-F 9:00 AM - 9:00 PM German Sat 9:00 AM - 6:00 PM M-TH 8:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM F 8:00 AM - 6:00 PM

Fletcher Medical Center Pharmacy Provider ID: TPV1043320716-0 3000 E Fletcher Ave Ste 130 Tampa, FL 33613 (813) 972-3774 Fax: (813) 971-8007 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

Germaine Pharmacy Compounding Inc Provider ID: TPV1376860866-0 2511 W. Swann Ave Ste 102 Tampa, FL 33609 (813) 356-0370 Fax: (813) 356-0379 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Foundational Health Pharmacy Express Specialty Pharmacy Davids Pharmacy Provider ID: TPV1265730345-0 Provider ID: TPV1073505954-0 3031 W Cypress St Ste A 2302 W Dr Martin Luther King Provider ID: TPV1730503889-0 Tampa, FL 33609 J (813) 527-0765 4111 Henderson Blvd Tampa, FL 33607 Fax: (813) 644-6992 Tampa, FL 33629 (813) 870-1967 00 Yrs/99 Yrs (813) 288-0777 Fax: (813) 870-3277 Languages: Spanish Fax: (888) 494-7084 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish, French, Freedomed Pharmacy M-F 9:00 AM - 5:00 PM Arabic Sat 9:00 AM - 1:00 PM Provider ID: TPV1336351402-0 M-F 9:00 AM - 5:00 PM 5535 Memorial Hwy Davis Islands Pharmacy Extra Care Pharmacy Inc Tampa, FL 33634 Provider ID: TPV1144265380-0 Provider ID: TPV1689675712-0 (813) 889-9779 2001 E Fletcher Ave Ste 101 232 E Davis Blvd Fax: (813) 889-9724 Tampa, FL 33612 Tampa, FL 33606 00 Yrs/99 Yrs (813) 558-9300 (813) 254-1888 Languages: Spanish Fax: (813) 558-9333 Fax: (813) 254-8396 M 8:00 AM - 5:00 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs TWTHF 9:00 AM - 5:00 PM Languages: Spanish Languages: Spanish, Hebrew Sat 9:00 AM - 1:00 PM MTWTHFSat 9:00 AM - 6:00 M-F 8:00 AM - 7:00 PM PM Friends Pharmacy Sat 9:00 AM - 2:00 PM Provider ID: TPV1427203876-0 Family Care Pharmacy Dollex Pharmacy 1813 E Fowler Ave Provider ID: TPV1386617850-0 Provider ID: TPV1376784926-0 Tampa, FL 33612 1505 W Reynolds St 7756 Palm River Rd (813) 632-3200 Plant City, FL 33563 Tampa, FL 33619 Fax: (813) 632-3205 (813) 659-9777 (813) 971-5551 00 Yrs/99 Yrs Fax: (813) 659-1485 Fax: (813) 979-1888 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Genoa-QOL Healthcare Languages: French M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Provider ID: TPV1104861764-0 5707 N 22nd St Fast and Friendly Pharmacy Exact Dose Pharmacy Inc Tampa, FL 33610 Provider ID: TPV1265755748-0 (813) 239-8116 Provider ID: TPV1013059120-0 10004 East Dr MLK Jr Blvd Fax: (813) 231-3108 404 N Alexander St Tampa, FL 33610 00 Yrs/99 Yrs Plant City, FL 33563 (813) 626-7353 M-F 8:00 AM - 5:00 PM (813) 719-3278 Fax: (813) 626-7358 Fax: (813) 754-7540 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish M-F 10:00 AM - 6:00 PM

Good Health Pharmacy Provider ID: TPV1548558463-0 1911 W Dr Martin L Kng Jr Blvd Tampa, FL 33607 (813) 933-5830 Fax: (813) 933-5841 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 750

Grace RX Pharmacy Provider ID: TPV1679743157-0 4602 N Armenia Ave Ste A2 Tampa, FL 33603 (813) 221-3131 Fax: (813) 343-4321 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Havana LTC Pharmacy Inc Provider ID: TPV1437121365-0 3818 S Himes Ave Ste Ste 1 Tampa, FL 33611 (813) 875-5914 Fax: (813) 875-5924 00 Yrs/99 Yrs Languages: Spanish M-F 10:00 AM - 4:00 PM Health Pro Pharmacy Provider ID: TPV1154750479-0 11349 Big Bend Rd Riverview, FL 33579 (813) 672-8889 Fax: (813) 672-8887 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Healthlink Pharmacy Provider ID: TPV1124026521-0 3301 W Waters Ave Ste 101 Tampa, FL 33614 (813) 868-6800 Fax: (813) 868-6802 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM Healthwise Pharmacy Inc Provider ID: TPV1104920156-0 2708 W Waters Ave Tampa, FL 33614 (813) 932-6337 Fax: (813) 932-7455 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM

Hoyes Pharmacy Provider ID: TPV1871713255-0 4330 S Manhattan Ave Tampa, FL 33611 (813) 839-8861 Fax: (813) 839-8941 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM Hudson Drugs Provider ID: TPV1841435914-0 11010 N Dale Mabry Hwy Ste 104 Tampa, FL 33618 (813) 961-5790 Fax: (813) 961-5741 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM

Idel Pharmacy Provider ID: TPV1851316731-0 3314 W Columbus Dr Hillsboro Specialty Pharmacy Blood Prss Tampa, FL 33607 Provider ID: TPV1932420247-0 (813) 877-6679 4505 E Hillsborough Ave Ste D Fax: (813) 877-1692 Tampa, FL 33610 00 Yrs/99 Yrs (813) 628-8400 Languages: Spanish Fax: (813) 628-8484 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 4:00 PM Languages: Spanish Imed Pharmacy M-F 9:00 AM - 6:00 PM Provider ID: TPV1528434404-0 Hillsborough River Pharmacy 1812 S Parsons Ave Ste 104 Inc Seffner, FL 33584 (813) 685-4444 Provider ID: TPV1225276595-0 Fax: (813) 685-4445 4603 N Armenia Ave 00 Yrs/99 Yrs Tampa, FL 33603 Languages: Spanish, Hindi (813) 873-3651 M-F 9:00 AM - 5:00 PM Fax: (813) 873-3691 00 Yrs/99 Yrs J S RX Pharmacy Languages: Spanish, French Provider ID: TPV1912334384-0 M-F 8:00 AM - 6:00 PM 1252 E Hillsborough Ave Sat 10:00 AM - 2:00 PM Tampa, FL 33604 Holiday Pharmacy Inc (813) 234-4200 Provider ID: TPV1972773984-0 Fax: (813) 234-4270 6815 N Dale Mabry Hwy Ste B 00 Yrs/99 Yrs Tampa, FL 33614 Languages: Spanish (813) 933-6900 M-F 10:00 AM - 6:00 PM Fax: (813) 933-0800 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

King Pharmacy Jrx Pharmacy Provider ID: TPV1255679080-0 Provider ID: TPV1104139294-0 1405 Tampa Park Plaza St 3940 W Hillsborough Ave Tampa, FL 33605 Tampa, FL 33614 (813) 374-0365 (813) 874-2900 Fax: (813) 374-2384 Fax: (813) 874-2909 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: French M-F 9:00 AM - 6:00 PM Life Saverx, LLC Provider ID: TPV1013226687-0 Kabs Pharmacy 207 E Robertson St Ste B Provider ID: TPV1437328986-0 Brandon, FL 33511 759 W Brandon Blvd (813) 283-1132 Brandon, FL 33511 Fax: (813) 681-6570 (813) 413-8362 00 Yrs/99 Yrs Fax: (813) 413-8370 Languages: Spanish, Korean 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish M-F 10:00 AM - 6:00 PM Logos Pharmacy Kabs Pharmacy Provider ID: TPV1659767515-0 Provider ID: TPV1992725485-0 8315 Sheldon Rd 2812 E Bearss Ave Tampa, FL 33615 Tampa, FL 33613 (813) 886-2800 (813) 988-4000 Fax: (813) 886-2822 Fax: (813) 849-1138 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Arabic Languages: Spanish M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Sat 11:00 AM - 3:00 PM Lutz Pharmacy Kay Pharmacy Provider ID: TPV1558691220-0 Provider ID: TPV1174684757-0 1930 Land O Lakes Blvd Ste 15 3500 E Fletcher Ave Ste 120 Lutz, FL 33549 Tampa, FL 33613 (813) 948-4500 (813) 632-9032 Fax: (813) 948-0400 Fax: (813) 632-9035 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Spanish Sat 9:00 AM - 1:00 PM M-F 8:00 AM - 6:00 PM Macdill Pharmacy Kay Pharmacy Provider ID: TPV1467690214-0 Provider ID: TPV1578715215-0 2800 N Macdill Ave Ste C 10802 Main St Ste A Tampa, FL 33607 Thonotosassa, FL 33592 (813) 870-6300 (813) 413-8242 Fax: (813) 870-6904 Fax: (813) 413-8302 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Korean Languages: Spanish M-F 9:00 AM - 6:00 PM M-TH 10:00 AM - 5:00 PM Sat 10:00 AM - 2:00 PM F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 751

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Maxxycom RX Pharmacy Provider ID: TPV1366770976-0 1825 Collier Pkwy Lutz, FL 33549 (813) 406-4929 Fax: (813) 406-4469 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM

Memorial Family Pharmacy Provider ID: TPV1013058973-0 3609 Henderson Blvd Tampa, FL 33609 (813) 874-0795 Fax: (813) 874-0851 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Medica Scripts Provider ID: TPV1427470780-0 15511 N Florida Ave Tampa, FL 33613 (813) 968-0520 Fax: (813) 968-0482 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM

Meridian Pharmacy Provider ID: TPV1821479510-0 8890 N 56th St Temple Terrace, FL 33617 (813) 374-0395 Fax: (813) 605-5860 00 Yrs/99 Yrs Languages: Spanish M-TH 10:00 AM - 6:00 PM F 9:00 AM - 5:00 PM

Medicine Place Provider ID: TPV1518153634-0 14936 N Florida Ave Tampa, FL 33613 (813) 961-6546 Fax: (813) 963-6379 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM

Michaels Pharmacy Provider ID: TPV1447536842-0 1329 E Fletcher Ave Tampa, FL 33612 (813) 907-0099 Fax: (813) 252-4652 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM

Medicine Shoppe Provider ID: TPV1871778225-0 10905 N Nebraska Ave Tampa, FL 33612 (813) 971-8401 Fax: (813) 971-8708 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Moffitt Cancer Center PUBLIX Provider ID: TPV1215293451-0 12902 USF Magnolia Dr Ste 1170 Tampa, FL 33612 (813) 745-8484 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

Meds To Home Provider ID: TPV1669749453-0 4801 George Rd Ste 190 Tampa, FL 33634 (813) 886-2023 Fax: (813) 374-7417 00 Yrs/99 Yrs Languages: Spanish M-F 10:00 AM - 6:00 PM

Moffitt Cancer Center PUBLIX Provider ID: TPV1730558586-0 10920 N McKinley Dr Ste 11.1114 Tampa, FL 33612 (813) 978-1694 Fax: (813) 438-7966 00 Yrs/99 Yrs M-F 8:00 AM - 6:00 PM

My Pharmacy of Big Bend Provider ID: TPV1811339336-0 947 Lithia Pinecrest Rd Brandon, FL 33511 (813) 741-2794 Fax: (813) 741-2795 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 5:00 PM My Pharmacy of Tampa Provider ID: TPV1457656373-0 7108 Causeway Blvd Tampa, FL 33619 (813) 628-4441 Fax: (813) 628-4442 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 8:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM New Waters Pharmacy Provider ID: TPV1174829352-0 4311 W Waters Ave Ste 590 Tampa, FL 33614 (813) 249-6593 Fax: (888) 287-6312 00 Yrs/99 Yrs Languages: Vietnamese M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM North Tampa Pharmacy Provider ID: TPV1538446182-0 104 E Fletcher Ave Tampa, FL 33612 (813) 265-4925 Fax: (813) 902-6283 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM Northdale Pharmacy Provider ID: TPV1841389525-0 3851 Northdale Blvd Tampa, FL 33624 (813) 264-6300 Fax: (813) 264-6336 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

www.wellcare.com/Florida | 752

Novopharm of Tampa, LLC Provider ID: TPV1114235579-0 5404 Hoover Blvd Ste 22 Tampa, FL 33634 (813) 374-9345 Fax: (813) 443-0559 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM Oaks Community Pharmacy Provider ID: TPV1346613239-0 7501 N Florida Ave Ste C-104 Tampa, FL 33604 (813) 237-2300 Fax: (813) 237-2304 00 Yrs/99 Yrs Languages: Spanish, French M-F 9:00 AM - 5:00 PM Omega Drugs Provider ID: TPV1043549520-0 11410 N 56th St Tampa, FL 33617 (813) 985-0044 Fax: (813) 985-0042 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Omnicare of Tampa Provider ID: TPV1538104732-0 8603 Florida Mining Blvd Tampa, FL 33634 (813) 247-9225 Fax: (813) 864-6302 00 Yrs/99 Yrs Languages: Spanish Onestop RX Pharmacy Provider ID: TPV1043445968-0 4830 N Armenia Ave Tampa, FL 33603 (813) 877-8900 Fax: (813) 877-8991 00 Yrs/99 Yrs Languages: Spanish, German M-F 9:00 AM - 6:00 PM Orange Bay Pharmacy Provider ID: TPV1457530040-0 4625 N Nebraska Ave Tampa, FL 33603 (813) 418-6780 Fax: (813) 238-0237 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont.

Palmyra Pharmacy Provider ID: TPV1497209159-0 4815 E Busch Blvd Ste 109 Tampa, FL 33617 (813) 899-2222 Fax: (813) 899-2223 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM

Pharma-Ville RX Medical Supply Provider ID: TPV1144605023-0 14857 N Dale Mabry Hwy Tampa, FL 33618 (813) 605-0732 Fax: (813) 605-0733 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM

Patient RX Solutions Pharmacy Palm Plaza Pharmacy Provider ID: TPV1063872562-0 Provider ID: TPV1699079756-0 3450 E Fletcher Ave Ste 140 Tampa, FL 33613 162 N Parsons Ave (813) 426-8234 Brandon, FL 33510 Fax: (813) 558-0030 (813) 689-7700 00 Yrs/99 Yrs Fax: (813) 689-7705 Languages: Spanish 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM Languages: Hindi M-F 9:00 AM - 5:00 PM Peak Pharmacy Inc Palm River Community Health Provider ID: TPV1912218108-0 Center 4707 E Busch Blvd Ste 101 Provider ID: TPV1043636566-0 Tampa, FL 33617 7728 Palm River Rd (813) 443-0833 Tampa, FL 33619 Fax: (813) 443-0837 (813) 630-3649 00 Yrs/99 Yrs Fax: (813) 630-3669 Languages: Spanish 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Languages: Spanish M-F 9:00 AM - 5:00 PM Pharmacore RX Provider ID: TPV1790141570-0 Palma Ceia Health Mart 5406 Hoover Blvd Ste 19 Pharmacy Tampa, FL 33634 Provider ID: TPV1093047029-0 (813) 580-8040 2506 S Macdill Ave Ste A Fax: (813) 580-8041 Tampa, FL 33629 00 Yrs/99 Yrs (813) 839-8700 Languages: Spanish Fax: (813) 839-7575 M-F 9:00 AM - 5:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Pharmacy Pros Corporation Sat 10:00 AM - 2:00 PM Provider ID: TPV1255316600-0 110 Whitaker Rd Palms Pharmacy Lutz, FL 33549 Provider ID: TPV1487019295-0 (813) 948-3135 17008 Palm Pointe Dr Fax: (877) 903-1390 Tampa, FL 33647 00 Yrs/99 Yrs (813) 252-9063 Languages: Spanish Fax: (813) 252-7017 M-F 9:00 AM - 5:00 PM 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM

Pharmax Specialty Pharmacy

Ousia Pharmacy Corp Provider ID: TPV1609231331-0 4343 Gunn Hwy Tampa, FL 33618 (813) 252-4076 Fax: (813) 252-4754 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Provider ID: TPV1457726150-0 7808 Woodland Center Blvd Tampa, FL 33614 (813) 880-2500 Fax: (813) 880-2501 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Pharmerica Provider ID: TPV1487843678-0 1228 Tech Blvd Tampa, FL 33619 (813) 514-4122 Fax: (855) 812-5834 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Pharmexpress Pharmacy Provider ID: TPV1629303714-0 507 E Dr MLK. Jr Blvd Ste 101 Tampa, FL 33603 (813) 406-4491 Fax: (813) 406-4493 00 Yrs/99 Yrs Languages: Spanish M-F 10:00 AM - 5:00 PM

Plant City Discount Pharmacy Provider ID: TPV1962712562-0 607 E Alexander St Plant City, FL 33563 (813) 703-1500 Fax: (813) 703-1505 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Plant City Family Care Provider ID: TPV1912273285-0 508 N Maryland Ave Plant City, FL 33563 (813) 349-7649 Fax: (813) 349-7629 00 Yrs/99 Yrs Languages: Spanish MWTHF 9:00 AM - 5:00 PM T 11:00 AM - 7:00 PM Precision RX Provider ID: TPV1043636921-0 6919 N Dale Mabry Hwy Ste 125 Tampa, FL 33614 (813) 463-8009 Fax: (813) 932-2070 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM

Precisionmed Pharmacy Provider ID: TPV1215321005-0 6919 N Dale Mabry Hwy Ste Pharmscript 150 Tampa, FL 33614 Provider ID: TPV1013242452-0 3801 Corporex Park Dr Ste 100 (813) 703-8839 Fax: (813) 344-0599 Tampa, FL 33619 00 Yrs/99 Yrs (908) 389-1818 M-F 9:00 AM - 5:00 PM Fax: (732) 868-9014 00 Yrs/99 Yrs Languages: Spanish, Chinese, Premier Pharmacy LLC Provider ID: TPV1508195769-0 Hindi 4307 N Armenia Ave Tampa, FL 33607 (813) 873-7470 Fax: (813) 874-1416 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 753

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Pronto Pharmacy Provider ID: TPV1083914477-0 1461 W Busch Blvd Tampa, FL 33612 (813) 443-0970 Fax: (813) 443-0971 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM

Royal RX Pharmacy Provider ID: TPV1154429181-0 4941 E Busch Blvd Ste 240 Tampa, FL 33617 (813) 980-6334 Fax: (813) 980-6338 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM

RX Solutions Inc Provider ID: TPV1659514214-0 5144 E Busch Blvd Tampa, FL 33617 (813) 988-7600 Fax: (813) 988-7676 00 Yrs/99 Yrs Languages: Spanish, French, Russian M-F 9:00 AM - 7:00 PM

SAMS CLUB Provider ID: TPV1750308144-0 5135 S Dale Mabry Hwy Tampa, FL 33611 (813) 805-6401 Fax: (813) 805-9342 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM

SAMS CLUB Rxperts Pharmacy Tampa Inc Ruskin Health Center Quick N Save Pharmacy Provider ID: TPV1922025311-0 Provider ID: TPV1477000693-0 Provider ID: TPV1770596058-0 Provider ID: TPV1154378784-0 2021 W Brandon Blvd 1911 N US Hwy 301 Ste 100 2814 14th Ave SE 8207 N Florida Ave Brandon, FL 33511 Tampa, FL 33619 Ruskin, FL 33570 Tampa, FL 33604 (813) 657-5441 (813) 740-1818 (813) 349-7849 (813) 549-5599 Fax: (813) 657-5443 Fax: (877) 242-2817 Fax: (813) 349-7869 Fax: (813) 433-5128 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Languages: Spanish Languages: Spanish Languages: Spanish, French Sat 9:00 AM - 6:00 PM M-F 8:00 AM - 10:00 PM MWTHF 9:00 AM - 5:00 PM M-F 9:00 AM - 5:00 PM Sat 8:00 AM - 2:00 PM SAMS CLUB T 11:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM Sun 8:00 AM - 4:00 PM Provider ID: TPV1972807113-0 RX Express Pharmacy 10385 Big Bend Rd Republic Pharmacy Provider ID: TPV1497892871-0 Salhab Pharmacy Riverview, FL 33578 Provider ID: TPV1538472261-0 Provider ID: TPV1558755280-0 24718 State Rd 54 (813) 371-6775 106 S Parsons Ave 12643 N 56th St Lutz, FL 33559 Fax: (813) 371-2395 Brandon, FL 33511 Temple Terrace, FL 33617 (813) 948-4321 00 Yrs/99 Yrs (813) 653-4802 (813) 515-7918 Fax: (813) 948-1889 M-F 9:00 AM - 9:00 PM Fax: (813) 653-4844 Fax: (813) 515-7925 00 Yrs/99 Yrs Sat 9:00 AM - 7:00 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 10:00 AM - 2:00 PM Languages: Spanish, Russian, Save-Rite Pharmacy M-F 10:00 AM - 6:00 PM Arabic Rite RX Care Provider ID: TPV1033425079-0 Sat 10:00 AM - 12:00 PM M-F 9:00 AM - 7:00 PM Provider ID: TPV1700037587-0 7402 N 56th St Ste 907 Sat 9:00 AM - 3:00 PM RX Oasis 7520 W Waters Ave Ste 6 Tampa, FL 33617 Tampa, FL 33615 Provider ID: TPV1548716061-0 (813) 623-1800 Sallykay Pharmacy (813) 333-5343 6102 S Macdill Ave Ste B Fax: (813) 985-1700 Provider ID: TPV1619208568-0 Fax: (813) 333-5274 Tampa, FL 33611 00 Yrs/99 Yrs 735 W Martin Luther King Blvd Languages: Spanish, Hindi 00 Yrs/99 Yrs (813) 570-7194 Seffner, FL 33584 Languages: Spanish, Hindi Fax: (813) 570-7199 MTWTHFSat 9:00 AM - 6:00 (813) 409-3840 PM M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Fax: (813) 409-3841 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Script Choice Pharmacy Riverview Pharmacy Sat 10:00 AM - 2:00 PM Languages: Spanish Provider ID: TPV1053615567-0 Provider ID: TPV1255654992-0 M-F 9:00 AM - 6:00 PM 1721 W Fletcher Ave RX Oasis 9858 US Hwy 301 S Tampa, FL 33612 Riverview, FL 33578 Provider ID: TPV1982978854-0 Sat 9:00 AM - 2:00 PM (813) 374-9944 (813) 677-3800 9304 Balm Riverview Rd SAMS CLUB Fax: (813) 374-9945 Fax: (813) 677-3899 Riverview, FL 33569 Provider ID: TPV1013934405-0 00 Yrs/99 Yrs 00 Yrs/99 Yrs (813) 677-6000 15835 N Dale Mabry Hwy Languages: Vietnamese M-F 9:00 AM - 6:00 PM Fax: (816) 677-6077 Tampa, FL 33618 M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM 00 Yrs/99 Yrs (813) 269-4764 Languages: Spanish, Hindi Fax: (813) 269-0963 MTH 8:00 AM - 7:00 PM 00 Yrs/99 Yrs TWF 8:00 AM - 6:00 PM M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 1:00 PM Sat 9:00 AM - 6:00 PM

www.wellcare.com/Florida | 754

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont.

Staywell Pharmacy Provider ID: TPV1336405109-0 4002 W . Waters Ave Ste 7 Scripts Direct LLC Provider ID: TPV1558656678-0 Tampa, FL 33614 (813) 249-9999 8313 W Hillsborough Ave Ste Fax: (813) 249-9992 260 00 Yrs/99 Yrs Tampa, FL 33615 Languages: Vietnamese (727) 359-0040 M-F 9:00 AM - 6:00 PM Fax: (813) 887-1882 00 Yrs/99 Yrs Summerfield Pharmacy Inc Languages: Spanish, Hindi, Provider ID: TPV1437201613-0 Arabic 13057 Summerfield Square Dr M-F 9:00 AM - 5:00 PM Riverview, FL 33578 (813) 234-9409 Scruples Pharmacy Fax: (813) 234-9416 Provider ID: TPV1194014993-0 1408 N Dalemabry Hwy Ste 115 00 Yrs/99 Yrs Languages: Spanish Lutz, FL 33548 MTWTHFSun 10:00 AM - 6:00 (813) 948-8111 PM Fax: (813) 948-8116 Sat 10:00 AM - 2:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sunrise Pharmacy Provider ID: TPV1841439502-0 Seffner Pharmacy 139 S Pebble Beach Blvd Ste Provider ID: TPV1194119875-0 103 2007 S Parsons Ave Sun City Center, FL 33573 Seffner, FL 33584 (813) 633-8222 (813) 655-9800 Fax: (813) 633-8227 Fax: (813) 655-4567 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Hindi Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM Seniorcare Comm Pharmacy Super Discount Pharmacy Provider ID: TPV1407041817-0 Provider ID: TPV1487751301-0 1423 S Collins St 6712 Hanley Rd Plant City, FL 33563 Tampa, FL 33634 (813) 752-1133 (813) 884-4090 Fax: (813) 752-8866 Fax: (813) 884-7282 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Hindi Languages: Spanish M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Sat 9:00 AM - 1:00 PM St Joseph Pharmacy Provider ID: TPV1487993788-0 7933 N Armenia Ave Tampa, FL 33604 (813) 930-6000 Fax: (813) 930-6007 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM

Tampa Family Health Centers-Florida Hospital Provider ID: TPV1912378795-0 3100 E Fletcher Ave Tampa, FL 33613 (813) 866-0930 Fax: (813) 866-0929 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 3:00 PM Tampa Family Pharmacy Provider ID: TPV1134400823-0 2919 W Swann Ave Ste 101 Tampa, FL 33609 (813) 871-5161 Fax: (813) 877-2479 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM

Tfhc 15 Pharmacy Provider ID: TPV1225179625-0 4620 North 22nd St Tampa, FL 33610 (813) 272-6240 Fax: (813) 272-6241 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Tfhc 16 Pharmacy Provider ID: TPV1568503985-0 1502 E Fowler Ave Tampa, FL 33612 (813) 866-0950 Fax: (813) 866-0376 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Tfhc 17 Pharmacy Tampa General Hospital OP Provider ID: TPV1477604486-0 Pharmacy 2103 N Rome Ave Provider ID: TPV1699836205-0 Tampa, FL 33607 5 Tampa General Cir (813) 490-1426 Tampa, FL 33606 Fax: (813) 490-1760 (813) 844-7688 00 Yrs/99 Yrs Fax: (813) 844-7242 M-F 8:00 AM - 5:00 PM 00 Yrs/99 Yrs Languages: Spanish Tfhc 18 Pharmacy M-F 7:00 AM - 8:00 PM Provider ID: TPV1306988910-0 Sat 7:00 AM - 7:00 PM 8213 W Waters Ave Tampa, FL 33615 Tampa Palms Pharmacy (813) 490-5420 Provider ID: TPV1952776536-0 Fax: (813) 490-5422 15309 Amberly Dr 00 Yrs/99 Yrs Tampa, FL 33647 M-F 9:00 AM - 5:00 PM (813) 605-0300 Fax: (813) 605-0303 Tfhc 21 Pharmacy 00 Yrs/99 Yrs Provider ID: TPV1962724807-0 Languages: Spanish, Hindi 7814 N Dale Mabry Hwy M-F 9:00 AM - 6:00 PM Tampa, FL 33614 (813) 405-3939 Temple Terrace Pharmacy Fax: (813) 405-3942 Provider ID: TPV1609948488-0 00 Yrs/99 Yrs 5671 E Fowler Ave Ste 215 M-F 9:00 AM - 5:00 PM Tampa Drugs Diabetic Center Temple Terrace, FL 33617 (813) 989-1351 Tfhc 23 Pharmacy Provider ID: TPV1144310319-0 Fax: (813) 988-4795 Provider ID: TPV1629340922-0 3209 N 22nd St 00 Yrs/99 Yrs 8108 N Nebraska Ave Tampa, FL 33605 Languages: Spanish Tampa, FL 33604 (813) 231-7788 M-F 9:00 AM - 5:00 PM (813) 712-1930 Fax: (813) 232-5210 Fax: (813) 405-3706 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

www.wellcare.com/Florida | 755

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Tfhc 28 Pharmacy Provider ID: TPV1114268950-0 7608 Causeway Blvd Tampa, FL 33619 (813) 405-3710 Fax: (813) 549-1031 00 Yrs/99 Yrs M-F 9:00 AM - 3:00 PM Tfhc 29 Pharmacy Provider ID: TPV1851718811-0 5611 Sheldon Rd Tampa, FL 33615 (813) 397-5320 Fax: (813) 405-3709 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Tfhc 30 - Fletcher Ave Provider ID: TPV1417356148-0 302 W Fletcher Ave Tampa, FL 33612 (813) 866-0930 Fax: (813) 866-0929 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 3:00 PM Tfhc- Sligh 31 Provider ID: TPV1760881437-0 6216 E Sligh Ave Tampa, FL 33617 (813) 549-8060 Fax: (813) 549-7843 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Tfhc22 Pharmacy Provider ID: TPV1891061255-0 3901 S W. Shore Blvd Tampa, FL 33611 (813) 712-1940 Fax: (813) 549-1031 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM The Drug Shoppe Provider ID: TPV1265529457-0 4060 N Armenia Ave Tampa, FL 33607 (813) 870-3939 Fax: (813) 870-3933 00 Yrs/99 Yrs MTWTHFSat 9:00 AM - 6:00 PM

Univ Pain Management Valued Choice Pharmacy The Medicine Shoppe Provider ID: TPV1538579503-0 Provider ID: TPV1063584845-0 Center Provider ID: TPV1427029404-0 5537 Sheldon Rd Ste Y 216 Oakfield Dr 3220 Cove Bend DR Tampa, FL 33615 Brandon, FL 33511 Tampa, FL 33613 (813) 881-0600 (813) 662-9926 (813) 615-0742 Fax: (813) 881-0700 Fax: (813) 662-9936 Fax: (813) 615-0782 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Vietnamese M-F 9:00 AM - 6:00 PM Languages: Hindi, Arabic M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM Times Pharmacy Veracity Pharmacy Provider ID: TPV1528381415-0 USF Health Pharmacy Plus Provider ID: TPV1538527130-0 Provider ID: TPV1235544594-0 2210 E Hillsborough Ave Ste 4 13135 Kings Lake Dr Ste 102 13330 USF Laurel Dr Tampa, FL 33610 Gibsonton, FL 33534 Tampa, FL 33612 (813) 237-6900 (813) 677-8811 (813) 974-0133 Fax: (813) 237-8600 Fax: (813) 677-8812 Fax: (813) 905-9947 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish Languages: Spanish, Arabic Languages: Arabic M-F 9:00 AM - 6:00 PM M-F 10:00 AM - 6:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 4:00 PM Sat 10:00 AM - 2:00 PM Tom Lee Community Health V T Pharmacy Center Provider ID: TPV1033414339-0 Veterans Pharmacy Provider ID: TPV1376553883-0 Provider ID: TPV1972896314-0 4040 W Waters Ave Ste 105 14254 SR 574 11434 N 53rd St Tampa, FL 33614 Dover, FL 33527 Temple Terrace, FL 33617 (813) 443-4732 (813) 349-7749 (813) 964-6881 Fax: (813) 443-4789 Fax: (813) 349-7769 Fax: (813) 964-6890 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Vietnamese Languages: Spanish M-F 8:00 AM - 5:00 PM MF 9:00 AM - 6:00 PM MWTHF 9:00 AM - 5:00 PM TWTH 9:00 AM - 5:00 PM Vistacare Pharmacy T 11:00 AM - 7:00 PM Sat 9:00 AM - 1:00 PM Provider ID: TPV1245622117-0 Total Care Pharmacy of V T Pharmacy 1441 E Fletcher Ave Ste 113 Bloomingdale Tampa, FL 33612 Provider ID: TPV1457788010-0 Provider ID: TPV1457741696-0 (813) 444-4410 11967 Sheldon Rd 519 E Bloomingdale Ave Ste C Fax: (813) 422-7946 Tampa, FL 33626 Brandon, FL 33511 00 Yrs/99 Yrs (813) 926-3470 (813) 689-2273 Languages: Spanish Fax: (813) 926-3478 Fax: (813) 689-8200 M-F 10:00 AM - 6:00 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Vietnamese Languages: Hindi Vistara Pharmacy M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Provider ID: TPV1326422189-0 Sat 9:00 AM - 12:00 PM Valrico Pharmacy 2931 W Hillsborough Ave Provider ID: TPV1558509950-0 Tampa, FL 33614 Total Care Pharmacy of (813) 667-6075 2224 State Rd 60E Brandon Fax: (813) 667-6076 Valrico, FL 33594 Provider ID: TPV1871999516-0 00 Yrs/99 Yrs (813) 681-7800 1218 Millennium Pkwy Languages: Spanish, Hindi Fax: (813) 681-7833 Brandon, FL 33511 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs (813) 662-4791 M-F 9:00 AM - 7:00 PM Fax: (813) 662-4792 Sat 9:00 AM - 3:00 PM 00 Yrs/99 Yrs Languages: Hindi MTWF 8:00 AM - 5:00 PM TH 10:00 AM - 7:00 PM Sat 9:00 AM - 12:00 PM

www.wellcare.com/Florida | 756

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Vp Pharmacy Provider ID: TPV1639541733-0 7617 N 56th St Tampa, FL 33617 (813) 988-0818 Fax: (813) 988-0830 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

Walmart Pharmacy Provider ID: TPV1053338350-0 6216 Elliot Dr Tampa, FL 33615 (813) 249-3152 Fax: (813) 249-3154 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 8:00 AM - 7:00 PM Sun 11:00 AM - 5:00 PM

Walmart Pharmacy Provider ID: TPV1336434315-0 901 Lithia Pinecrest Rd Brandon, FL 33511 (813) 261-0532 Fax: (813) 261-0375 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1013287499-0 10863 Bloomingdale Ave Riverview, FL 33578 (813) 261-3664 Fax: (813) 261-3597 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1124045513-0 11110 Causeway Blvd Brandon, FL 33511 (813) 661-4816 Fax: (813) 661-4904 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1336551407-0 4525 Gunn Hwy Tampa, FL 33624 (813) 261-6088 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1598782807-0 2602 James L Redman Pkwy Plant City, FL 33566 (813) 752-5765 Fax: (813) 754-1179 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1033136429-0 1505 N Dale Mabry Hwy Tampa, FL 33607 (813) 876-0599 Fax: (813) 872-0779 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1154348456-0 6192 Gunn Hwy Tampa, FL 33625 (813) 968-4359 Fax: (813) 963-6731 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1417974718-0 8220 N Dale Mabry Hwy Tampa, FL 33614 (813) 887-3058 Fax: (813) 887-5810 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1609023415-0 1601 W Kennedy Blvd Tampa, FL 33606 (813) 254-6125 Fax: (813) 254-6319 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1043237415-0 4928 State Rd 674 Wimauma, FL 33598 (813) 633-1463 Fax: (813) 634-1764 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1215954615-0 19910 Bruce B Downs Blvd Tampa, FL 33647 (813) 907-7587 Fax: (813) 907-7798 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1457775124-0 15302 N Nebraska Ave Tampa, FL 33613 (813) 371-0375 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1669499059-0 2701 E Fletcher Ave Tampa, FL 33612 (813) 558-0383 Fax: (813) 558-8964 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1043237423-0 7011 W Waters Ave Tampa, FL 33634 (813) 881-0802 Fax: (813) 885-9532 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1295139061-0 10327 Big Bend Rd Riverview, FL 33578 (813) 498-4101 Fax: (813) 498-4100 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1497062442-0 4302 W Gandy Blvd Tampa, FL 33611 (813) 839-3175 Fax: (813) 371-9445 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 757

Walmart Pharmacy Provider ID: TPV1538563309-0 3671 W Hillsborough Ave Tampa, FL 33614 (813) 498-4097 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1689691065-0 14941 N Dale Mabry Hwy Tampa, FL 33618 (813) 265-8870 Fax: (813) 960-3896 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont.

Walmart Pharmacy Provider ID: TPV1932592243-0 1720 E Hillsborough Ave Walmart Pharmacy Provider ID: TPV1689692022-0 Tampa, FL 33610 (813) 675-3697 11720 Dr Martin L King Jr Blvd 00 Yrs/99 Yrs Seffner (Mango), FL 33584 M-F 9:00 AM - 9:00 PM (813) 684-0292 Sat 9:00 AM - 7:00 PM Fax: (813) 689-5403 Sun 10:00 AM - 6:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Walmart Pharmacy Sat 9:00 AM - 5:00 PM Provider ID: TPV1952320939-0 949 E Bloomingdale Ave Walmart Pharmacy Brandon, FL 33511 Provider ID: TPV1760400618-0 (813) 681-6481 1575 Land O Lakes Blvd Fax: (813) 684-7343 Lutz, FL 33549 00 Yrs/99 Yrs (813) 949-3664 M-F 9:00 AM - 9:00 PM Fax: (813) 949-4642 Sat 9:00 AM - 7:00 PM 00 Yrs/99 Yrs Sun 10:00 AM - 6:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Wecare Pharmacy LLC Sun 10:00 AM - 6:00 PM Provider ID: TPV1396067799-0 7830 Gunn Hwy Ste A Walmart Pharmacy Tampa, FL 33626 Provider ID: TPV1790703122-0 (813) 908-6868 9205 Gibsonton Dr Fax: (813) 908-1818 Gibsonton, FL 33534 00 Yrs/99 Yrs (813) 672-4932 Languages: Spanish, Chinese Fax: (813) 672-4957 M-F 9:00 AM - 5:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 1:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Wellness Pharmacy Inc Sun 10:00 AM - 6:00 PM Provider ID: TPV1811201452-0 120 W Bougainvillea Ave Walmart Pharmacy Tampa, FL 33612 Provider ID: TPV1871510172-0 (813) 774-8856 8885 N Florida Ave Fax: (813) 319-3760 Tampa, FL 33604 00 Yrs/99 Yrs (813) 932-0723 Languages: Spanish, Arabic Fax: (813) 932-1886 M-F 9:00 AM - 5:00 PM 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM West Coast Pharmacy LLC Sat 8:00 AM - 7:00 PM Provider ID: TPV1760575542-0 Sun 11:00 AM - 5:00 PM 8439 N Florida Ave Tampa, FL 33604 Walmart Pharmacy Provider ID: TPV1902825987-0 (813) 932-8380 Fax: (813) 915-8617 1208 E Brandon Blvd 00 Yrs/99 Yrs Brandon, FL 33511 Languages: Spanish (813) 643-5885 M-F 9:00 AM - 5:00 PM Fax: (813) 643-9356 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

West Shore Pharmacy Provider ID: TPV1467520262-0 3206 S W. Shore Blvd Tampa, FL 33629 (813) 837-9095 Fax: (813) 839-0902 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1215958681-0 6188 US 41 Apollo Beach, FL 33572 (941) 649-1304 Fax: (813) 649-1305 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 6:00 PM Sun 9:00 AM - 5:00 PM

Williams Pharmacy Provider ID: TPV1720315153-0 2808 North Tampa St Tampa, FL 33602 (813) 223-4303 Fax: (813) 223-4149 00 Yrs/99 Yrs M-W 7:00 AM - 7:00 PM TH 2:00 AM - 6:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1245652668-0 2770 Fowler Ave Tampa, FL 33612 (813) 972-4605 Fax: (813) 977-0486 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1083036750-0 16751 Fishhawk Blvd Lithia, FL 33547 (813) 643-5123 Fax: (813) 643-7034 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM Winn-Dixie Pharmacy Provider ID: TPV1124049432-0 8424 Sheldon Rd Tampa, FL 33615 (813) 886-9427 Fax: (813) 886-9280 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1144642828-0 4317 Gandy Blvd Tampa, FL 33611 (813) 839-5411 Fax: (813) 835-8128 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

www.wellcare.com/Florida | 758

Winn-Dixie Pharmacy Provider ID: TPV1255352555-0 9535 E Fowler Ave Thonotosassa, FL 33592 (813) 986-0788 Fax: (813) 986-9607 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 6:00 PM Sun 9:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1255753026-0 252 Harbor Village Lane Apollo Beach, FL 33572 (813) 645-9739 Fax: (813) 641-3039 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 9:00 AM - 3:00 PM Winn-Dixie Pharmacy Provider ID: TPV1346261641-0 2525 E Hillsborough Ave Tampa, FL 33610 (813) 237-1282 Fax: (813) 237-6454 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 6:00 PM Sun 9:00 AM - 5:00 PM

Last update 08/14/2017

Pharmacy Hillsborough Retail - cont. Winn-Dixie Pharmacy Provider ID: TPV1356763031-0 1023 N Tamiami Trail Ruskin, FL 33570 (813) 645-3871 Fax: (813) 645-5433 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1447271812-0 8438 N Armenia Ave Tampa, FL 33604 (813) 931-7728 Fax: (813) 933-6631 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 9:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1447672860-0 8837 N 56th St Tampa, FL 33617 (813) 988-4357 Fax: (813) 984-8404 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1457773129-0 2535 State Rd 60 East Valrico, FL 33594 (813) 657-4987 Fax: (813) 662-9167 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM Winn-Dixie Pharmacy Provider ID: TPV1477574770-0 18407 US Hwy 41 N Lutz, FL 33549 (813) 948-1560 Fax: (813) 949-0367 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1497177174-0 6929 US Hwy 301 S Riverview, FL 33578 (813) 677-6088 Fax: (813) 671-2314 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1659392959-0 179 E Bloomingdale Ave Brandon, FL 33511 (813) 681-9858 Fax: (813) 661-3602 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1497177802-0 2525 N Dale Mabry Tampa, FL 33607 (813) 870-1476 Fax: (813) 871-2031 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1700208121-0 750 Martin Luther King W Seffner, FL 33584 (813) 651-1588 Fax: (813) 655-1203 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

Winn-Dixie Pharmacy Winn-Dixie Pharmacy Provider ID: TPV1528480209-0 Provider ID: TPV1760804173-0 205 W Alexander St 13508 Florida Ave Plant City, FL 33563 Tampa, FL 33613 (813) 754-9449 (813) 962-0768 Fax: (813) 719-7902 Fax: (813) 269-4550 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 6:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM Winn-Dixie Pharmacy Provider ID: TPV1538581004-0 Winn-Dixie Pharmacy 10579 Big Bend Rd Provider ID: TPV1932521358-0 Riverview, FL 33579 805 E Dr Martin Luther King Jr (813) 234-3216 Tampa, FL 33603 Fax: (813) 234-3264 (813) 277-0292 00 Yrs/99 Yrs Fax: (813) 301-0067 M-F 8:00 AM - 8:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 5:00 PM M-F 9:00 AM - 9:00 PM Sun 10:00 AM - 4:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1639190945-0 Xtra Care Pharmacy 4445 Sun City Center Blvd Provider ID: TPV1184063455-0 Sun City Center, FL 33573 6520 US Hwy S 301 (813) 633-9695 Riverview, FL 33578 Fax: (813) 633-6641 (813) 280-0927 00 Yrs/99 Yrs Fax: (813) 677-4500 M-F 8:00 AM - 8:00 PM 00 Yrs/99 Yrs Sat-Sun 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 5:00 PM

www.wellcare.com/Florida | 759

Specialty Exactus Pharmacy Solutions Inc Provider ID: TPV1073733408-0 4110 George Rd Ste 100 Tampa, FL 33634 (866) 458-9246 Fax: (866) 458-9245 00 Yrs/99 Yrs Languages: French, Chinese, German M-TH 8:00 AM - 7:00 PM F 8:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Manatee Retail Advance Pharmacy-2 Provider ID: TPV1770974750-0 5325 26th St W Bradenton, FL 34207 (941) 216-3788 Fax: (941) 216-3789 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Bayshore Pharmacy Provider ID: TPV1861718892-0 6229 14th St W Bradenton, FL 34207 (941) 753-6075 Fax: (941) 753-1417 00 Yrs/99 Yrs Languages: Spanish, Russian, Hindi M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM Benzer Pharmacy Provider ID: TPV1053770420-0 2104 59th St W Bradenton, FL 34209 (813) 304-2221 Fax: (888) 239-8423 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Bradenton Hometown Pharmacy Provider ID: TPV1295933299-0 1407 57th Ave W Bradenton, FL 34207 (941) 727-9120 Fax: (941) 727-9122 00 Yrs/99 Yrs Languages: Polish M-F 9:00 AM - 5:00 PM Central Pharmacy Provider ID: TPV1770668188-0 1505 26th Ave E Bradenton, FL 34208 (941) 776-4000 Fax: (941) 845-4963 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

CVS Provider ID: TPV1164526042-0 3724 84th Ave Cir E Sarasota, FL 34243 (941) 360-6707 Fax: (941) 358-1475 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1467522375-0 5310 45th St E Bradenton, FL 34203 (941) 751-4472 Fax: (941) 751-4688 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1184729923-0 8700 US Hwy 301 N Parrish, FL 34219 (941) 776-5039 Fax: (941) 776-2335 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1467556381-0 520 1st St Bradenton, FL 34208 (941) 746-9259 Fax: (941) 744-0259 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1194747717-0 6150 14th St W Bradenton, FL 34207 (941) 756-3582 Fax: (941) 799-5808 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

CVS Provider ID: TPV1508960584-0 6204 14th St W Bradenton, FL 34207 (941) 755-3716 Fax: (941) 758-9406 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1205930153-0 611 Manatee Ave Holmes Beach, FL 34217 (941) 778-1411 Fax: (941) 779-9444 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1538263447-0 5403 University Pkwy University Park, FL 34201 (941) 355-0456 Fax: (941) 360-1151 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1275637258-0 3813 Manatee Ave W Bradenton, FL 34205 (941) 747-5944 Fax: (941) 747-4927 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1811091705-0 945 8th Ave W Palmetto, FL 34221 (941) 722-0529 Fax: (941) 729-4339 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 760

CVS Provider ID: TPV1881776243-0 101 N Cattlemen Rd Sarasota, FL 34243 (941) 360-7521 Fax: (941) 360-7531 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat-Sun 9:00 AM - 6:00 PM CVS Provider ID: TPV1902900822-0 4302 Cortez Rd W Bradenton, FL 34210 (941) 794-2899 Fax: (941) 792-2583 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1942307434-0 7195 53rd Ave E Bradenton, FL 34203 (941) 727-2803 Fax: (941) 727-2813 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1952405839-0 1520 Lakewood Ranch Blvd Bradenton, FL 34211 (941) 745-1076 Fax: (941) 748-4802 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM East Manatee Pharmacy Provider ID: TPV1710909312-0 1312 Manatee Ave E Bradenton, FL 34208 (941) 708-8520 Fax: (941) 708-8728 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 8:00 PM

Last update 08/14/2017

Pharmacy Manatee Retail - cont. Ellenton Discount Pharmacy Provider ID: TPV1407214885-0 8324 US Hwy 301 N Parrish, FL 34219 (941) 444-2233 Fax: (941) 417-7144 00 Yrs/99 Yrs Languages: Hindi M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM Fairway Pharmacy Provider ID: TPV1316205271-0 5139 Manatee Ave W Bradenton, FL 34209 (941) 538-7122 Fax: (941) 538-7133 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 3:00 PM

Lawton Chiles Childfamily Health Center Provider ID: TPV1225052095-0 1515 26th Ave E Bradenton, FL 34208 (941) 776-4000 Fax: (941) 845-4963 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Manatee Discount Pharmacy Provider ID: TPV1831515121-0 3549 1st St Bradenton, FL 34208 (941) 209-1234 Fax: (941) 209-1177 00 Yrs/99 Yrs Languages: French, Russian, Arabic M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM

Pelots Pharmacy Provider ID: TPV1003837345-0 831 Manatee Ave E Bradenton, FL 34208 (941) 748-8130 Fax: (941) 749-5406 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM SAMS CLUB Provider ID: TPV1578580973-0 5300 30th St E Bradenton, FL 34203 (941) 727-6896 Fax: (941) 727-6978 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM

Southeast Pharmacy Provider ID: TPV1295769362-0 919 53rd Ave E Bradenton, FL 34203 Manatee Family Pharmacy (941) 776-4000 Familycare Discount Pharmacy Provider ID: TPV1245650852-0 Fax: (941) 845-4963 3705 Manatee Ave W 00 Yrs/99 Yrs Bradenton, FL 34205 Languages: Spanish Provider ID: TPV1861793655-0 (941) 281-2903 MTWF 8:00 AM - 5:00 PM 3633 Cortez Rd W Ste B9 Fax: (941) 281-2906 TH 8:00 AM - 8:00 PM Bradenton, FL 34210 00 Yrs/99 Yrs (941) 914-9991 Truecare Pharmacy M-F 9:00 AM - 6:00 PM Fax: (941) 914-9160 Sat 9:00 AM 2:00 PM Provider ID: TPV1669755195-0 00 Yrs/99 Yrs 304 W Main St Languages: Hindi North Manatee Pharmacy Bowling Green, FL 33834 M-F 8:00 AM - 6:00 PM Provider ID: TPV1356363121-0 (863) 375-3699 Sat 9:00 AM - 2:00 PM 5600 Bayshore Rd Fax: (863) 375-2057 Palmetto, FL 34221 00 Yrs/99 Yrs Genoa-QOL Healthcare (941) 721-2028 M-F 9:00 AM - 6:00 PM Provider ID: TPV1730124397-0 Fax: (941) 721-2031 379 6th Ave W University Pharmacy 00 Yrs/99 Yrs Bradenton, FL 34205 Provider ID: TPV1487956421-0 Languages: Spanish (941) 748-9409 8451 Shade Ave Ste 108 MTTHF 8:00 AM - 5:00 PM Fax: (941) 748-9634 Sarasota, FL 34243 W 8:00 AM 1:00 PM 00 Yrs/99 Yrs (941) 355-2500 M-F 8:00 AM - 5:00 PM Palmetto Drug Mart Fax: (941) 355-2511 00 Yrs/99 Yrs Provider ID: TPV1316243686-0 Lakewood Ranch Pharmacy M-F 9:00 AM - 6:00 PM 907 10th St E Sat 9:00 AM - 1:00 PM Palmetto, FL 34221 Provider ID: TPV1275772915-0 (941) 404-4121 6310 Health Park Way Ste 130 Fax: (941) 404-4122 Lakewood Ranch, FL 34202 00 Yrs/99 Yrs (941) 907-1500 Languages: Spanish, Hindi Fax: (941) 907-1544 M-F 9:00 AM - 7:00 PM 00 Yrs/99 Yrs Sat 10:00 AM - 3:00 PM Languages: Hindi M-F 8:00 AM - 6:00 PM

www.wellcare.com/Florida | 761

Vanguard Advanced Pharmacy Systems Provider ID: TPV1417045493-0 905 Manatee Ave E Bradenton, FL 34208 (941) 739-9974 Fax: (941) 755-3967 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Walmart Pharmacy Provider ID: TPV1063439438-0 5315 Cortez Rd W Bradenton, FL 34210 (941) 795-1807 Fax: (941) 795-1710 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1407873706-0 6225 E State Rd 64 Bradenton, FL 34208 (941) 708-2812 Fax: (941) 708-2814 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1619336914-0 4536 53rd Ave East Bradenton, FL 34203 (941) 213-6910 Fax: (941) 213-6909 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1770500142-0 8320 Lockwood Ridge Rd Sarasota, FL 34243 (941) 351-7060 Fax: (941) 351-9162 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Manatee Retail - cont. Walmart Pharmacy Provider ID: TPV1871510180-0 2911 53rd Ave E Bradenton, FL 34203 (941) 753-6764 Fax: (941) 758-7343 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1942572037-0 5810 Ranch Lake Blvd Bradenton, FL 34202 (941) 799-5545 Fax: (941) 799-5539 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1962429274-0 508 10th St E Palmetto, FL 34221 (941) 723-2677 Fax: (941) 723-2844 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 11:00 AM - 5:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1568884245-0 515 7th St Palmetto, FL 34221 (941) 722-8624 Fax: (941) 721-7106 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1588086094-0 5802 14th St W. Bradenton, FL 34207 (941) 751-4738 Fax: (941) 751-4841 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM Winn-Dixie Pharmacy Provider ID: TPV1598187288-0 5805 Manatee Ave Bradenton, FL 34209 (941) 795-5075 Fax: (941) 794-6946 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1033130349-0 7400 Cortez Rd W Bradenton, FL 34210 (941) 795-5185 Fax: (941) 795-5385 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1114948585-0 1010 53rd Ave E Bradenton, FL 34203 (941) 727-2797 Fax: (941) 727-2792 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

www.wellcare.com/Florida | 762

Last update 08/14/2017

Pharmacy Pasco Retail 1st Choice Pharmacy Provider ID: TPV1891971198-0 2208 US Hwy 19 Holiday, FL 34691 (727) 934-1300 Fax: (727) 934-1313 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM Ab Specialty Pharmacy Inc Provider ID: TPV1871708735-0 2311 Seven Springs Blvd New Port Richey, FL 34655 (727) 375-9520 Fax: (727) 375-9552 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 5:00 PM

Benzer Pharmacy Provider ID: TPV1437535234-0 3535 US Hwy 19 New Port Richey, FL 34652 (727) 848-8400 Fax: (727) 848-8422 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM Benzer Pharmacy Provider ID: TPV1922450196-0 34490 Cortez Blvd Ridge Manor, FL 33523 (813) 304-2221 Fax: (888) 239-8423 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 10:00 AM - 2:00 PM

Blake Pharmacy Provider ID: TPV1659513638-0 5628 Trouble Creek Rd New Port Richey, FL 34652 Aum Pharmacy (727) 846-7600 Provider ID: TPV1205060464-0 Fax: (727) 846-8866 00 Yrs/99 Yrs 2646 Narnia Way Unit 101 Languages: Hindi Land O Lakes, FL 34638 M-F 9:00 AM - 6:00 PM (813) 388-6875 Sat 10:00 AM - 1:00 PM Fax: (813) 388-6871 00 Yrs/99 Yrs CVS Languages: Hindi Provider ID: TPV1023112935-0 M-F 9:00 AM - 6:00 PM 36440 State Rd 54 Zephyrhills, FL 33541 Axcess Pharmacy (813) 782-9515 Provider ID: TPV1073813309-0 Fax: (813) 788-0532 5504 Gateway Blvd Ste 102 00 Yrs/99 Yrs Wesley Chapel, FL 33544 M-F 8:00 AM - 9:00 PM (813) 333-1494 Sat 9:00 AM - 6:00 PM Fax: (888) 556-8496 Sun 10:00 AM - 6:00 PM 00 Yrs/99 Yrs Languages: Spanish, Hindi CVS M-F 10:00 AM - 6:00 PM Provider ID: TPV1043314933-0 Sat 10:00 AM - 7:00 PM 7325 State Rd 54 Benzer Pharmacy Provider ID: TPV1225406200-0 2653 Bruce B Downs Blvd Ste 115 Wesley Chapel, FL 33544 (813) 991-9200 Fax: (813) 991-1900 00 Yrs/99 Yrs M-F 8:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM

New Port Richey, FL 34653 (727) 376-7415 Fax: (727) 376-7356 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1053415034-0 2513 US Hwy 19 Holiday, FL 34691 (727) 937-5193 Fax: (727) 942-6310 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1215124292-0 5606 Post Oak Blvd Wesley Chapel, FL 33544 (813) 973-3786 Fax: (813) 991-5832 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1083718985-0 12015 Little Rd Hudson, FL 34667 (727) 862-3573 Fax: (727) 862-5185 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1235233214-0 12804 US Hwy 301 Dade City, FL 33525 (352) 567-5656 Fax: (352) 567-9615 00 Yrs/99 Yrs

CVS Provider ID: TPV1104070101-0 30050 County Line Rd Wesley Chapel, FL 33543 (813) 907-1423 Fax: (813) 994-6367 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1144324120-0 13839 Little Rd Hudson, FL 34667 (727) 868-9420 Fax: (727) 863-5175 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1154425130-0 37943 Eiland Blvd Zephyrhills, FL 33542 (813) 788-0224 Fax: (813) 788-0955 00 Yrs/99 Yrs

www.wellcare.com/Florida | 763

CVS Provider ID: TPV1285738179-0 11938 US Hwy 19 Port Richey, FL 34668 (727) 868-9408 Fax: (727) 862-5351 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1386748366-0 11500 Ridge Rd New Port Richey, FL 34654 (727) 856-1334 Fax: (727) 856-1458 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1548364409-0 7071 Mitchell Blvd New Port Richey, FL 34655 (727) 376-8181 Fax: (727) 372-6408 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Pasco Retail - cont.

CVS Provider ID: TPV1720182702-0 CVS 3511 US Hwy 19 Provider ID: TPV1548364466-0 New Port Richey, FL 34652 7120 Ridge Rd (727) 841-8205 Port Richey, FL 34668 Fax: (727) 841-8271 (727) 848-3442 00 Yrs/99 Yrs Fax: (727) 843-8092 M-F 9:00 AM - 9:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 6:00 PM M-F 8:00 AM - 9:00 PM Sun 10:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM CVS Sun 10:00 AM - 6:00 PM Provider ID: TPV1730101387-0 CVS 1201 County Rd 581 Provider ID: TPV1558442657-0 Wesley Chapel, FL 33544 1929 Bruce B Downs Blvd (813) 907-6682 Wesley Chapel, FL 33544 Fax: (813) 528-4690 (813) 991-1293 00 Yrs/99 Yrs Fax: (813) 991-5761 M-F 9:00 AM - 9:00 PM 00 Yrs/99 Yrs Sat-Sun 9:00 AM - 6:00 PM

Elfers Pharmacy Healthmart Provider ID: TPV1114166691-0 6113 State Rd 54 New Port Richey, FL 34653 (727) 849-6000 Fax: (727) 849-6007 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

Florida Pharmacy Provider ID: TPV1891924569-0 5445 James St New Port Richey, FL 34652 (727) 848-8300 Fax: (727) 848-8330 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM

Embassy Pharmacy Provider ID: TPV1215208616-0 9320 US Hwy 19 N Port Richey, FL 34668 (727) 842-3400 Fax: (727) 842-3800 00 Yrs/99 Yrs Languages: Spanish, German, Arabic M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 7:00 PM

Harbor Behavioral Health Care Provider ID: TPV1508864521-0 8002 King Helie Blvd New Port Richey, FL 34653 (727) 841-4455 Fax: (727) 841-4393 00 Yrs/99 Yrs Languages: Spanish, Vietnamese M-F 9:00 AM - 4:00 PM

CVS CVS Provider ID: TPV1649425448-0 Provider ID: TPV1962424564-0 10925 State Rd 54 Hudson Pharmacy 2900 Little Rd Empire Pharmacy New Port Richey, FL 34655 Provider ID: TPV1386969665-0 Trinity, FL 34655 Provider ID: TPV1033564836-0 (727) 372-9030 8117 State Rd 52 (727) 376-5466 6834 Gall Blvd Ste 105 Fax: (727) 372-9386 Hudson, FL 34667 Fax: (727) 264-5113 Zephyrhills, FL 33542 00 Yrs/99 Yrs (727) 378-5882 00 Yrs/99 Yrs (813) 602-8729 M-F 8:00 AM - 9:00 PM Fax: (727) 378-5883 M-F 9:00 AM - 9:00 PM Fax: (813) 602-8759 Sat 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat-Sun 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sun 10:00 AM - 6:00 PM Languages: Spanish, Hindi M-TH 9:00 AM - 5:00 PM Doctors Choice Pharmacy M-F 9:00 AM - 6:00 PM F 10:00 AM 2:00 PM CVS Provider ID: TPV1700822640-0 Provider ID: TPV1659525657-0 7455 State Rd 52 Florida Med Clinic Pharmacy Jacks Pharmacy 34502 State Rd 54 Provider ID: TPV1992144091-0 Bayonet Point, FL 34667 of Wiregrass Zephyrhills, FL 33541 7813 Mitchell Blvd Ste 113 (727) 697-1090 Provider ID: TPV1609323732-0 (813) 782-1865 New Port Richey, FL 34655 Fax: (727) 697-1074 2352 Bruce B Downs Blvd Fax: (813) 782-6827 (727) 375-9999 00 Yrs/99 Yrs Wesley Chapel, FL 33543 00 Yrs/99 Yrs Fax: (727) 375-9920 Languages: Spanish (813) 751-3377 M-F 8:00 AM - 9:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Fax: (813) 377-1672 Sat 9:00 AM - 6:00 PM M-F 10:00 AM - 6:00 PM 00 Yrs/99 Yrs Sun 10:00 AM - 6:00 PM Drug Store Healthmart Languages: Spanish Js Pharmacy Provider ID: TPV1669797569-0 M-F 8:00 AM - 6:00 PM CVS Provider ID: TPV1407251465-0 7535 Medical Dr Unit 1 Provider ID: TPV1700980786-0 6416 Ridge Rd Hudson, FL 34667 Florida Medical Clinic 5432 US Hwy 19 (727) 869-3784 Provider ID: TPV1669548020-0 Port Richey, FL 34668 New Port Richey, FL 34652 (727) 847-2211 Fax: (727) 869-3783 38045 Market Sq (727) 843-8645 Fax: (727) 847-2212 00 Yrs/99 Yrs Zephyrhills, FL 33542 Fax: (727) 843-8655 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM (813) 715-0354 00 Yrs/99 Yrs Languages: Spanish, Hindi Sat 9:00 AM 1:00 PM Fax: (813) 779-8049 M-F 8:00 AM - 9:00 PM M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM M-F 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 764

Last update 08/14/2017

Pharmacy Pasco Retail - cont. Land O Lakes Pharmacy Provider ID: TPV1043602618-0 7040 Land O Lakes Blvd Unit 10 Land O Lakes, FL 34638 (813) 803-7303 Fax: (813) 803-7305 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 8:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM Lily Care Pharmacy Provider ID: TPV1669869376-0 8811 State Rd 52 Ste 11 Hudson, FL 34667 (727) 233-9908 Fax: (727) 233-9910 00 Yrs/99 Yrs Languages: Vietnamese M-F 9:00 AM - 6:00 PM Little Road Pharmacy Provider ID: TPV1578814539-0 4211 Little Rd Unit 4 New Port Richey, FL 34655 (727) 372-5222 Fax: (727) 372-5225 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Magnolia Pharmacy Provider ID: TPV1841532108-0 12304 Curley St San Antonio, FL 33576 (352) 588-3330 Fax: (352) 588-3337 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Maxcare Pharmacy Provider ID: TPV1447523345-0 6624 US Hwy 19 New Port Richey, FL 34652 (727) 807-7050 Fax: (727) 807-6050 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 6:00 PM

Medicine Shoppe Pharmacy Provider ID: TPV1467652024-0 10720 State Rd 54 Ste 103 New Port Richey, FL 34655 (727) 375-2502 Fax: (727) 375-2508 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Medilink Pharmacy Provider ID: TPV1861886186-0 5812 State Rd 54 New Port Richey, FL 34652 (727) 846-1300 Fax: (727) 846-1310 00 Yrs/99 Yrs Languages: Hindi, Vietnamese M-F 9:00 AM - 6:00 PM Medsource Pharmacy Provider ID: TPV1245658236-0 13910 Fivay Rd Ste 3 Hudson, FL 34667 (727) 857-4837 Fax: (727) 857-4839 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Nimoh Pharmacy Compounding LLC Provider ID: TPV1053729418-0 12878 US Hwy 301 Dade City, FL 33525 (352) 437-5985 Fax: (352) 437-5986 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Rays Pharmacy Provider ID: TPV1457652257-0 1936 US Hwy 19 N Holiday, FL 34691 (727) 945-7297 Fax: (727) 945-8600 00 Yrs/99 Yrs Languages: French, Hindi M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

Ricx Pharmacy RX Discount Pharmacy Provider ID: TPV1780098434-0 Provider ID: TPV1033342654-0 10618 Devco Dr 12620 US Hwy 301 Port Richey, FL 34668 Dade City, FL 33525 (727) 863-4035 (352) 521-0155 Fax: (727) 863-5690 Fax: (352) 521-0675 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Rowan Discount Pharmacy Sat 9:00 AM - 1:00 PM Provider ID: TPV1083097026-0 SAMS CLUB Provider ID: TPV1881611192-0 4140 Rowan Rd 27727 State Rd 56 New Port Richey, FL 34653 Wesley Chapel, FL 33544 (727) 372-1070 (813) 929-7095 Fax: (727) 372-1357 Fax: (813) 929-7097 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 7:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Royal Pharmacy Provider ID: TPV1497053920-0 5335 Main St New Port Richey, FL 34652 (727) 845-8000 Fax: (727) 845-8008 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM RX Care Pharmacy Provider ID: TPV1871895433-0 38008 North Ave Zephyrhills, FL 33542 (813) 780-7216 Fax: (813) 780-6888 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 8:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM RX Care Pharmacy Kwik Mart Provider ID: TPV1447275391-0 14306 7th St Dade City, FL 33523 (352) 567-2238 Fax: (352) 567-2259 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

www.wellcare.com/Florida | 765

SAMS CLUB Provider ID: TPV1891712303-0 4330 US 19 New Port Richey, FL 34652 (727) 815-1483 Fax: (727) 815-9574 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM Save N Care Pharmacy Provider ID: TPV1518202878-0 13850 Little Rd Hudson, FL 34667 (727) 863-5200 Fax: (727) 863-5225 00 Yrs/99 Yrs Languages: Spanish, Arabic M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM South Lake Pharmacy Provider ID: TPV1700194800-0 38101 5th Ave Zephyrhills, FL 33542 (813) 395-5667 Fax: (813) 715-2478 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

Last update 08/14/2017

Pharmacy Pasco Retail - cont. St Josephs Pharmacy Provider ID: TPV1326294919-0 35780 State Rd 54 Ste 101 Zephyrhills, FL 33541 (813) 782-4854 Fax: (813) 569-0105 00 Yrs/99 Yrs Languages: Spanish, Hindi, Arabic M-F 10:00 AM - 5:00 PM Starcare Pharmacy Provider ID: TPV1629514864-0 7200 Ridge Rd Ste Ste 106 Port Richey, FL 34668 (727) 312-8888 Fax: (727) 312-8889 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Summergate Pharmacy Provider ID: TPV1669728176-0 27432 Cashford Cir Ste 101 Wesley Chapel, FL 33544 (813) 667-6100 Fax: (813) 667-6200 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Suntrust Pharmacy Provider ID: TPV1811399041-0 6237 Ridge Rd Port Richey, FL 34668 (727) 914-5900 Fax: (727) 835-7831 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1154348522-0 8745 State Rd 54 New Port Richey, FL 34655 (727) 376-5545 Fax: (727) 376-0827 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1679977540-0 8745 Little Rd New Port Richey, FL 34654 (727) 264-5224 Fax: (727) 264-5223 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1578584876-0 1640 US Hwy 19 Holiday, FL 34691 (727) 938-3731 Fax: (727) 943-8159 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 8:00 AM - 6:00 PM Sun 9:00 AM - 5:00 PM

Walmart Pharmacy Provider ID: TPV1194901520-0 12610 US Hwy 19 Hudson, FL 34667 (727) 861-0050 Fax: (727) 861-0052 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1801206727-0 28500 State Rd 54 Wesley Chapel, FL 33543 (813) 262-6844 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1750703161-0 6400 Massachusetts New Port Richey, FL 34653 (727) 841-8645 Fax: (727) 842-7916 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

Walmart Pharmacy Provider ID: TPV1396762779-0 7425 Gall Blvd Zephyrhills, FL 33541 (813) 782-4110 Fax: (813) 788-5293 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1396895637-0 8701 US Hwy 19 Port Richey, FL 34668 (727) 846-1093 Fax: (727) 849-7950 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

The Medicine Shoppe Provider ID: TPV1699944439-0 Walmart Pharmacy 4539 Grand Blvd Provider ID: TPV1417975848-0 New Port Richey, FL 34652 12650 US Hwy 301 (727) 845-5550 Dade City, FL 33525 Fax: (727) 836-9905 (352) 567-1771 00 Yrs/99 Yrs Fax: (352) 567-1773 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1013339431-0 27301 Wesley Chapel Blvd Wesley Chapel, FL 33544 (813) 994-6630 Fax: (813) 994-8510 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1497776702-0 14134 US Hwy 19 Hudson, FL 34667 (727) 869-3114 Fax: (727) 861-2412 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 6:00 PM Winn-Dixie Pharmacy Provider ID: TPV1538180849-0 12120 Moon Lake Rd New Port Richey, FL 34654 (727) 856-3588 Fax: (727) 856-2705 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat-Sun 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 766

Xtra Discount Drugs Provider ID: TPV1174600902-0 6953 Gall Blvd Zephyrhills, FL 33542 (813) 788-7885 Fax: (813) 788-0950 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Z Orange Pharmacy Provider ID: TPV1710335971-0 7268 SR 54 New Port Richey, FL 34653 (727) 312-3155 Fax: (727) 312-3166 00 Yrs/99 Yrs Languages: German, Arabic M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail 1st Choice Pharmacy Provider ID: TPV1558657718-0 8808 4th St N Saint Petersburg, FL 33702 (727) 954-8877 Fax: (727) 329-8872 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM

All Childrens Outpatient Pharmacy Provider ID: TPV1346343555-0 501 6th Ave S Saint Petersburg, FL 33701 (727) 767-8933 Fax: (727) 767-8818 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 1:00 AM - 11:00 PM

4th Street Pharmacy Provider ID: TPV1518109685-0 5415 4th St N Saint Petersburg, FL 33703 (727) 329-8798 Fax: (727) 329-8800 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Alpha-Omega Pharmacy Provider ID: TPV1770828741-0 4625 East Bay Dr Ste 313 Clearwater, FL 33764 (844) 557-0835 Fax: (800) 563-2710 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

54th Ave Pharmacy Provider ID: TPV1760891147-0 2705 54th Ave N Ste 6 Saint Petersburg, FL 33714 (727) 350-1500 Fax: (727) 388-8216 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM

Amen Pharmacy Provider ID: TPV1003060195-0 521 Dr Martin Luther King Jr S Saint Petersburg, FL 33705 (727) 209-0619 Fax: (727) 209-0625 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

AHF Pharmacy - Safety Harbor Provider ID: TPV1659321933-0 3135 State Rd 580 Ste 1 Safety Harbor, FL 34695 (727) 259-2000 Fax: (727) 259-2001 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Alexander Pharmacy Provider ID: TPV1912210758-0 6530 Park Blvd Pinellas Park, FL 33781 (727) 623-0962 Fax: (727) 329-8711 00 Yrs/99 Yrs Languages: Vietnamese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Bay Dermat Cosmetic Surgery Baycare Homecare Provider ID: TPV1225090087-0 Provider ID: TPV1740694942-0 8452 118th Ave Largo, FL 33773 7500 Gulf Blvd Ste B (727) 394-6585 Saint Pete Beach, FL 33706 Fax: (727) 394-6540 (727) 585-8591 00 Yrs/99 Yrs Fax: (925) 269-8423 Languages: Hindi 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM Bay Life Pharmacy Baycare Pharmacy Provider ID: TPV1407044035-0 Provider ID: TPV1619336195-0 1235 S Missouri Ave 303 Pinellas St Clearwater, FL 33756 Clearwater, FL 33756 (727) 581-5400 (727) 462-3311 Fax: (727) 581-5411 Fax: (727) 333-6073 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM MWTHF 8:00 AM - 7:00 PM Sat 9:00 AM - 1:00 PM T 8:00 AM - 5:00 PM Bay Life Pharmacy Provider ID: TPV1952779282-0 2864 W. Bay Dr Belleair Bluffs, FL 33770 (727) 400-4860 Fax: (727) 400-4861 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Bay Life Pharmacy II Anclote Pharmacy Provider ID: TPV1205115656-0 Provider ID: TPV1346565645-0 2090 Gulf To Bay Blvd 1933 N Pinellas Ave Clearwater, FL 33765 Tarpon Springs, FL 34689 (727) 216-6374 (727) 944-5800 Fax: (727) 400-6948 Fax: (727) 944-5844 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Hindi Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Sat 9:00 AM - 2:00 PM Bay Life Pharmacy III Provider ID: TPV1558616391-0 Asap Pharmacy 3350 East Bay Dr Provider ID: TPV1346314861-0 Largo, FL 33771 1361 Main St (727) 614-9933 Dunedin, FL 34698 Fax: (727) 614-9934 (727) 281-8242 00 Yrs/99 Yrs Fax: (727) 281-8289 M 9:00 AM - 6:00 PM 00 Yrs/99 Yrs TWTHF 9:00 AM - 4:00 PM M-F 10:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

www.wellcare.com/Florida | 767

Baycare Pharmacy Provider ID: TPV1669553715-0 1840 Mease Dr Ste 100 Safety Harbor, FL 34695 (727) 499-0085 Fax: (727) 499-0142 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Baycare Pharmacy Provider ID: TPV1679810568-0 620 10th St N Saint Petersburg, FL 33705 (727) 502-4144 Fax: (727) 502-4143 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Baydoun Pharmacy Provider ID: TPV1154624856-0 4749 34th St S Saint Petersburg, FL 33711 (727) 329-8868 Fax: (727) 329-8662 00 Yrs/99 Yrs Languages: Spanish, Arabic M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 3:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail - cont. Bayview Pharmacy Provider ID: TPV1700275716-0 11270 4th St N Ste 206 Saint Petersburg, FL 33716 (727) 317-5825 Fax: (727) 255-5484 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Benzer Pharmacy Provider ID: TPV1710352075-0 6280 66th St N Pinellas Park, FL 33781 (727) 544-4203 Fax: (727) 544-5200 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Care Plus Pharmacy Provider ID: TPV1316329014-0 33915 US Hwy 19 N Palm Harbor, FL 34684 (727) 784-6200 Fax: (727) 784-6210 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM Chen NBHD Medical Clearwater Provider ID: TPV1700310422-0 855 S. Highland Ave Clearwater, FL 33756 (727) 219-1833 Fax: (727) 219-1833 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM Chen NBHD Medical St Petersburg Provider ID: TPV1801320528-0 901 22nd Ave South Saint Petersburg, FL 33705 (727) 310-0925 Fax: (727) 310-0925 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 5:00 PM

Community Health Ctrs of Pinellas Provider ID: TPV1831236512-0 1344 22nd St S Saint Petersburg, FL 33712 (727) 824-8131 Fax: (727) 894-2734 00 Yrs/99 Yrs M-F 8:00 AM - 5:00 PM

CVS Provider ID: TPV1033132345-0 2747 Gulf To Bay Blvd Clearwater, FL 33759 (727) 431-0232 Fax: (727) 431-0980 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat-Sun 9:00 AM - 6:00 PM

Community Specialty Pharmacy Provider ID: TPV1982900981-0 2215 Dr Martin Luther King Jr Saint Petersburg, FL 33705 (727) 896-0001 Fax: (727) 896-0002 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM

CVS Provider ID: TPV1033213913-0 2390 E Bay Dr Largo, FL 33771 (727) 585-4774 Fax: (727) 586-4213 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Curant Health Florida Provider ID: TPV1205975257-0 11001 Roosevelt Blvd N Ste Saint Petersburg, FL 33716 (866) 448-8040 Fax: (866) 509-5866 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

CVS Provider ID: TPV1033213947-0 4000 E Bay Dr Clearwater, FL 33764 (727) 532-4157 Fax: (727) 538-5679 00 Yrs/99 Yrs M-F 9:00 AM - 10:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Curlew Pharmacy Provider ID: TPV1740456417-0 30226 US Hwy 19 N Clearwater, FL 33761 (727) 773-1600 Fax: (866) 568-1243 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM CVS Provider ID: TPV1013011931-0 3771 Tampa Rd Oldsmar, FL 34677 (813) 855-5781 Fax: (813) 854-2820 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1063516045-0 1000 E Tarpon Ave Tarpon Springs, FL 34689 (727) 937-4203 Fax: (727) 942-7687 00 Yrs/99 Yrs M-F 8:00 AM - 12:00 PM Sat-Sun 8:00 AM - 8:00 PM CVS Provider ID: TPV1063516938-0 2200 34th St N Saint Petersburg, FL 33713 (727) 328-7644 Fax: (727) 323-8065 00 Yrs/99 Yrs

www.wellcare.com/Florida | 768

CVS Provider ID: TPV1073535613-0 7701 Dr Martin Luther King Jr Saint Petersburg, FL 33702 (727) 576-3826 Fax: (727) 828-6088 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM CVS Provider ID: TPV1083718977-0 1298 County Rd 1 Dunedin, FL 34698 (727) 736-5686 Fax: (727) 734-5593 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1154425023-0 845 4th St N Saint Petersburg, FL 33701 (727) 821-1172 Fax: (727) 821-0883 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1174627152-0 13998 Walsingham Rd Largo, FL 33774 (727) 595-2521 Fax: (727) 596-8046 00 Yrs/99 Yrs CVS Provider ID: TPV1184728081-0 8905 Bryan Dairy Rd Largo, FL 33777 (727) 393-7542 Fax: (727) 319-9254 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail - cont. CVS Provider ID: TPV1184890667-0 3426 Central Ave Saint Petersburg, FL 33711 (727) 321-1257 Fax: (727) 327-3823 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1245334119-0 7101 Park Blvd Pinellas Park, FL 33781 (727) 544-1200 Fax: (727) 544-1044 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1316041221-0 2100 66th St N Saint Petersburg, FL 33710 (727) 345-3599 Fax: (727) 384-6763 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1326142308-0 23682 US Hwy 19 N Clearwater, FL 33765 (727) 799-0910 Fax: (727) 725-9231 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1346344314-0 2528 N McMullen Booth Rd Clearwater, FL 33761 (727) 797-5803 Fax: (727) 796-9602 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1356363998-0 4450 Park St N Saint Petersburg, FL 33709 (727) 541-3930 Fax: (727) 828-6101 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat-Sun 9:00 AM - 6:00 PM CVS Provider ID: TPV1356445332-0 7400 49th St Pinellas Park, FL 33781 (727) 544-1491 Fax: (727) 541-6123 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1366546251-0 7405 Starkey Rd Largo, FL 33777 (727) 391-9728 Fax: (727) 399-2095 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1376647297-0 5801 Central Ave Saint Petersburg, FL 33710 (727) 343-8116 Fax: (727) 347-1284 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1386748358-0 7850 131st St Seminole, FL 33776 (727) 398-4489 Fax: (727) 391-1468 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS CVS Provider ID: TPV1396849204-0 Provider ID: TPV1538263413-0 51 Missouri Ave N 467 Mandalay Ave Largo, FL 33770 Clearwater Beach, FL 33767 (727) 518-2951 (727) 447-6429 Fax: (727) 518-8461 Fax: (727) 441-1619 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1457455354-0 5400 4th St N Saint Petersburg, FL 33703 (727) 525-2184 Fax: (727) 522-6801 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1538263512-0 4260 6th St S Saint Petersburg, FL 33705 (727) 896-3119 Fax: (727) 823-2250 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1487758330-0 3765 Ulmerton Rd Clearwater, FL 33762 (727) 573-3383 Fax: (727) 572-5716 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1568566537-0 5345 66th St N Saint Petersburg, FL 33709 (727) 548-5768 Fax: (727) 548-5761 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1518061480-0 975 Tampa Rd Palm Harbor, FL 34683 (727) 772-8119 Fax: (727) 772-7748 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1629172598-0 2390 Belcher Rd S Largo, FL 33771 (727) 533-0731 Fax: (727) 533-8632 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1518061597-0 8001 Dr Martin Luther King Jr Saint Petersburg, FL 33702 (727) 577-6888 Fax: (727) 576-6226 00 Yrs/99 Yrs

CVS Provider ID: TPV1629172606-0 294 37th Ave N Saint Petersburg, FL 33704 (727) 896-3166 Fax: (727) 823-0341 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat-Sun 8:00 AM - 8:00 PM

www.wellcare.com/Florida | 769

Last update 08/14/2017

Pharmacy Pinellas Retail - cont.

CVS Provider ID: TPV1710081690-0 15222 Municipal Dr Madeira Beach, FL 33708 (727) 397-5535 Fax: (727) 398-1049 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS CVS Provider ID: TPV1780606392-0 Provider ID: TPV1952323578-0 CVS 7150 US Hwy 19 N 900 E Lake Rd Provider ID: TPV1649374554-0 Pinellas Park, FL 33781 Palm Harbor, FL 34685 3501 54th Ave S (727) 803-0023 (727) 784-5771 Saint Petersburg, FL 33711 Fax: (727) 324-2704 Fax: (727) 431-3528 (727) 864-1546 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (727) 864-9800 M-F 9:00 AM - 7:00 PM M-F 9:00 AM - 9:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 5:00 PM Sat-Sun 9:00 AM - 6:00 PM Sun 11:00 AM - 5:00 PM CVS CVS Provider ID: TPV1659475572-0 CVS CVS Provider ID: TPV1962506873-0 30387 US Hwy 19 N Provider ID: TPV1710081799-0 Provider ID: TPV1780788653-0 1899 N Highland Ave Clearwater, FL 33761 6820 Gulfport Blvd S 5405 49th St N Clearwater, FL 33755 (727) 781-2955 South Pasadena, FL 33707 Saint Petersburg, FL 33709 (727) 441-4585 Fax: (727) 781-2965 (727) 345-9103 (727) 527-8285 Fax: (727) 449-1377 00 Yrs/99 Yrs Fax: (727) 347-1844 Fax: (727) 527-8345 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM CVS M-F 8:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Provider ID: TPV1659475630-0 Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM 301 3rd St S Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Saint Petersburg, FL 33701 Danang Pharmacy (727) 822-7115 CVS CVS Provider ID: TPV1114323961-0 Fax: (727) 820-9877 Provider ID: TPV1730283698-0 Provider ID: TPV1790889772-0 5944 34th St N Ste 1 00 Yrs/99 Yrs 700 E Lake Rd 4685 Gulf Blvd Saint Petersburg, FL 33714 M-F 8:00 AM - 9:00 PM Palm Harbor, FL 34685 Saint Pete Beach, FL 33706 (727) 623-9854 Sat 9:00 AM - 6:00 PM (727) 785-6838 (727) 360-0818 Fax: (727) 623-9856 Sun 10:00 AM - 6:00 PM Fax: (727) 787-3134 Fax: (727) 367-1049 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Vietnamese CVS M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 9:00 PM MTWTHFSat 9:00 AM - 6:00 Provider ID: TPV1699879569-0 Sat 9:00 AM - 6:00 PM PM Sat 9:00 AM - 6:00 PM 2200 Gulf To Bay Blvd Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Clearwater, FL 33765 Dap Pharmacy Management (727) 791-3548 CVS and Consult CVS Fax: (727) 791-0669 Provider ID: TPV1740384668-0 Provider ID: TPV1801990882-0 Provider ID: TPV1730540980-0 00 Yrs/99 Yrs 2175 Main St 1 S Missouri Ave 11880 28th St N Ste 300 M-F 8:00 AM - 9:00 PM Dunedin, FL 34698 Clearwater, FL 33756 Saint Petersburgh, FL 33716 Sat 9:00 AM - 6:00 PM (727) 733-6241 (727) 446-6037 (727) 460-1855 Sun 10:00 AM - 6:00 PM Fax: (727) 736-8396 Fax: (727) 461-7627 Fax: (954) 253-4661 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs CVS M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 9:00 PM M-F 9:00 AM - 4:00 PM Provider ID: TPV1710081609-0 Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM 10200 Seminole Blvd Edwards Pharmacy Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Seminole, FL 33778 Provider ID: TPV1063651537-0 (727) 395-0139 CVS 12071 Indian Rocks Rd CVS Fax: (727) 395-9829 Provider ID: TPV1760586671-0 Largo, FL 33774 Provider ID: TPV1861414484-0 00 Yrs/99 Yrs 10195 66th St (727) 724-4171 10500 Ulmerton Rd M-F 8:00 AM - 9:00 PM Pinellas Park, FL 33782 Fax: (727) 216-6259 Largo, FL 33771 Sat 9:00 AM - 6:00 PM (727) 541-4681 00 Yrs/99 Yrs (727) 581-4424 Sun 10:00 AM - 6:00 PM Fax: (727) 545-4301 Languages: Hindi Fax: (727) 431-3508 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 10:00 AM - 2:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sat-Sun 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 770

Last update 08/14/2017

Pharmacy Pinellas Retail - cont. Empath Health Pharmacy Provider ID: TPV1407257470-0 11701 Belcher Rd S Ste 128 Largo, FL 33773 (727) 523-2572 Fax: (727) 523-2571 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Empath Health Pharmacy Provider ID: TPV1790194975-0 3050 1st Ave S Saint Petersburg, FL 33712 (727) 209-3500 Fax: (727) 209-3501 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 11:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Genoa-QOL Healthcare Provider ID: TPV1841572872-0 1437 S Belcher Rd Clearwater, FL 33764 (727) 533-9073 Fax: (727) 531-8500 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM

Healthnow Pharmacy Provider ID: TPV1457729618-0 7599 Park Blvd N Ste 100 Pinellas Park, FL 33781 (727) 999-2076 Fax: (727) 999-2078 00 Yrs/99 Yrs Languages: Vietnamese M-F 9:00 AM - 5:00 PM

Good Samaritan Pharmacy Hp Pharmacy Provider ID: TPV1659764959-0 Provider ID: TPV1245505247-0 33130 US Hwy 19 N 4616 Park Blvd N Palm Harbor, FL 34684 Pinellas Park, FL 33781 (727) 785-2640 (727) 827-2947 Fax: (727) 784-0701 Fax: (727) 827-2948 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Vietnamese Sat 9:00 AM - 2:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM Guardian Pharmacy

Provider ID: TPV1740485556-0 Hp Pharmacy 9402 International Ct N Provider ID: TPV1811216005-0 Saint Petersburg, FL 33716 8730 49th St N Ste 1 (727) 577-0000 Pinellas Park, FL 33782 Fax: (727) 577-5100 FMC Pharmacy Services (727) 954-8857 Provider ID: TPV1598864050-0 00 Yrs/99 Yrs Fax: (727) 954-8858 M-F 8:00 AM - 5:00 PM 11001 Danka Way N Ste 2 00 Yrs/99 Yrs Saint Petersburg, FL 33716 Languages: Vietnamese Gulfport Pharmacy (727) 568-9404 M-F 9:00 AM - 6:00 PM Provider ID: TPV1730598293-0 Fax: (727) 563-2013 Sat 9:00 AM - 3:00 PM 5004 Gulfport Blvd S 00 Yrs/99 Yrs Gulfport, FL 33707 Jk Care Pharmacy Languages: Spanish (727) 223-1075 Provider ID: TPV1164864039-0 M-F 8:00 AM - 5:00 PM Fax: (727) 388-8217 756 N Belcher Rd 00 Yrs/99 Yrs G and H Pharmacy Clearwater, FL 33765 Languages: Hindi Provider ID: TPV1962506147-0 (727) 447-6622 M-F 9:00 AM - 5:00 PM 8091 66th St N Fax: (727) 446-2288 Pinellas Park, FL 33781 00 Yrs/99 Yrs Healthmed Pharmacy (727) 209-9999 Languages: German, Arabic Provider ID: TPV1922236421-0 Fax: (727) 209-9977 M-F 9:00 AM - 6:00 PM 1839 Central Ave Fl 1 00 Yrs/99 Yrs Sat 10:00 AM - 2:00 PM Saint Petersburg, FL 33713 M-F 9:00 AM - 6:00 PM (727) 894-3001 King Pharmacy Compounding Fax: (727) 894-3000 Genoa-QOL Healthcare LLC 00 Yrs/99 Yrs Provider ID: TPV1518064351-0 Provider ID: TPV1851728703-0 Languages: Spanish, French, 4024 Central Ave 31201 US Hwy 19 N Ste 1 Italian Saint Petersburg, FL 33711 Palm Harbor, FL 34684 M-F 9:00 AM - 6:00 PM (727) 327-7262 (727) 772-6868 Fax: (727) 327-7292 Fax: (727) 772-6969 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 5:00 PM

www.wellcare.com/Florida | 771

Lake Seminole Pharmacy Provider ID: TPV1073987723-0 9117 Park Blvd N Seminole, FL 33777 (727) 592-4588 Fax: (727) 592-4541 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Lincourt Assisted Living, Inc Provider ID: TPV1750611331-0 501 Lincoln Ave Ste 10 Clearwater, FL 33756 (727) 479-3048 Fax: (727) 479-3047 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Lincourt Pharmacy Provider ID: TPV1134234164-0 501 S Lincoln Ave Clearwater, FL 33756 (727) 447-4248 Fax: (727) 445-9604 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Mail Meds Clinical Pharmacy Provider ID: TPV1356713127-0 3251 3rd Ave N Ste 125 Saint Petersburg, FL 33713 (239) 939-9226 Fax: (855) 523-0910 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Main Street Pharmacy Provider ID: TPV1487053344-0 531 Main St Ste K Safety Harbor, FL 34695 (727) 330-7530 Fax: (727) 286-8932 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM Sat 10:00 AM - 12:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail - cont.

Pegasus RX Pharmacy Provider ID: TPV1649593179-0 McAre Pharmacy 1992 Alt US Hwy 19 Provider ID: TPV1265890404-0 Tarpon Springs, FL 34689 5853 54th Ave N (727) 938-6400 Kenneth City, FL 33709 Fax: (727) 938-6433 (727) 202-6684 00 Yrs/99 Yrs Fax: (727) 213-6785 Languages: Spanish, German 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Pharmaco Med Shop Sat 9:00 AM - 1:00 PM Provider ID: TPV1275086787-0 Medrock Pharmacy 2640 Bayshore Blvd Provider ID: TPV1992035182-0 Dunedin, FL 34698 3209 Tampa Rd (727) 754-9497 Palm Harbor, FL 34684 Fax: (727) 281-4444 (727) 240-1341 00 Yrs/99 Yrs Fax: (727) 240-1343 Languages: Spanish 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Spanish, French, Sat 9:00 AM - 2:00 PM Arabic Pharmacy Innovations M-F 9:00 AM - 6:00 PM Provider ID: TPV1972500130-0 Michaels Pharmacy 4000 Park St N Provider ID: TPV1144467143-0 Saint Petersburg, FL 33709 11987 Seminole Blvd (727) 381-9799 Largo, FL 33778 Fax: (727) 347-2050 (727) 585-2000 00 Yrs/99 Yrs Fax: (727) 585-2099 M-F 10:00 AM - 6:00 PM 00 Yrs/99 Yrs Pharmalabs Languages: Arabic M-F 9:00 AM - 6:00 PM Provider ID: TPV1639415839-0 10901 Roosevelt Blvd N Ste MP Pharmacy 1200C Provider ID: TPV1902290471-0 Saint Petersburg, FL 33716 28813 US Hwy 19 N (727) 498-1228 Clearwater, FL 33761 Fax: (888) 247-0840 (727) 240-0271 00 Yrs/99 Yrs Fax: (727) 240-0289 Languages: French, Chinese, German, Arabic 00 Yrs/99 Yrs M-TH 9:00 AM - 6:00 PM M-F 9:00 AM - 5:00 PM F 9:00 AM - 5:00 PM Option Care Provider ID: TPV1205924826-0 Pharmerica 2880 Scherer Dr N Ste 850 Provider ID: TPV1669405239-0 Saint Petersburg, FL 33716 2200 Tall Pines Dr Ste SUITE118 (727) 592-0045 Largo, FL 33771 Fax: (727) 592-0050 (727) 524-9333 00 Yrs/99 Yrs Fax: (727) 524-9343 M-F 9:00 AM - 5:00 PM 00 Yrs/99 Yrs

Prime RX Pharmacy Provider ID: TPV1528290269-0 5985 49th St N Ste B Saint Petersburg, FL 33709 (727) 522-3222 Fax: (727) 522-7111 00 Yrs/99 Yrs Languages: Hindi M-F 10:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM Prime RX Pharmacy Provider ID: TPV1528296639-0 10720 Park Blvd Ste E Seminole, FL 33772 (727) 398-1969 Fax: (727) 398-1992 00 Yrs/99 Yrs Languages: Hindi M-F 10:00 AM - 6:00 PM Promise Pharmacy Provider ID: TPV1124132196-0 31818 US 19 Palm Harbor, FL 34684 (727) 772-0500 Fax: (727) 772-0511 00 Yrs/99 Yrs Languages: Spanish, French, Arabic M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Quick Pharmacy Provider ID: TPV1386959914-0 6578 Central Ave Saint Petersburg, FL 33707 (727) 258-4892 Fax: (727) 498-8512 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 10:00 AM - 6:00 PM SAMS CLUB Provider ID: TPV1164770145-0 1725 34th St N Saint Petersburg, FL 33713 (727) 369-0518 Fax: (727) 369-0512 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM

www.wellcare.com/Florida | 772

SAMS CLUB Provider ID: TPV1497772891-0 2575 Gulf To Bay Blvd Clearwater, FL 33765 (727) 712-1363 Fax: (727) 712-1394 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM SAMS CLUB Provider ID: TPV1700803210-0 7001 Park Blvd N Pinellas Park, FL 33781 (727) 547-6411 Fax: (727) 547-6663 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM Scotts RX Provider ID: TPV1760622013-0 2215 N Hercules Ave Clearwater, FL 33763 (727) 733-4100 Fax: (727) 733-8426 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Scripts Pharmacy Provider ID: TPV1073802377-0 4910 34th St S Saint Petersburg, FL 33711 (727) 867-4900 Fax: (727) 867-4999 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Shields Pharmacy Provider ID: TPV1336680412-0 2196 Main St Ste A Dunedin, FL 34698 (727) 648-2680 Fax: (727) 648-2695 00 Yrs/99 Yrs Languages: Spanish, Arabic M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail - cont.

St Petersburg Pharmacy The Medicine Shoppe Provider ID: TPV1265820807-0 Provider ID: TPV1154493930-0 Southcare Pharmacy Inc 6399 38th Ave N Ste A-5 938 Patricia Ave Provider ID: TPV1467755488-0 Saint Petersburg, FL 33710 Dunedin, FL 34698 6499 38th Ave N Ste A1 (727) 201-9500 (727) 733-0404 Saint Petersburg, FL 33710 Fax: (727) 201-9501 Fax: (727) 733-0594 (727) 344-3902 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (727) 343-1356 Languages: Hindi M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 3:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 1:00 PM The Medicine Shoppe Sat 9:00 AM - 12:00 PM Sun Pharmacy Provider ID: TPV1568556975-0 Provider ID: TPV1336245448-0 St Luke Pharmacy 1555 E Bay Dr Ste H 3320 Scherer Dr N Ste A Provider ID: TPV1831458868-0 Largo, FL 33771 Saint Petersburg, FL 33716 2019 Gulf To Bay Blvd (727) 501-0188 (727) 394-1901 Clearwater, FL 33765 Fax: (727) 501-0185 Fax: (727) 392-1515 (727) 754-7851 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (727) 754-7852 Languages: Spanish, Greek M-F 7:00 AM - 11:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 8:00 AM - 6:00 PM Languages: Arabic Sat 9:00 AM - 1:00 PM M-F 9:00 AM - 6:00 PM Sunlife Pharmacy The Medicine Shoppe St Marks Pharmacy Provider ID: TPV1861931156-0 Provider ID: TPV1790857571-0 Provider ID: TPV1477713667-0 3420 Tampa Rd 6401 Dr Martin Luther King Jr 4954 Ridgemoor Blvd Palm Harbor, FL 34684 Saint Petersburg, FL 33702 Palm Harbor, FL 34685 (727) 491-8300 (727) 527-5778 (727) 772-7070 Fax: (727) 491-8400 Fax: (727) 526-6920 Fax: (727) 772-7010 00 Yrs/99 Yrs 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Languages: Arabic M-F 10:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM The Prescription Shop Sat 9:00 AM - 1:00 PM Provider ID: TPV1437154879-0 Tampa Road Pharmacy 600 1st Ave N Ste 100 Provider ID: TPV1215335948-0 St Mary Pharmacy Saint Petersburg, FL 33701 3705 Tampa Rd Ste 19 Provider ID: TPV1740423573-0 (727) 822-4546 Oldsmar, FL 34677 1290 W Bay Dr Fax: (727) 821-5668 (813) 925-9666 Largo, FL 33770 00 Yrs/99 Yrs Fax: (813) 925-9664 (727) 585-1333 M-F 8:00 AM - 6:00 PM 00 Yrs/99 Yrs Fax: (727) 585-1344 Sat 8:00 AM - 1:00 PM M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 10:00 AM - 2:00 PM Tri Med Medical Pharmacy Languages: French, Arabic Provider ID: TPV1003933664-0 M-F 9:00 AM - 6:00 PM Tarpon Discount Drugs 5779 49th St N Sat 10:00 AM - 3:00 PM Provider ID: TPV1912928961-0 Saint Petersburg, FL 33709 St Mary Pharmacy II 742 S Pinellas Ave (727) 527-4569 Provider ID: TPV1881990265-0 Tarpon Springs, FL 34689 Fax: (727) 521-1253 30606 US Hwy 19 N (727) 934-3400 00 Yrs/99 Yrs Palm Harbor, FL 34684 Fax: (727) 934-3440 M-F 9:00 AM - 6:00 PM (727) 773-9000 00 Yrs/99 Yrs Fax: (727) 773-9001 Languages: Spanish 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Arabic Sat 9:00 AM - 1:00 PM M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

www.wellcare.com/Florida | 773

Trinity Pharmacy Provider ID: TPV1366638157-0 1474 S Belcher Rd Clearwater, FL 33764 (727) 531-2007 Fax: (727) 531-2205 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Trust Pharmacy Provider ID: TPV1801103486-0 36515 US Hwy 19 N Palm Harbor, FL 34684 (727) 781-7400 Fax: (727) 781-7433 00 Yrs/99 Yrs Languages: French M-F 9:00 AM - 5:00 PM Urban Specialty Pharmacy Provider ID: TPV1306134952-0 1617 34th St South Ste A Saint Petersburg, FL 33711 (727) 327-9881 Fax: (727) 327-9884 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 5:00 PM Vcare Pharmacy Provider ID: TPV1427378488-0 2595 Tampa Rd Ste E Palm Harbor, FL 34684 (727) 787-2273 Fax: (727) 787-0044 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1063841153-0 2677 Roosevelt Blvd Largo, FL 33760 (727) 431-4914 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail - cont.

Walmart Pharmacy Provider ID: TPV1467686832-0 Walmart Pharmacy 13817 Walsingham Rd Provider ID: TPV1063859296-0 Largo, FL 33774 7500 66th St (727) 593-0316 Pinellas Park, FL 33781 Fax: (727) 593-0583 (727) 202-3120 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Sun 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Walmart Pharmacy Provider ID: TPV1497772792-0 Provider ID: TPV1134146517-0 3501 34th St S 8001 US Hwy 19 N Saint Petersburg, FL 33711 Pinellas Park, FL 33781 (727) 906-4030 (727) 578-5020 Fax: (727) 906-4060 Fax: (727) 578-6463 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Walmart Pharmacy Provider ID: TPV1497772875-0 Provider ID: TPV1245619238-0 35404 US Hwy 19 N 3400 E Lake Rd Palm Harbor, FL 34684 Palm Harbor, FL 34685 (727) 784-8897 (727) 431-1419 Fax: (727) 784-6492 Fax: (727) 431-1418 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Walmart Pharmacy Provider ID: TPV1588681985-0 Provider ID: TPV1346533932-0 3801 Tampa Rd 201 34th St N Oldsmar, FL 34677 Saint Petersburg, FL 33713 (813) 854-2391 (727) 803-9607 Fax: (813) 854-3533 Fax: (727) 803-4962 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Walmart Pharmacy Provider ID: TPV1598911778-0 Provider ID: TPV1447689476-0 6900 US Hwy 19 N 2171 Gulf To Bay Blvd Bldg 10 Pinellas Park, FL 33781 Clearwater, FL 33765 (727) 527-2063 (727) 431-5904 Fax: (727) 527-5032 Fax: (727) 431-4901 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1669733127-0 41232 US Hwy 19 N Tarpon Springs, FL 34689 (727) 940-9295 Fax: (727) 940-9290 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1851318232-0 1111 Missouri Ave N Largo, FL 33770 (727) 581-9922 Fax: (727) 586-2264 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1700216116-0 6850 Gulfport Blvd S South Pasadena, FL 33707 (727) 202-3877 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1952328346-0 23106 US Hwy 19 N Clearwater, FL 33765 (727) 724-3403 Fax: (727) 791-7126 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1720418908-0 9020 Ulmerton Rd Largo, FL 33771 (727) 431-5023 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1750663381-0 2102 Main St Dunedin, FL 34698 (727) 431-0278 Fax: (727) 431-0155 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1770500159-0 10237 Bay Pines Blvd Saint Petersburg, FL 33708 (727) 345-8319 Fax: (727) 347-1762 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 774

Walmart Pharmacy Provider ID: TPV1962647560-0 1803 N Highland Ave Clearwater, FL 33755 (727) 441-6819 Fax: (727) 443-4327 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 9:00 AM - 5:00 PM Wecare Pharmacy Provider ID: TPV1043517949-0 5665 Park St N Saint Petersburg, FL 33709 (727) 544-2525 Fax: (727) 544-2599 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Winn-Dixie Pharmacy Provider ID: TPV1255352548-0 1049 62nd Ave N Saint Petersburg, FL 33702 (727) 525-0700 Fax: (727) 525-0901 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Pinellas Retail - cont. Winn-Dixie Pharmacy Provider ID: TPV1639591316-0 7491 4th St N Saint Petersburg, FL 33702 (727) 528-2123 Fax: (727) 528-2132 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM Winn-Dixie Pharmacy Provider ID: TPV1770905465-0 2139 34th North Saint Petersburg, FL 33713 (727) 323-2911 Fax: (727) 323-7163 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Wize Pharmacy Provider ID: TPV1134413560-0 1153 Main St Ste 102 Dunedin, FL 34698 (727) 953-9880 Fax: (727) 953-9882 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

www.wellcare.com/Florida | 775

Last update 08/14/2017

Pharmacy Polk Retail

Benzer Pharmacy Provider ID: TPV1629413737-0 American Care of Tampa Inc 700 1st St S Ste 1 Lakeland Winter Haven, FL 33880 Provider ID: TPV1043480502-0 (863) 292-6111 2600 Industrial Park DR Fax: (863) 292-6112 Lakeland, FL 33801 00 Yrs/99 Yrs (863) 666-6100 M-F 9:00 AM - 6:00 PM Fax: (863) 248-4395 Sat 10:00 AM - 2:00 PM 00 Yrs/99 Yrs Languages: Spanish Careplus Pharmacy MTWTHFSat 8:00 AM - 11:00 Provider ID: TPV1679623987-0 PM 3020 S Combee Rd Lakeland, FL 33803 American Care of Tampa (863) 668-8490 Winter Haven Fax: (863) 668-8497 Provider ID: TPV1689934648-0 00 Yrs/99 Yrs 2791 Lake Alfred Rd Languages: Spanish Winter Haven, FL 33881 M-F 9:00 AM - 7:00 PM (863) 291-4590 Sat 9:00 AM - 3:00 PM Fax: (863) 508-6503 00 Yrs/99 Yrs Central Florida Health Care Languages: Spanish Pharmacy MTWTHFSat 8:00 AM - 11:00 Provider ID: TPV1356737605-0 PM 106 NW 9th Ave Mulberry, FL 33860 American Care Tampa Haines (863) 425-6201 City Fax: (863) 425-6218 Provider ID: TPV1245652221-0 00 Yrs/99 Yrs 502 E Hinson Ave Languages: Spanish Haines City, FL 33844 M-TH 9:00 AM - 5:00 PM (863) 438-7911 F 8:00 AM - 5:00 PM Fax: (863) 638-5035 00 Yrs/99 Yrs Central Florida Health Care Languages: Spanish Pharmacy Lakeland MTWTHFSat 8:00 AM - 11:00 Provider ID: TPV1487893277-0 PM 1129 N Missouri Ave Bartow Pharmacy Med Supply Lakeland, FL 33805 (863) 413-8668 Fax: (863) 413-8666 Provider ID: TPV1013296649-0 00 Yrs/99 Yrs 1478 N Wilson Ave Languages: Spanish Bartow, FL 33830 M-TH 9:00 AM - 5:00 PM (863) 537-6694 F 8:00 AM - 5:00 PM Fax: (863) 537-6579 00 Yrs/99 Yrs Central Pharmacy Languages: Spanish, French Provider ID: TPV1427365972-0 M-F 9:00 AM - 6:00 PM 1671 E Hinson Ave Sat 9:00 AM - 12:00 PM Haines City, FL 33844 (863) 419-7777 Fax: (863) 419-7772 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 3:00 PM

Cleveland Heights Pharmacy Provider ID: TPV1275609919-0 3405 Cleveland Heights Blvd Lakeland, FL 33803 (863) 646-5041 Fax: (863) 644-9220 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

CVS Provider ID: TPV1245252840-0 4005 US Hwy 98 N Lakeland, FL 33809 (863) 815-9408 Fax: (863) 279-3409 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

CVS Provider ID: TPV1083718068-0 400 6th St NW Winter Haven, FL 33881 (863) 294-4493 Fax: (863) 291-8521 00 Yrs/99 Yrs M-F 8:00 AM - 12:00 PM Sat-Sun 8:00 AM - 8:00 PM

CVS Provider ID: TPV1265536247-0 970 Cypress Gardens Blvd Winter Haven, FL 33880 (863) 294-3138 Fax: (863) 291-0499 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1134360712-0 39902 Hwy 27 Davenport, FL 33837 (863) 419-2721 Fax: (863) 422-5049 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1164526141-0 500 S 11th St Lake Wales, FL 33853 (863) 676-2564 Fax: (863) 678-1353 00 Yrs/99 Yrs M-F 8:00 AM - 12:00 PM Sat-Sun 8:00 AM - 8:00 PM CVS Provider ID: TPV1174627061-0 5010 S Florida Ave Lakeland, FL 33813 (863) 644-2411 Fax: (863) 648-4696 00 Yrs/99 Yrs

www.wellcare.com/Florida | 776

CVS Provider ID: TPV1336243310-0 120 W Van Fleet Dr Bartow, FL 33830 (863) 533-4153 Fax: (863) 519-0027 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1447354329-0 99 Magnolia Ave Auburndale, FL 33823 (863) 967-4451 Fax: (863) 967-3647 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 9:00 AM - 10:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1447354428-0 1635 Bartow Rd Lakeland, FL 33801 (863) 686-5161 Fax: (863) 683-0788 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 9:00 PM Sun 9:00 AM - 8:00 PM

Last update 08/14/2017

Pharmacy Polk Retail - cont.

CVS CVS First Choice Pharmacy, Zocalo Provider ID: TPV1750485603-0 Provider ID: TPV1982708962-0 Plaza CVS 5391 N Socrum Loop Rd 35799 Hwy 27 Provider ID: TPV1124389689-0 Provider ID: TPV1457455321-0 Lakeland, FL 33809 Haines City, FL 33844 460 US Hwy 17-92 N 6170 Lakeland Highlands Rd (863) 858-6001 (863) 422-4969 Haines City, FL 33844 Lakeland, FL 33813 Fax: (863) 859-2554 Fax: (863) 422-9370 (863) 422-4222 (863) 619-6409 00 Yrs/99 Yrs 00 Yrs/99 Yrs Fax: (863) 422-4290 Fax: (863) 619-8407 M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 9:00 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM Languages: Spanish M-F 8:00 AM - 9:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM M-F 9:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sat 10:00 AM - 8:00 PM Dundee Community CVS Sun 10:00 AM - 6:00 PM Sun 11:00 AM - 6:00 PM Pharmacy Provider ID: TPV1881616431-0 CVS Provider ID: TPV1184999328-0 First Choice Specialty 3570 Harden Blvd 5999 Dundee Rd Ste 200 Pharmacy Provider ID: TPV1477730406-0 Lakeland, FL 33803 Winter Haven, FL 33884 5000 Grandview Pkwy (863) 648-0512 Provider ID: TPV1609321082-0 (863) 324-4100 Davenport, FL 33837 Fax: (863) 279-3432 2306 North Blvd W Ste A&B Fax: (863) 324-4110 (863) 256-1052 00 Yrs/99 Yrs Davenport, FL 33837 00 Yrs/99 Yrs Fax: (863) 256-1062 M-F 9:00 AM - 7:00 PM (863) 547-9922 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 5:00 PM Fax: (863) 547-9950 M-F 9:00 AM - 7:00 PM Sun 11:00 AM - 5:00 PM 00 Yrs/99 Yrs Eagle Lake Pharmacy Sat 9:00 AM - 5:00 PM Languages: Spanish CVS Provider ID: TPV1023374063-0 Sun 11:00 AM - 5:00 PM M-F 9:00 AM - 9:00 PM Provider ID: TPV1891899878-0 5245 A US Hwy 98 N Sat 9:00 AM - 6:00 PM CVS 101 N Wabash Ave Lakeland, FL 33809 Sun 11:00 AM - 5:00 PM Provider ID: TPV1548364458-0 Lakeland, FL 33815 (863) 937-7992 7009 Cypress Gardens Blvd (863) 686-3131 Fax: (863) 937-7994 Genoa-QOL Healthcare Winter Haven, FL 33884 Fax: (863) 686-7254 00 Yrs/99 Yrs Provider ID: TPV1376645127-0 (863) 324-5873 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM 1201 1st St S Fax: (863) 324-9452 M-F 8:00 AM - 9:00 PM Winter Haven, FL 33880 Fast and Friendly Pharmacy 00 Yrs/99 Yrs Sat 8:00 AM - 6:00 PM (863) 291-4707 M-F 8:00 AM - 9:00 PM Sun 10:00 AM - 6:00 PM Fax: (863) 291-4823 Sat 9:00 AM - 6:00 PM Provider ID: TPV1457599250-0 00 Yrs/99 Yrs CVS Sun 10:00 AM - 6:00 PM 13 W Broadway St M-F 8:00 AM - 5:00 PM Provider ID: TPV1902900806-0 Fort Meade, FL 33841 CVS 6105 US Hwy 98 N Genoa-QOL Healthcare (863) 622-2087 Provider ID: TPV1548364524-0 Lakeland, FL 33809 Fax: (863) 622-2085 Provider ID: TPV1720432040-0 3005 SR 540 W. (863) 858-4441 00 Yrs/99 Yrs 1831 Gilmore Ave Ste 1 Winter Haven, FL 33880 Fax: (863) 859-2392 Languages: Spanish, Filipino Lakeland, FL 33805 (863) 293-0193 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM (836) 614-0066 Fax: (863) 293-3751 Sat 9:00 AM - 2:00 PM Fax: (863) 284-3600 CVS 00 Yrs/99 Yrs 00 Yrs/99 Yrs Provider ID: TPV1962506824-0 First Choice Pharmacy M-F 8:00 AM - 9:00 PM Languages: Spanish 2536 US Hwy 92 E Sat 9:00 AM - 6:00 PM Provider ID: TPV1366756561-0 M-F 8:00 AM - 5:00 PM Lakeland, FL 33801 Sun 8:00 AM - 6:00 PM 401 E Hinson Ave (863) 665-3171 Good Health Pharmacy Haines City, FL 33844 CVS Fax: (863) 665-7936 Provider ID: TPV1609111764-0 (863) 438-2799 Provider ID: TPV1659673713-0 00 Yrs/99 Yrs 1501 1st St S Fax: (863) 438-2770 49581 US Hwy 27 M-F 8:00 AM - 9:00 PM Winter Haven, FL 33880 00 Yrs/99 Yrs Davenport, FL 33897 Sat 9:00 AM - 6:00 PM (863) 229-5974 Languages: Spanish (863) 420-7563 Sun 10:00 AM - 6:00 PM Fax: (863) 229-5975 M-F 9:00 AM - 8:00 PM Fax: (863) 424-6748 00 Yrs/99 Yrs Sat-Sun 10:00 AM 5:00 PM 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 777

Last update 08/14/2017

Pharmacy Polk Retail - cont. Good Health Pharmacy Provider ID: TPV1871940148-0 1110 Druid Circle Ste E Lake Wales, FL 33853 (863) 300-1984 Fax: (863) 300-1985 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM

Lakeland Family Pharmacy Provider ID: TPV1326447988-0 605 W Memorial Blvd Lakeland, FL 33815 (863) 698-7260 Fax: (863) 698-7937 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

Mulberry Pharmacy Inc Providence Pharmacy Provider ID: TPV1609973445-0 Provider ID: TPV1568891125-0 1009 N Church Ave 5515 US Hwy 98 N Ste 1 Mulberry, FL 33860 Lakeland, FL 33809 (863) 425-1101 (863) 937-8092 Fax: (863) 425-2802 Fax: (863) 937-8093 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Sat 10:00 AM - 2:00 PM

Lakeland Red Med Center Publix Ph HC Pharmacy Provider ID: TPV1093148199-0 Provider ID: TPV1609265594-0 1324 Lakeland Hills Blvd Ste 203 33048 US Hwy 27 Lakeland, FL 33805 Haines City, FL 33844 (863) 284-1834 (863) 547-6921 Fax: (863) 284-1861 Fax: (863) 547-6923 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM M-F 8:00 AM - 5:00 PM

Noble Care Pharmacy Provider ID: TPV1922544535-0 7066 N Church Ave Mulberry, FL 33860 (863) 583-4535 Fax: (863) 337-4678 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 3:00 PM

Medina-Meds Pharmacy Provider ID: TPV1881094712-0 4675 Old Pleasant Hill Rd Kissimmee, FL 34759 (407) 394-1111 Fax: (407) 394-1470 00 Yrs/99 Yrs Languages: Spanish M-F 8:00 AM - 6:00 PM

One-Stop Pharmacy 101 Provider ID: TPV1518344027-0 1130 6th St NW Winter Haven, FL 33881 (863) 845-5800 Fax: (863) 875-7912 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM

K M Drugs Provider ID: TPV1386196616-0 395 Village Dr Ste C Poinciana, FL 34759 (863) 496-7927 Fax: (863) 675-6048 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Kay Pharmacy 003 Provider ID: TPV1598081994-0 637 1st St S Winter Haven, FL 33880 (863) 268-8218 Fax: (863) 875-5628 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM

Medoz Pharmacy of Polk Inc Provider ID: TPV1346647005-0 40230 US Hwy 27 Ste 100-110 Davenport, FL 33837 (855) 633-6948 Fax: (844) 329-6348 00 Yrs/99 Yrs M-F 10:00 AM - 6:00 PM Sat 10:00 AM - 1:00 PM

Lake Wales Pharmacy Provider ID: TPV1497099055-0 Mulberry Long Term Care Pharmacy 1322 State Rd 60 E Provider ID: TPV1750561619-0 Lake Wales, FL 33853 1011 N Church Ave (863) 676-0400 Mulberry, FL 33860 Fax: (863) 676-0445 (863) 425-1101 00 Yrs/99 Yrs Fax: (863) 425-2802 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 1:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

Peoples Pharmacy Provider ID: TPV1184736019-0 4977 US Hwy 98 N Lakeland, FL 33809 (863) 858-4444 Fax: (863) 858-4832 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Pharmacy One Pro Specialty Care Ph Provider ID: TPV1417968900-0 65 3rd St NW Ste 59 Winter Haven, FL 33881 (863) 401-9300 Fax: (863) 401-9330 00 Yrs/99 Yrs Languages: Spanish, French M-F 9:00 AM - 6:00 PM

www.wellcare.com/Florida | 778

Quickn Save Pharmacy Provider ID: TPV1275971244-0 722 E Memorial Blvd Lakeland, FL 33801 (863) 583-4999 Fax: (863) 583-4998 00 Yrs/99 Yrs Languages: French M-F 9:00 AM - 6:00 PM Ritemed Pharmacy Provider ID: TPV1447688452-0 1014 Cypress Pkwy Kissimmee, FL 34759 (407) 287-6727 Fax: (407) 287-6737 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM RX Care Pharmacy Provider ID: TPV1942584057-0 301 Havendale Blvd Auburndale, FL 33823 (863) 875-5700 Fax: (863) 875-5619 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 8:00 PM Sat 10:00 AM - 2:00 PM SAMS CLUB Provider ID: TPV1588681977-0 4600 US Hwy 98 N Lakeland, FL 33809 (863) 853-3701 Fax: (863) 853-3478 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Polk Retail - cont.

The Apothecary Shop Provider ID: TPV1003139577-0 437 S 11th St Lake Wales, FL 33853 (863) 676-1974 Fax: (863) 676-5830 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM

Walmart Pharmacy Provider ID: TPV1235156449-0 3501 S Florida Ave Lakeland, FL 33803 (863) 644-0671 Fax: (863) 644-7411 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1699792077-0 5800 US Hwy 98 N Lakeland, FL 33809 (863) 859-3772 Fax: (863) 858-2701 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Villa Medical Health Solutions Walmart Pharmacy Provider ID: TPV1245257542-0 Smart RX Pharmacy Provider ID: TPV1215396346-0 6745 N Church Ave Provider ID: TPV1053685305-0 105 Ave R NW Mulberry, FL 33860 350 1st St N Winter Haven, FL 33881 (863) 701-8049 Winter Haven, FL 33881 (863) 229-5978 Fax: (863) 701-8632 (863) 271-8441 Fax: (863) 662-3953 00 Yrs/99 Yrs Fax: (863) 271-8443 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 7:00 PM Languages: Spanish Sun 10:00 AM - 6:00 PM M-F 8:00 AM - 5:00 PM Villa Pharmacy Provider ID: TPV1720415599-0 Walmart Pharmacy Sunrise Pharmacy 105 Ave R NW Provider ID: TPV1316964620-0 Provider ID: TPV1588107528-0 Winter Haven, FL 33881 1050 State Rd 60 E 4543 Pleasant Hill Rd, Ste D (863) 229-5978 Bartow, FL 33830 Kissimmee, FL 34759 Fax: (863) 662-3953 (863) 533-2131 (407) 343-4434 00 Yrs/99 Yrs Fax: (863) 533-5423 Fax: (407) 343-4435 Languages: French 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM M-F 8:00 AM - 8:00 PM Languages: Spanish Sat 9:00 AM - 7:00 PM M-F 9:00 AM - 7:00 PM Walmart Pharmacy Sun 10:00 AM - 6:00 PM Sat 10:00 AM - 4:00 PM Provider ID: TPV1053338368-0 7450 Cypress Gardens Blvd Walmart Pharmacy Sunshine Pharmacy Winter Haven, FL 33884 Provider ID: TPV1326066754-0 Provider ID: TPV1245479161-0 (863) 318-0252 36205 US Hwy 27 120 Carter Blvd Ste 6 Fax: (863) 318-0282 Haines City, FL 33844 Polk City, FL 33868 00 Yrs/99 Yrs (863) 422-7582 (321) 947-5847 M-F 9:00 AM - 9:00 PM Fax: (863) 422-7583 Fax: (863) 688-5462 Sat 9:00 AM - 6:00 PM 00 Yrs/99 Yrs 00 Yrs/99 Yrs Sun 11:00 AM - 5:00 PM M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Walmart Pharmacy Sun 10:00 AM - 6:00 PM Supreme RX Provider ID: TPV1225055528-0 Provider ID: TPV1841577640-0 904 Cypress Pkwy Walmart Pharmacy 1611 N Florida Ave Kissimmee, FL 34759 Provider ID: TPV1598782708-0 Lakeland, FL 33805 (407) 870-2501 2000 State Rd 60 E (863) 940-4733 Fax: (407) 870-2507 Lake Wales, FL 33898 Fax: (863) 940-4734 00 Yrs/99 Yrs (863) 676-9468 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Fax: (863) 676-4484 Languages: Spanish Sat 9:00 AM - 7:00 PM 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM M-F 9:00 AM - 9:00 PM Sat 10:00 AM - 3:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1770500985-0 355 Cypress Gardens Blvd Winter Haven, FL 33880 (863) 299-5131 Fax: (863) 299-4661 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

SAMS CLUB Provider ID: TPV1821216219-0 3530 Lakeland Highlands Rd Lakeland, FL 33803 (863) 644-9513 Fax: (863) 647-3280 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 779

Walmart Pharmacy Provider ID: TPV1962429266-0 2120 US Hwy 92 W Auburndale, FL 33823 (863) 551-3536 Fax: (863) 551-9178 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 7:00 PM Sun 11:00 AM - 5:00 PM Watsons Pharmacy Provider ID: TPV1225181670-0 16 W Wall St Frostproof, FL 33843 (863) 635-4568 Fax: (863) 635-2831 00 Yrs/99 Yrs Languages: Spanish, French M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM Webbs Square Pharmacy Provider ID: TPV1295042133-0 2200 South Blvd W Davenport, FL 33837 (863) 421-9200 Fax: (863) 421-9220 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM

Last update 08/14/2017

Pharmacy Polk Retail - cont. Winn-Dixie Pharmacy Provider ID: TPV1184645566-0 2630 US Hwy 92 E Lakeland, FL 33801 (941) 665-5553 Fax: (863) 665-5311 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

Winter Haven Pharmacy Provider ID: TPV1477854164-0 345 Cypress Gardens Blvd Winter Haven, FL 33880 (863) 291-0400 Fax: (863) 291-0422 00 Yrs/99 Yrs Languages: Spanish, Hindi M-F 9:00 AM - 6:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1689695058-0 319A Havendale Blvd Auburndale, FL 33823 (941) 967-7803 Fax: (863) 967-8696 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1689695991-0 2700 Recker Hwy Winter Haven, FL 33880 (863) 291-3522 Fax: (863) 291-3919 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1851312169-0 36019 US Hwy 27 Haines City, FL 33844 (941) 421-0639 Fax: (863) 421-0578 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1871514174-0 28047 Hwy 27 Dundee, FL 33838 (863) 439-3511 Fax: (863) 439-4038 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

www.wellcare.com/Florida | 780

Last update 08/14/2017

Pharmacy Sarasota Retail Americas Pharmacy Provider ID: TPV1780075903-0 3076 17th St Sarasota, FL 34234 (941) 955-7700 Fax: (941) 955-0800 00 Yrs/99 Yrs Languages: Spanish, Portuguese M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Childrens Health Center Pharmacy Provider ID: TPV1013324235-0 1750 17th St Sarasota, FL 34234 (941) 861-1413 Fax: (941) 361-8468 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM Comfort IV Therapy Provider ID: TPV1265853337-0 1800 Northgate Blvd Ste A-7 Sarasota, FL 34234 (941) 355-8330 Fax: (941) 355-8322 00 Yrs/99 Yrs M-F 9:00 AM - 5:00 PM CVS Provider ID: TPV1033214879-0 14998 Tamiami Trl North Port, FL 34287 (941) 426-1144 Fax: (941) 423-6804 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1174627046-0 5250 Clark Rd Sarasota, FL 34233 (941) 924-4106 Fax: (941) 923-0286 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1497852982-0 100 N US 41 Bypass Venice, FL 34285 (941) 484-8814 Fax: (941) 488-2612 00 Yrs/99 Yrs M-F 8:00 AM - 10:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1639273501-0 8546 S Tamiami Trl Sarasota, FL 34238 (941) 918-1514 Fax: (941) 918-9886 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1255578001-0 215 Jacaranda Cir Venice, FL 34285 (941) 485-8393 Fax: (941) 485-8646 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1528080165-0 5350 Fruitville Rd Sarasota, FL 34232 (941) 379-6677 Fax: (941) 444-3120 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat-Sun 9:00 AM - 6:00 PM

CVS Provider ID: TPV1649374505-0 1231 Beneva Rd S Sarasota, FL 34232 (941) 365-4353 Fax: (941) 316-0846 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1265536155-0 2811 Clark Rd Sarasota, FL 34231 (941) 921-5781 Fax: (941) 927-5050 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1407950397-0 1220 S Tamiami Trl Osprey, FL 34229 (941) 966-5667 Fax: (941) 918-1221 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1437253416-0 CVS 3709 N Tamiami Trl Provider ID: TPV1063434660-0 Sarasota, FL 34234 8401 S Tamiami Trl (941) 355-4155 Sarasota, FL 34238 Fax: (941) 355-3780 (941) 921-6893 00 Yrs/99 Yrs Fax: (941) 444-3182 M-F 8:00 AM - 9:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 6:00 PM M-F 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM

CVS Provider ID: TPV1528162500-0 4301 Bee Ridge Rd Sarasota, FL 34233 (941) 371-6328 Fax: (941) 343-0222 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1669576575-0 4090 Tamiami Trl S Venice, FL 34293 (941) 493-6882 Fax: (941) 496-8124 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

CVS Provider ID: TPV1588768485-0 CVS Provider ID: TPV1760586663-0 505 Bay Isles Pkwy 1111 Tamiami Trl N Longboat Key, FL 34228 Nokomis, FL 34275 (941) 383-2475 (941) 484-8406 Fax: (941) 387-0208 Fax: (941) 480-9213 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 10:00 PM Sat 9:00 AM - 6:00 PM Sat 8:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Sun 9:00 AM - 6:00 PM CVS Provider ID: TPV1619071693-0 CVS Provider ID: TPV1780788760-0 2773 Fruitville Rd 3800 S Tamiami Trl Sarasota, FL 34237 Sarasota, FL 34239 (941) 365-1464 (941) 955-3328 Fax: (941) 365-3663 Fax: (941) 365-7993 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 781

Last update 08/14/2017

Pharmacy Sarasota Retail - cont. CVS Provider ID: TPV1801819107-0 4271 Tamiami Trl S Venice, FL 34293 (941) 497-7885 Fax: (941) 882-5286 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 5:00 PM Sun 11:00 AM - 5:00 PM CVS Provider ID: TPV1821192782-0 5361 Fruitville Rd Sarasota, FL 34232 (941) 378-4700 Fax: (941) 378-2412 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM CVS Provider ID: TPV1881798866-0 1760 S McCall Rd Englewood, FL 34223 (941) 474-3267 Fax: (941) 474-6313 00 Yrs/99 Yrs M-F 8:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Davidson Drug Provider ID: TPV1194868307-0 5124 Ocean Blvd Sarasota, FL 34242 (941) 349-1111 Fax: (941) 312-0631 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 4:00 PM Sun 10:00 AM - 2:00 PM Davidson Drugs Inc Provider ID: TPV1336282383-0 1281 S Tamiami Trl Sarasota, FL 34239 (941) 365-9116 Fax: (941) 953-4099 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 4:00 PM Sun 10:00 AM - 2:00 PM

Davidson Drugs Inc Provider ID: TPV1538202585-0 6595 Midnight Pass Rd Sarasota, FL 34242 (941) 349-4343 Fax: (941) 349-0801 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 4:00 PM Englewood Pharmacy Provider ID: TPV1548326432-0 900 Pine St Ste 211 Englewood, FL 34223 (941) 475-3784 Fax: (941) 460-0104 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Family Pharmacy Provider ID: TPV1184666984-0 3644 Webber St Sarasota, FL 34232 (941) 921-6645 Fax: (941) 923-7558 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Gulf Gate Pharmacy Provider ID: TPV1932429271-0 2134 Gulf Gate Dr Sarasota, FL 34231 (941) 493-6500 Fax: (941) 493-6552 00 Yrs/99 Yrs Languages: Russian M-F 10:00 AM - 6:00 PM Healthcite Pharmacy Provider ID: TPV1740732635-0 343 Interstate Blvd Sarasota, FL 34240 (941) 312-2777 Fax: (941) 359-0255 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM

Hedges Healthmart Pharmacy Meds Made Easy Provider ID: TPV1275782450-0 Provider ID: TPV1669577656-0 3830 Bee Ridge Rd Ste 101 Sarasota, FL 34233 24 N Lime Ave (941) 225-2005 Sarasota, FL 34237 Fax: (941) 255-1701 (941) 366-2424 00 Yrs/99 Yrs Fax: (941) 954-6043 Languages: Hindi 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Languages: Spanish, French, Vietnamese Sat 10:00 AM - 2:00 PM M-F 9:00 AM - 6:00 PM North Port Family Health Sat 9:00 AM - 3:00 PM Center Pharmacy Lemon Bay Drugs East Provider ID: TPV1386671105-0 Provider ID: TPV1568462380-0 6950 Outreach Way North Port, FL 34287 3542 N Access Rd (941) 861-3828 Englewood, FL 34224 Fax: (941) 861-3831 (941) 475-5636 00 Yrs/99 Yrs Fax: (941) 474-7993 Languages: Spanish, Russian 00 Yrs/99 Yrs M-TH 8:00 AM - 5:00 PM Languages: German F 8:00 AM - 1:00 PM M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 12:00 PM North Port Pharmacy Lemon Bay Drugs North Provider ID: TPV1588732317-0 14255 Tamiami Trl Provider ID: TPV1972598738-0 North Port, FL 34287 13221 Tamiami Trl (941) 426-2800 North Port, FL 34287 Fax: (941) 423-6368 (941) 426-1123 00 Yrs/99 Yrs Fax: (941) 423-2827 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 1:00 PM Languages: Hindi M-F 9:00 AM - 6:00 PM Olson Liggett Drug Sat 9:00 AM - 3:00 PM Provider ID: TPV1568468932-0 Medical Arts Pharmacy 75 S Tuttle Ave Provider ID: TPV1508090572-0 Sarasota, FL 34237 (941) 366-0090 4417 Bee Ridge Rd Fax: (941) 954-5535 Sarasota, FL 34233 00 Yrs/99 Yrs (941) 706-1777 Languages: Spanish Fax: (941) 388-7844 M-F 9:00 AM - 6:00 PM 00 Yrs/99 Yrs Sat 9:00 AM - 2:00 PM Languages: Russian, Arabic M-F 9:00 AM - 7:00 PM Pharmerica Sat 10:00 AM - 3:00 PM Provider ID: TPV1487687059-0 Medplus Pharmacy 775 Bell Rd Sarasota, FL 34240 Provider ID: TPV1346633245-0 (941) 342-2500 5751 Beneva Rd Fax: (941) 342-2526 Sarasota, FL 34233 00 Yrs/99 Yrs (941) 960-2549 M-F 8:00 AM - 10:00 PM Fax: (941) 960-2579 Sat-Sun 9:00 AM - 7:00 PM 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

www.wellcare.com/Florida | 782

Last update 08/14/2017

Pharmacy Sarasota Retail - cont. Prime Pharmacy Services Provider ID: TPV1154554111-0 2427 Porter Lake Dr Ste 109 Sarasota, FL 34240 (954) 919-1818 Fax: (954) 923-9261 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 5:00 PM SAMS CLUB Provider ID: TPV1114944519-0 300 N Cattlemen Rd Sarasota, FL 34232 (941) 341-9524 Fax: (941) 341-9796 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 6:00 PM Sarasota Apothecary Provider ID: TPV1275070716-0 8620 S Tamiami Trl Ste N-P Sarasota, FL 34238 (941) 218-4090 Fax: (941) 412-4502 00 Yrs/99 Yrs M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 2:00 PM Sarasota County Health Dept

Sarasota Pharmacy Sv Co Bee Ridge Pharmacy Provider ID: TPV1164456349-0 4086 Bee Ridge Rd Sarasota, FL 34233 (941) 378-0008 Fax: (941) 378-0022 00 Yrs/99 Yrs Languages: Russian, Hindi MTWF 9:00 AM - 6:00 PM TH 9:00 AM - 7:00 PM St Simon Pharmacy Provider ID: TPV1861885170-0 4012 Sawyer Rd Ste 107 Sarasota, FL 34233 (941) 552-6054 Fax: (941) 256-3707 00 Yrs/99 Yrs Languages: Arabic M-F 9:00 AM - 5:00 PM Sat 9:00 AM - 12:00 PM Sun Discount Pharmacy Provider ID: TPV1952611329-0 2817 Bee Ridge Rd Sarasota, FL 34239 (941) 556-9622 Fax: (941) 556-9623 00 Yrs/99 Yrs Languages: Spanish, Hindi, Vietnamese M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 2:00 PM

Provider ID: TPV1679500490-0 Sun Pharmacy of Venice 2200 Ringling Blvd Provider ID: TPV1760934384-0 Sarasota, FL 34237 1214 E Venice Ave Ste C (941) 861-2932 Venice, FL 34285 Fax: (941) 861-2945 (941) 584-2080 00 Yrs/99 Yrs Fax: (941) 584-2084 Languages: Spanish 00 Yrs/99 Yrs MTTH 8:00 AM - 5:00 PM Languages: Spanish, Hindi W 8:00 AM - 7:00 PM M-F 9:00 AM - 7:00 PM F 8:00 AM - 1:00 PM Sat 9:00 AM - 2:00 PM Sarasota Discount Pharmacy Town Pharmacy Provider ID: TPV1851418149-0 Provider ID: TPV1114384187-0 14826 Tamiami Trl 110 N Lime Ave North Port, FL 34287 Sarasota, FL 34237 (941) 429-7766 (941) 444-6888 Fax: (941) 429-1105 Fax: (941) 444-1313 00 Yrs/99 Yrs 00 Yrs/99 Yrs Languages: Spanish, Russian Languages: Spanish, French, M-F 9:00 AM - 7:00 PM Arabic Sat 9:00 AM - 2:00 PM M-F 9:00 AM - 6:00 PM Sat 10:00 AM - 2:00 PM

Venice Apothecary Provider ID: TPV1386665339-0 560 The Rialto Venice, FL 34285 (941) 485-8205 Fax: (941) 485-4725 00 Yrs/99 Yrs M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 2:00 PM Village Pharmacy Provider ID: TPV1962457796-0 1095 Tamiami Trl N Nokomis, FL 34275 (941) 488-8800 Fax: (941) 488-8802 00 Yrs/99 Yrs Languages: Spanish M-F 9:00 AM - 7:00 PM Sat 9:00 AM - 4:00 PM Walmart Pharmacy Provider ID: TPV1073531406-0 13140 South Tamiami Trail Osprey, FL 34229 (941) 918-2473 Fax: (941) 918-2565 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 11:00 AM - 5:00 PM Walmart Pharmacy Provider ID: TPV1144247354-0 4150 Tamiami Trl S Venice, FL 34293 (941) 493-5902 Fax: (941) 497-2210 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Walmart Pharmacy Provider ID: TPV1316964703-0 2931 S McCall Rd Englewood, FL 34224 (941) 475-8899 Fax: (941) 475-8431 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1346698545-0 5401 Palmer Crossing Cir Sarasota, FL 34233 (941) 554-2352 Fax: (941) 554-2351 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1598171985-0 3560 Bee Ridge Rd Sarasota, FL 34239 (941) 702-6244 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Walmart Pharmacy Provider ID: TPV1639111495-0 17000 Tamiami Trl North Port, FL 34287 (941) 423-8336 Fax: (941) 423-8667 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 11:00 AM - 5:00 PM

Walmart Pharmacy Walmart Pharmacy Provider ID: TPV1285999565-0 Provider ID: TPV1639540263-0 3500 N Tamiami Trl 1100 S Main St Sarasota, FL 34234 North Port, FL 34287 (941) 444-8415 (941) 240-3093 Fax: (941) 444-8411 Fax: (941) 240-3092 00 Yrs/99 Yrs 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM Sun 10:00 AM - 6:00 PM

www.wellcare.com/Florida | 783

Last update 08/14/2017

Pharmacy Sarasota Retail - cont. Walmart Pharmacy Provider ID: TPV1942227335-0 4381 Cattlemen Rd Sarasota, FL 34233 (941) 379-0944 Fax: (941) 379-0741 00 Yrs/99 Yrs M-F 9:00 AM - 9:00 PM Sat 9:00 AM - 7:00 PM Sun 10:00 AM - 6:00 PM

Winn-Dixie Pharmacy Provider ID: TPV1982026662-0 1254 Jacaranda Blvd Venice, FL 34292 (941) 497-3368 Fax: (941) 492-6089 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 5:00 PM Sun 10:00 AM - 4:00 PM

We Care Pharmacy Provider ID: TPV1184024788-0 1849 Tamiami Trl S Venice, FL 34293 (941) 786-9181 Fax: (941) 786-9183 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 6:00 PM Sat 9:00 AM - 1:00 PM We-Care Pharmacy Provider ID: TPV1215352224-0 5561 Palmer Crossing Cir Sarasota, FL 34233 (941) 893-3050 Fax: (941) 893-3051 00 Yrs/99 Yrs Languages: Hindi M-F 9:00 AM - 7:00 PM Sat 10:00 AM - 3:00 PM Winn-Dixie Pharmacy Provider ID: TPV1417978701-0 5400 Fruitville Rd Sarasota, FL 34232 (941) 342-8686 Fax: (941) 371-2055 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM Winn-Dixie Pharmacy Provider ID: TPV1841211158-0 4100 N Access Rd Englewood, FL 34224 (941) 473-2933 Fax: (941) 473-3709 00 Yrs/99 Yrs M-F 8:00 AM - 8:00 PM Sat 9:00 AM - 6:00 PM Sun 10:00 AM - 5:00 PM

www.wellcare.com/Florida | 784

ALTERNATE LANGUAGES INDEX You can find a provider who speaks a different language in this index. First look for the language you need. Then check the specialty and provider name. Indice de idiomas alternativos: En este índice, usted puede encontrar un proveedor que hable otro idioma. Primero busque el idioma que necesita, y luego verifique la especialidad y el nombre del proveedor.

Albanian Cardiology Kokolis, Rodamanthos MD American Sign Language Psychiatry Dempsey, Donna ARNP Amharic Urgent Care Center First Care Walk In Clinic LLC Arabic Ambulatory Surgery Center Brandon Outpatient Surgery Center Behavioral Health Counseling Aboul-Hosn, Nawal LMHC Hassan, Mahmoud LMHC Cardiology Ayoubi, Maher MD Belal, Farouk MD Dagher, George MD Elchahal, Sami MD Matar, Fadi MD Mukayed, Usama MD Sayad, Dany MD Ear, Nose & Throat Sargi, Zoukaa MD Endocrinology, Diabetes, Metabolism Faris, Talal MD Family Practice Abdelmalek, Hend MD Lewis-Serag, Maha MD Serag, Sherif MD

General Dentistry Acquaro, Ronald DMD Allen, Kathie DDS Awad, Asma DDS Belaunzaran, Pedro DDS Curd, Francis DDS Hanna, Mina DMD Lipton, Barry DDS Louis, Salwan DDS Lugo, Francis DDS Manibo, Lourdes Alexandra DDS Scheurer, Monica DMD Scialfa, August DDS Snoke, Don Blair DDS Zaki, Fady DDS Zmiyiwsky, Mark DDS General Surgery Atalla, Sameh MD Fikry, Driss PA Osman Mohamed, Hussein MD Patel, Ajay MD Patel, Sharad MD Vaikunth, Sachin MD Hematology & Oncology Hlalah, Osama MD Hussein, Mohammad MD Mace, Joseph MD Infectious Disease Levenson, Jeffrey MD Rihana, Nancy MD Internal Medicine Eldin, Adel MD Korbaj, Rabee MD Mukayed, Usama MD Saba, Fadi MD Shah, Apurva MD Tanyous, Walid MD

www.wellcare.com/Florida | 785

Nephrology Doumit, Elias MD Neurology Bitar, Hassan MD Mousli, Hasan MD Obstetrics/Gynecology Abdel-Aziz, Mohamed MD Best, Erin MD Prabhakaran, Sujatha MD Ophthalmology Ahn, Byung-Joon MD Anthony, Charles MD Berger, Todd MD El-Jabali, Fayssal DO Foster, John MD Friedman, Scott MD Garruto, Bryan MD Hector, Richard MD Kasper, Jeffrey MD Mali, Joshua MD Newsom, Thomas MD Srivastava, Vinita MD Optometry Detweiler, Edwin OD Fazio, Eric OD Forde, Jessica OD Petit, Mitchell OD Pediatric Cardiology Ballal, Natraj MD Pediatric Pulmonology Sifain, Maggie MD Pediatrics Albanna, Issam MD Emara, Magdi MD Lokesh, Haravu MD

ALTERNATE LANGUAGES INDEX Arabic - cont. Pediatrics - cont. Rizkallah, Munir MD Salib, Magda MD Pedodontics Lewis, Andre DDS Olli, Edward DMD Periodontics Evans, Michael DDS Pulmonary Disease Ghobrial, Victor MD Loutfi, Rabih MD Quefatieh, Amir MD Radiation Oncology Bishay, Sawsan MD Retail 1st Choice Pharmacy Baydoun Pharmacy Care Plus Pharmacy Embassy Pharmacy Express Specialty Pharmacy Jk Care Pharmacy Logos Pharmacy Manatee Discount Pharmacy Maxcare Pharmacy Medical Arts Pharmacy Medrock Pharmacy Medsource Pharmacy Michaels Pharmacy Palmyra Pharmacy Pharmalabs Promise Pharmacy Salhab Pharmacy Sarasota Discount Pharmacy Save N Care Pharmacy Scripts Direct LLC Shields Pharmacy St Joseph Pharmacy St Josephs Pharmacy St Luke Pharmacy St Marks Pharmacy St Mary Pharmacy St Mary Pharmacy II St Simon Pharmacy Starcare Pharmacy

Trinity Pharmacy Univ Pain Management Center USF Health Pharmacy Plus Veracity Pharmacy Wellness Pharmacy Inc Z Orange Pharmacy Sleep Diagnostic Studies Mousli, Hasan MD

Family Practice Stoyanov, Veselin MD General Practice Heinrichs, Richard MD Nusbaum, Lana MD Snyder, Donald MD Neurology Raccio, Diane ARNP

Thoracic & Cardiovascular Surgery Hakki, A MD Burmese Urgent Care Center Doctors Express Vascular Surgery Wilson, Scott MD Armenian Obstetrics/Gynecology Prabhakaran, Sujatha MD Bengali Cardiology Roy, Bipul MD General Dentistry Nakarmi, Bibek DDS Internal Medicine Choe, Leo DO Datta, Indrani MD Roy, Bipul MD

Cardiology Khadim, Ghazanfar MD Tun, Aung MD Internal Medicine Khadim, Ghazanfar MD Khin, U MD Latt, Khin MD Cambodian General Dentistry Keo, Phanith DMD Internal Medicine Hardiman, James MD Cantonese Nephrology Numrungroad, Visal MD Chinese

Obstetrics/Gynecology Prabhakaran, Sujatha MD

Cardiology Khadim, Ghazanfar MD

Bosnian

Hematology Knipe, Richard MD

Durable Medical Equipment Solarus Enterprises LLC Bulgarian Behavioral Health Counseling Christova, Albena LMHC Cardiology Georgiev, Maria MD Endocrinology, Diabetes, Metabolism Chaykin, Louis MD

www.wellcare.com/Florida | 786

Hematology & Oncology Ho, Vu Tran MD Tang, Huayang MD Yan, Ben MD Hospice Lifepath Hospice Inc Infectious Disease Morano, Jamie MD Internal Medicine Chang Chen Lin, Yih MD

ALTERNATE LANGUAGES INDEX Chinese - cont.

Wecare Pharmacy LLC

Internal Medicine - cont. Khadim, Ghazanfar MD Korbaj, Rabee MD

Rheumatology Chang Chen Lin, Yih MD

Interventional Cardiology Lin, Lang MD Medical Genetics Pope, Kathleen MD Medical Oncology Knipe, Richard MD Neonatal Perinatal Medicine Chua, Caroline MD Nephrology Hou, Peng MD Numrungroad, Visal MD Qi, Quanle MD Neurology Gu, Qin MD Neurosurgery Lau, Tsz MD Shulman, Carrie MD Nurse Midwife Runyan, Fuying ARNP Obstetrics Gallagher, James MD Pediatric Endocrinology Lin, Tsu-Hui MD Pediatrics Zhao, Wenying MD Physical Therapy Lester, Lawrence PT Podiatry Chi, Andy DPM Wong, William DPM Radiation Oncology Sha, Sandra MD Retail Exactus Pharmacy Solutions Inc Pharmalabs Pharmscript

Specialty Exactus Pharmacy Solutions Inc Creole Adolescent Medicine Marcelin, Jackie ARNP Behavioral Health Facility Family Preservation Service Cardiology Salazar, Manuel MD

Obstetrics/Gynecology Levine, Paul MD Lewis, Michael MD Louis, Judette MD Spellacy, William MD Occupational Therapy Jean, Gerda OT Pediatric Endocrinology Declue, Terry MD Root, Allen William MD Pediatric Gastroenterology Ignacio, Joseph MD

Pediatrics Community Mental Health Center Marcelin, Jackie ARNP Childrens Home Society of Florida Physical Medicine & Rehabilitation Diagnostic Imaging Epting, Stephanie DO Rose Radiology Centers Inc Psychiatry Family Practice Monosiet, Frederic MD Confident, Leonard MD Pulmonary Disease General Practice Argeles, Horacio MD Aime Celian, Beatrice MD Skilled Nursing Facility Pierre, Jean MD Advanced Care Center General Surgery Fletcher Health and Rehabilitation Center Albrink, Michael MD Heather Hill Nursing Home-Pcs Cox, Charles MD Heritage Health Care Center Geriatric Psychiatry St Petersburg Nursing and Monosiet, Frederic MD Rehabilitation Home Health Care Speech Therapy Apollo Advanced Home Health Barth, Jeanne SLP Corp Substance Abuse Assisting Hands Gulf Coast Childrens Home Society of Florida Better At Home LLC Medical Personnels Services Inc Urgent Care Center Hospice Compassionate Care Hospice of Central Florida

Doctor Today Urgent Care LLC Florida Hospital Centra Care University

Internal Medicine Schreibman, Tanya MD

Vascular Surgery Gabriel, Yves MD

Maternal Fetal Medicine Louis, Judette MD

Czech

www.wellcare.com/Florida | 787

Allergy & Immunology Weiss, William MD

ALTERNATE LANGUAGES INDEX Czech - cont. Cardiology Georgiev, Maria MD Durable Medical Equipment Medi Health Care Inc Endocrinology, Diabetes, Metabolism Chaykin, Louis MD General Practice Nusbaum, Lana MD Snyder, Donald MD Infectious Disease Offner, Lenka MD Vega, Vilma MD Internal Medicine Vega, Vilma MD

Infectious Disease Lacson, J Agustin MD

Diagnostic Imaging Tampa Bay Diagnostic Imaging

Internal Medicine Maningo, Evelyn MD Poblete, Sarah Jessica MD

Durable Medical Equipment Ally Medical Services LLC

Pediatrics Depadua, Maria MD Depauda, Maria MD Khan, Maria MD Santa Maria, Ramon MD Tayao, Maria Concepcion MD Tayao, Maria MD Retail Fast and Friendly Pharmacy French

Danish

Adolescent Medicine Marcelin, Jackie ARNP

Behavioral Health Counseling Baker, Joanna LMHC

Allergy & Immunology Kornfeld, Stephen MD

Dutch

Behavioral Health Counseling Aboul-Hosn, Nawal LMHC Averoff, Lisa LMHC Kassed, Marvin LMHC

Nephrology Brucculeri, Michael MD Obstetrics/Gynecology Wagner, Stephen MD Faroese Ear, Nose & Throat Tabesh, Amanollah MD Infectious Disease Offner, Lenka MD Obstetrics/Gynecology Igel, G MD Shafii, Sohrab MD Filipino Family Practice Tangunan, Ray MD General Practice De Vera, Melva MD General Surgery Medalle, Gregorio MD

Behavioral Health Facility The Florida Center For Early Childhood Cardiology Dagher, George MD Elchahal, Sami MD Gallardo, Ignacio MD Marques, Vasco MD Matar, Fadi MD Rogal, Philip MD Sayad, Dany MD Weston, Patrick MD Chiropractic Patel, Anish DC Stangherlin, Michael DC

Ear, Nose & Throat Berrios, Jose MD Sargi, Zoukaa MD Family Practice Asuncion, Melissa MD Confident, Leonard MD Gastroenterology Ekici, Sedat MD General Dentistry Antony, Archana DDS Cardenas, Carlos DDS Cocchieri, Richard DDS Cooper, Angela DDS Doshi, Amit DDS Gomara, Denise DDS Jenkins, James DDS Malik, Chander DDS McKenzie, Karen DDS Misischia, William DDS Mora, Viviana DMD Ormaza, Efren DMD Rumbel, Richard DDS Seifert, Thomas DDS Sierra-Nieves, Elsie DMD Stein, Paul DDS Ward, Clifford DDS Ward, Tasha DDS Yoho, Thomas DDS General Practice Aime Celian, Beatrice MD Gagot-Rivera, Mirza MD Pierre, Jean MD General Surgery Altaras, Rona MD Clarke, John MD Fikry, Driss PA

Community Mental Health Center Geriatric Psychiatry Peace River Center For Personal Monosiet, Frederic MD Developm Suncoast Center Inc

www.wellcare.com/Florida | 788

ALTERNATE LANGUAGES INDEX French - cont. Hematology Knipe, Richard MD Hematology & Oncology Bergier, Gregoire MD Diaz, Michael MD Mace, Joseph MD Tang, Huayang MD Home Health Care Assisting Hands Gulf Coast Hospice Lifepath Hospice Inc Infectious Disease Levenson, Jeffrey MD Rihana, Nancy MD Suciu, Lavinia MD Internal Medicine Amato, Frank ARNP Asuncion, Melissa MD Jacob, Nirmala MD Korbaj, Rabee MD Leclercq, Baudouin MD Ramiro, Lucila MD Saba, Fadi MD Shires-Waldron, Sarah MD Trevino, Miguel MD Medical Oncology Knipe, Richard MD Lautersztain, Julio MD Nephrology Doumit, Elias MD Durr, Jacques MD Leclercq, Baudouin MD Neurology Benbadis, Selim MD Neurosurgery Valdivia Valdivia, Juan MD Obstetrics/Gynecology Wagner, Stephen MD Young, Caroline ARNP

Cook, Brittany MD Cope, Winston MD Desai, Neel MD Diakonis, Vasilios MD Friedman, Scott MD Greenidge, Kevin MD Hairston, Richard MD Ho, Janie MD Kirsch, Leonard MD Mohadjer, Yasaman MD Moinfar, Nader MD Moscoso, Walter MD Schwartz, Jeffrey MD Swann, Forrest MD Weinstock, Stephen MD Optometry Anderson, Angela OD Anderson, Nicholas OD Barreiro, Francis OD Billings, Rick OD Black, Daniel OD Cothran, Nora OD Gruszka, Melinda OD Johnson, Douglas OD Laplume, Jeffery OD Panchal, Priti OD Peltzer, Bradley OD Russell, Robyn OD Sacksteder, Ryan OD Sevigny, Mark OD Sevigny, Ronald OD Smith, Mary OD Wilcoxon, Dennis OD

Pediatric Hematology/Oncology Goldenberg, Neil MD Pediatric Rheumatology Nickeson Jr, Robert MD Pediatrics Cosic, Sanja MD Herrero, Vivian MD Jara, Audrey MD Marcelin, Jackie ARNP Mulinda, Simon ARNP Pham, Thuy MD Rizkallah, Munir MD Weinberger, Alyssa MD Wolfson, James PA Pedodontics Marcano, Zaida DDS Physical Medicine & Rehabilitation Epting, Stephanie DO Physical Therapy Le, Hoang PT Plastic & Reconstructive Surgery Lo, Percy MD Mir, Haaris MD Podiatry Valins, Robert DPM Psychiatry Monosiet, Frederic MD Patel, Shodhan MD Seignon, Caroline ARNP

Orthopaedic Surgery Cronen, Geoffrey MD Pinkas, Daphne MD Shereff, Michael MD

Pulmonary Disease Ameh, Joseph MD Loutfi, Rabih MD Zanchi, Dragos MD

Pediatric Cardiology Bernus, Anna MD Freire, Grace MD Garcia, Jorge MD Ramos, Agustin MD

Retail Bartow Pharmacy Med Supply Bay Discount Pharmacy Best Deal RX Pharmacy Careplus Pharmacy Dollex Pharmacy Exactus Pharmacy Solutions Inc Express Specialty Pharmacy Healthmed Pharmacy

Pediatric Cardiovascular Surgery Viegas, Melita MD

Ophthalmology Barnes, Raymond MD

www.wellcare.com/Florida | 789

ALTERNATE LANGUAGES INDEX French - cont. Retail - cont. Hedges Healthmart Pharmacy Hillsborough River Pharmacy Inc Jrx Pharmacy Manatee Discount Pharmacy Medrock Pharmacy Oaks Community Pharmacy Pharmacy One Pro Specialty Care Ph Pharmalabs Promise Pharmacy Quick N Save Pharmacy Quickn Save Pharmacy Rays Pharmacy RX Solutions Inc Sarasota Discount Pharmacy St Mary Pharmacy Trust Pharmacy Villa Pharmacy Watsons Pharmacy Skilled Nursing Facility Florida Presbyterian Homes Inc Heather Hill Nursing Home-Pcs Heritage Health Care Center St Petersburg Nursing and Rehabilitation

Behavioral Health Facility Adoption Related SVS - Pinellas, Inc Cardiac Electrophysiology Herweg, Bengt MD Cardiology Chang, Fong MD Georgiev, Maria MD Herweg, Bengt MD Jauch, Werner MD Zaki, Khaja MD Dermatology Vasiloudes, Panos MD Durable Medical Equipment Activstyle Inc Ally Medical Services LLC Solarus Enterprises LLC Endocrinology, Diabetes, Metabolism Chaykin, Louis MD Family Practice Fleener, Carola MD

Specialty Exactus Pharmacy Solutions Inc

Gastroenterology Freedland, Curtis DO Luckey, Lisa DO Staffetti, Joseph MD

Substance Abuse Peace River Center For Personal Developm

General Practice Heinrichs, Richard MD Nusbaum, Lana MD

Vascular Surgery Gabriel, Yves MD

General Surgery Altaras, Rona MD Pernicone, Meira MD Straub, Donald DO Wright, Alene MD

Georgian Hematology & Oncology Hopman, Rusudan MD German Behavioral Health Counseling Christova, Albena LMHC Cooney, Patricia LCSW Dubovsky, Ladislaus LMHC Kassed, Marvin LMHC

Hematology & Oncology Bergier, Gregoire MD Internal Medicine Tanyous, Walid MD Nephrology Durr, Jacques MD Toka, Hakan MD

www.wellcare.com/Florida | 790

Neurology Raccio, Diane ARNP Neurosurgery Agazzi, Siviero MD Obstetrics/Gynecology Holstrom, Shelly MD Wagner, Stephen MD Orthopaedic Surgery Nofsinger, Charles MD Pediatric Cardiology Ivsic, Tomislav MD Kakavand, Bahram MD Ramos, Agustin MD Pediatric Hematology/Oncology Rossbach, Hans-Christoph MD Pediatric Neurosurgery Rodriguez, Luis MD Pediatrics Armstrong, Christine MD Fleener, Carola MD Meyer, Ernesto MD Smith, Jessica MD Weinberger, Alyssa MD Physical Medicine & Rehabilitation Beard, Margita MD Physical Therapy Watson, Maxine PT Plastic & Reconstructive Surgery Dayicioglu, Deniz MD Psychology Hemsath, Randolph PsyD Pulmonary Disease Zanchi, Dragos MD Retail Best Deal RX Pharmacy City Pharmacy Embassy Pharmacy Exactus Pharmacy Solutions Inc Jk Care Pharmacy Lemon Bay Drugs East Onestop RX Pharmacy

ALTERNATE LANGUAGES INDEX German - cont. Retail - cont. Pegasus RX Pharmacy Pharmalabs Z Orange Pharmacy

Pediatrics Allison, Joanna MD Retail The Medicine Shoppe

Skilled Nursing Facility Advanced Care Center Greenbriar Nursing & Rehab

Gujarati

Specialty Exactus Pharmacy Solutions Inc

Allergy & Immunology Degala, Ami MD

Vascular Surgery Wilson, Scott MD

Cardiology Patel, Darshan MD

Greek

Diagnostic Imaging Gateway Radiology At McEr Gateway Radiology Consultants

Behavioral Health Counseling Averoff, Lisa LMHC Cardiology Goldman, Stephen MD Kokolis, Rodamanthos MD Pitarys II, Christos MD Chiropractic Constantine, Nicholas DC Dermatology Fotopoulos, Theodore MD Vasiloudes, Panos MD Diagnostic Imaging Carlisle Imaging Center Durable Medical Equipment Mercury Medical Internal Medicine Pitarys II, Christos MD Obstetrics/Gynecology Igel, G MD Oral & Maxillofacial Surgery Ricalde, Pat DDS Orthopaedic Surgery Moreno, Anthony MD Pediatric Cardiology Raptoulis, Arthur MD

Adolescent Medicine Derasari, Kalyani MD

Shastri, Milind MD Nephrology Dessani, Nehal MD Neurology Kalidas, Kavita MD Patel, Pruthu MD Shah, Rakesh MD Obstetrics Patel, Niraj MD Pediatric Cardiology Trivedi, Bhavya MD

Endocrinology, Diabetes, Metabolism Parbhoo, Arvind MD Patel, Sonal MD

Pediatrics Derasari, Kalyani MD Desai, Rupal MD Patel, Daksha MD Patel, Jaydeep MD Patel, Payal MD Roscher, Elizabeth ARNP Umeh, Ifeyinwa MD

Family Practice Patel-Elio, Bhiru MD

Physical Medicine & Rehabilitation Gupta, Amitabh MD

Gastroenterology Mehta, Ashwin MD

Psychiatry Patel, Pragnesh MD Patel, Shodhan MD Shah, Nihal MD Vijapura, Ashit MD

General Practice Patel, Mangesh MD Geriatric Medicine Choksi, Tarak MD Hematology & Oncology Desai, Pratibha MD Patel, Anjan MD Internal Medicine Amin, Mukund MD Bhadja, Kantilal MD Choksi, Tarak MD Desai, Pratibha MD Patel, Chandravadan MD Patel, Krunal MD Patel, Pragnesh MD Patel, Pritesh MD Patel, Sonal MD Shah, Avani MD Shah, Nilamben MD

www.wellcare.com/Florida | 791

Pulmonary Disease Pansuriya, Vinubhai MD Patel, Nirav MD Shah, Sailesh DO Haitian Creole Behavioral Health Counseling Dulcio, Magdala LMHC Hebrew Behavioral Health Facility Neuropsychiatric Institute LLC Cardiology Talit, Uzi MD Gastroenterology Izsak, Eliezer MD

ALTERNATE LANGUAGES INDEX Hebrew - cont. General Surgery Pernicone, Meira MD Neurology Khamisani, Saleem MD Retail Davis Islands Pharmacy Hindi Adolescent Medicine Derasari, Kalyani MD Allergy & Immunology Rohatgi, Nalini MD Salim, Nauman MD Weiss, William MD Ambulatory Surgery Center St Petersburg Endoscopy Center Cardiac Electrophysiology Ahmed, Safi MD Gandhi, Malay MD Shah, Shalin MD Cardiology Bhandare, Deepti MD Bhashyam, Siva MD Chauhan, Ketul MD Goldman, Stephen MD Gupta, Sunil MD Javeed, Najam MD Kethireddy, Ravi MD Khamare, Chetan MD Krishnamurthy, Ashok MD Kumar, Siva MD Parekh, Dipak MD Rahim, Abdur MD Rajendran, Pattabhraman MD Rao, Ramanath MD Raxwal, Vinod MD Reddy, Mohan MD Sawar, Asad MD Sharma, Nagaraja MD Singh, Alok MD Thangam, Sabanayagam MD Child Neurology Rao, Radhakrishna MD

Dermatology Thareja, Sumeet MD Diagnostic Imaging Central Florida Imaging Center Inc Excel Medical Imaging Gateway Radiology At McEr Gateway Radiology Consultants Endocrinology, Diabetes, Metabolism Baig, Mohammad MD Family Practice Chintakayala, Durga MD Desai, Sanjiv MD Khan, Kashan MD Khurana, Sunaina MD Kurakula, Satya MD Mankodi, Kshemal MD Noorani, Nazneen MD Patel-Elio, Bhiru MD Pothiawala, Yakub MD Shoba, Sama MD Singh, Manju MD Soni, Ambica MD Gastroenterology Choudhry, Umesh MD Freedland, Curtis DO Ghanekar, Dilip MD Iyunni, Venkata MD Kahlon, Devendra MD Patel, Jigneshkumar MD Patel, Mihir MD Prasad, Ishwari MD Reddy, Tiyyagura MD Sanjeevi, Arthi MD Taunk, Jawahar MD Vangara, Sreenivas MD General Dentistry Ankalikar, Satish DDS Kapadia, Mukesh DDS General Practice Bhatia, Gitashree MD Patel, Mangesh MD General Surgery Deshpande, Vilas MD

www.wellcare.com/Florida | 792

Menon, Meera MD Ravindra, Nagella MD Geriatric Medicine Choksi, Tarak MD Hussain, Sayyed MD Hematology Gupta, Eva MD Kamath, Geetha MD Hematology & Oncology Dandamudi, Uday MD Desai, Pratibha MD Jooma, Nurruddin MD Nakka, Sushma MD Patel, Hitesh MD Shah, Ramesh MD Infectious Disease Aneja, Parul MD Khan, Nadeem MD Internal Medicine Ali, Asad MD Amin, Mukund MD Aneja, Parul MD Atluri, Tej MD Bhandare, Deepti MD Bhashyam, Siva MD Bhatia, Gitashree MD Chauhan, Ketul MD Chazhikattu, Ambrose John MD Choksi, Tarak MD Deray, Dipesh MD Desai, Pratibha MD Farooqui, Zubair MD Issar, Jeetendra MD Issar, Rekha MD Karkare, Rajendra MD Mathan, Sukumar MD Mehta, Shital DO Mora Rasquin, Georges MD Narayan, Aurindom MD Patel, Krunal MD Patel, Pragnesh MD Patel, Pritesh MD Patel, Rajnikant MD Quadri, A H Zehra MD Rao, Kavita MD

ALTERNATE LANGUAGES INDEX Hindi - cont. Internal Medicine - cont. Reddy, Ashok MD Sandhu, Jagdeep MD Shah, Nilamben MD Shastri, Milind MD Singh, Japinder MD Zaffar, Nauman MD Interventional Cardiology Raxwal, Vinod MD Maternal Fetal Medicine Nirgudkar, Pranita MD Medical Oncology Gupta, Eva MD Kamath, Geetha MD Raiker, Anilkumar MD Telukuntla, Koteshwar MD

Patel, Nandesh MD Perez Gonzalez Deapodaca, Jose MD Prado, Antonio MD Optometry Cuva, Philip OD Lieb, Gregory OD Orthopaedic Surgery Bhat, Anjali PA Nair, Sajeevakumar MD Pediatric Cardiology Babu, Keshava MD Ballal, Natraj MD Pediatric Gastroenterology Arasu, Thiru MD Pediatric Psychiatry Ali, Muhammad MD

Neonatal Perinatal Medicine Maheshwari, Akhil MD

Pediatric Pulmonology Verma, Shivani MD

Nephrology Adla Reddy, Mahathi MD Dcunha, Prakas MD Goel, Naveen MD Ramamurthy, Guruswamy MD Sagar, Vidya MD Varkala, Sreelatha MD

Pediatrics Brar, Sardul MD Derasari, Kalyani MD Desai, Rupal MD Hicks, Mary MD Issar, Jeetendra MD Kahlon, Harpreet MD Kamisetty, Sudarsan MD Kharbanda, Monica MD Kumar, Mudra MD Lokesh, Haravu MD Nimbargi, Stephen MD Pai, Rajendra MD Palta, Anoop MD Parikh, Snehal MD Patel, Anilkumar MD Patel, Daksha MD Patel, Payal MD Pillai, Anantha MD Pruthi, Jagdeep MD Raghuveera, Anavatti MD Raguthu, Lalitha MD Ramappa, Gogi MD Rau, Sathyanarayan MD Roscher, Elizabeth ARNP Savino, Tarah PA

Neurology Bitar, Hassan MD Chari, Ganesh MD Sahoo, Sanjiv MD Shah, Rakesh MD Shah, Siddharth MD Obstetrics Patel, Niraj MD Obstetrics/Gynecology Best, Erin MD Qadri, Syed MD Ramappa, Renuka MD Ophthalmology Berger, Todd MD Kasper, Jeffrey MD Levy-Clarke, Grace MD Orlick, Martin MD

www.wellcare.com/Florida | 793

Tabassum, Rana MD Umeh, Ifeyinwa MD Physical Medicine & Rehabilitation Gupta, Amitabh MD Plastic & Reconstructive Surgery Lo, Percy MD Mir, Haaris MD Psychiatry Ali, Muhammad MD Bedi, Bharminder MD Dhillon, Amarjeet MD Kirmani, Najib MD Nadeem, Abdul MD Patel, Ashok MD Patel, Pragnesh MD Shah, Nihal MD Vangala, Vidyasagar MD Psychology Williams, Mark PHD Pulmonary Disease Agrawal, Rajesh MD Cardona, Jerges MD Chandarana, Himanshu MD Kumar, Alok MD Patel, Nirav MD Shah, Rakesh MD Sorathia, Divyang MD Radiation Oncology Sinha, Purendra MD Retail 5 Star Pharmacy 54th Ave Pharmacy Ab Specialty Pharmacy Inc Acme Pharmacy Anclote Pharmacy Aum Pharmacy Axcess Pharmacy Bay Life Pharmacy II Baycare Homecare Bayshore Pharmacy Blake Pharmacy Cleveland Heights Pharmacy Community Specialty Pharmacy Curlew Pharmacy

ALTERNATE LANGUAGES INDEX Hindi - cont. Retail - cont. Edwards Pharmacy Ellenton Discount Pharmacy Fairway Pharmacy Familycare Discount Pharmacy Florida Pharmacy Good Health Pharmacy Gulfport Pharmacy Health Pro Pharmacy Healthlink Pharmacy Healthwise Pharmacy Inc Highlands Pharmacy Hudson Drugs Hudson Pharmacy Imed Pharmacy Js Pharmacy Lakewood Ranch Pharmacy Land O Lakes Pharmacy Lemon Bay Drugs North Medica Scripts Medicine Place Medilink Pharmacy Medplus Pharmacy Meds Made Easy Noble Care Pharmacy Northdale Pharmacy Novopharm of Tampa, LLC One-Stop Pharmacy 101 Palm Plaza Pharmacy Palmetto Drug Mart Palms Pharmacy Pharmscript Plant City Discount Pharmacy Prime RX Pharmacy Quick Pharmacy Rays Pharmacy Rite RX Care Ritemed Pharmacy Rowan Discount Pharmacy Royal Pharmacy RX Care Pharmacy RX Discount Pharmacy RX Express Pharmacy RX Oasis Sarasota Pharmacy Sv Co Bee Ridge Pharmacy Save-Rite Pharmacy

Scripts Direct LLC Seffner Pharmacy St Josephs Pharmacy St Petersburg Pharmacy Summergate Pharmacy Sun Discount Pharmacy Sun Pharmacy of Venice Sunlife Pharmacy Sunrise Pharmacy Super Discount Pharmacy Tampa Drugs Diabetic Center Tampa Palms Pharmacy The Apothecary Shop Total Care Pharmacy of Bloomingdale Total Care Pharmacy of Brandon Univ Pain Management Center Urban Specialty Pharmacy Vistara Pharmacy Wauchula Pharmacy We Care Pharmacy We-Care Pharmacy Winter Haven Pharmacy Urgent Care Center Doctor Today Urgent Care LLC Urology Rehman, Jamil MD Hungarian Diagnostic Imaging Gateway Radiology Consultants Family Practice Espinoza, Daniel MD Pediatrics Porcelli, Monica MD

Indonesian Child Neurology Rao, Radhakrishna MD Hematology & Oncology Shah, Ramesh MD Internal Medicine Rao, Kavita MD Italian Behavioral Health Facility Neuropsychiatric Institute LLC Cardiac Electrophysiology Herweg, Bengt MD Cardiology Arroyo, Luis MD Di Martino, Peter MD Herweg, Bengt MD Maniscalco, Benedict MD Marques, Vasco MD Mokotoff, David MD Talit, Uzi MD Chiropractic Stangherlin, Michael DC Family Practice Urso, Gaetano DO Gastroenterology Freedland, Curtis DO Ghanekar, Dilip MD Staffetti, Joseph MD General Practice Heinrichs, Richard MD

Indian

Internal Medicine Di Martino, Peter MD Jacob, Nirmala MD Maniscalco, Benedict MD Palazzolo, Arlene MD Portnow, Arthur MD

Cardiology Thangam, Sabanayagam MD

Medical Oncology Altemose, Rand MD

Psychiatry Rao, Takkallapelli MD

Nephrology Durr, Jacques MD

Ibo/Igbo Internal Medicine Mbakwem, Alexander MD

www.wellcare.com/Florida | 794

ALTERNATE LANGUAGES INDEX Italian - cont. Neurosurgery Agazzi, Siviero MD Obstetrics/Gynecology Hernandez, Lazaro MD Orthopaedic Surgery Moreno, Anthony MD Pediatric Cardiology Garcia, Jorge MD Ramos, Agustin MD Raptoulis, Arthur MD Pediatric Surgery Paidas, Charles MD Pediatrics Pelaez, Robert MD Podiatry Giannone, Louis DPM Valins, Robert DPM

Hematology Kamath, Geetha MD Infectious Disease Aneja, Parul MD Internal Medicine Aneja, Parul MD Bhashyam, Siva MD Chazhikattu, Ambrose John MD

Retail Life Saverx, LLC Macdill Pharmacy Kurdish

Medical Oncology Kamath, Geetha MD

Thoracic & Cardiovascular Surgery Hakki, A MD

Neurology Yathiraj, Sanjay MD

Laotian

Pediatrics Pai, Rajendra MD Ranganathan, Radhika MD Korean Behavioral Health Counseling Bjorkman, Tara LMHC

Retail Best Deal RX Pharmacy Healthmed Pharmacy

Gastroenterology Chang, John MD

Rheumatology Crager, Kenneth MD

General Dentistry Park, James DDS Woo, Kyung DDS

Skilled Nursing Facility Heritage Health Care Center

Optometry Braudway, Sonya OD Detweiler, Edwin OD Long, Lori OD

General Surgery Cha, John MD

Thoracic & Cardiovascular Surgery Ophthalmology Golino, Alessandro MD Ahn, Byung-Joon MD Smith Jr, Ronald MD Anthony, Charles MD Japanese Berger, Adam MD Berger, Todd MD Infectious Disease Foster, John MD Offner, Lenka MD Friedman, Robert MD Orthopaedic Surgery Friedman, Scott MD Moulton, Andrew MD Hamilton, Richard MD Hector, Richard MD Kannada Kasper, Jeffrey MD Cardiology Mali, Joshua MD Bhashyam, Siva MD McCabe, Cathleen MD Gowda, Umesh MD Misch, David MD Moon, Suk MD Child Neurology Randolph, John MD Rao, Radhakrishna MD

www.wellcare.com/Florida | 795

Gastroenterology Trotman, Bruce MD Neurology Raccio, Diane ARNP Lithuanian Gastroenterology Trotman, Bruce MD Malayalam Cardiology Mathew, Dilip MD General Surgery Menon, Meera MD Internal Medicine Chazhikattu, Ambrose John MD Jacob, Nirmala MD Rao, Kavita MD Shires-Waldron, Sarah MD Orthopaedic Surgery Nair, Sajeevakumar MD Mandarin Hematology & Oncology Yan, Ben MD Internal Medicine Durojaiye, Babatola MD Nephrology Numrungroad, Visal MD

ALTERNATE LANGUAGES INDEX Mandarin - cont. Neurology Gu, Qin MD Marathi Internal Medicine Desai, Pratibha MD Maternal Fetal Medicine Nirgudkar, Pranita MD Pediatrics Palta, Anoop MD Norwegian Behavioral Health Counseling Allen, Sarah LCSW Rehabilitation Facility Childrens Therapy Solutions Inc Pashtu Geriatric Medicine Hussain, Sayyed MD Persian - Farsi Cardiology Faghih, Fakhredin MD Shah, Abid MD Neurology Bazargan, Sadaf MD Polish

Gastroenterology Zalepuga, Rimantas MD General Dentistry Helmy, George DDS Park, James DDS Raffoul, Georges DMD Reyes, Monika DMD Hematology & Oncology Ho, Vu Tran MD Mace, Joseph MD Infectious Disease Casanas, Beata DO Internal Medicine Casanas, Beata DO Kaszuba, Robert MD Nowacki, Mark MD Nephrology Siedlecki, Michael MD Obstetrics/Gynecology Igel, G MD Orthodontics Nguyen, James DMD Pediatric Cardiology Raptoulis, Arthur MD Pediatrics Dembinksi, Karolina DO Jackson-Curtis, Danuta MD

Millstein, Ashley DMD General Dentistry Bacchelli, Lara DMD Branscombe, Tyler DMD Caputo, Michael DDS Dockus, Matthew DMD Genninger, Jasen DMD Hall, Joshua DMD Kanach, Paul DMD Mazariegos, Stephanie DMD Siemiet, Erika DDS Trivedi, Mehulkumar DMD Wade, Brianne DMD Hematology & Oncology Ayub, Jorge MD Diaz, Michael MD Medical Oncology Lautersztain, Julio MD Neurosurgery Valdivia Valdivia, Juan MD Obstetrics/Gynecology Ray, Tanya ARNP Orthopaedic Surgery Moulton, Andrew MD Pediatrics Carr, Silvana MD Meyer, Ernesto MD Weinberger, Alyssa MD

Retail Bradenton Hometown Pharmacy

Pedodontics Bezerra, Francisco DDS Nensey, Zara DDS

Child Neurology Sadlowski, Yolanta PA

Skilled Nursing Facility Bear Creek Nursing Center The Springs At Lake Pointe Woods

Pulmonary Disease Mikulic, Lucas MD

Dialysis American Dialysis Center Inc

Portuguese

Rehabilitation Facility True Blue Therapy LLC

Cardiology Hernandez, Felix MD Marques, Vasco MD

Retail Americas Pharmacy

Behavioral Health Counseling Christova, Albena LMHC Cooney, Patricia LCSW

Endocrinology, Diabetes, Metabolism Janicka, Ania DO Family Practice Kolanko, Przemyslaw MD

Diagnostic Imaging Tampa Bay Diagnostic Imaging Endodontics Gargasz, Bret DDS

www.wellcare.com/Florida | 796

Punjabi Allergy & Immunology Salim, Nauman MD

ALTERNATE LANGUAGES INDEX Punjabi - cont.

Romanian

Ambulatory Surgery Center St Petersburg Endoscopy Center

Cardiology Akel, Rami MD

Cardiology Raxwal, Vinod MD

Dermatology Funieru, Iulia MD

Gastroenterology Iyunni, Venkata MD Kahlon, Devendra MD Patel, Mihir MD

Gastroenterology & Hepatology Onea, Mirela MD

Infectious Disease Aneja, Parul MD Internal Medicine Aneja, Parul MD Kundlas, Kulmeet MD Sandhu, Jagdeep MD Zaffar, Nauman MD Interventional Cardiology Raxwal, Vinod MD Medical Oncology Haider, Kamal MD Ophthalmology Berger, Todd MD Kasper, Jeffrey MD Levy-Clarke, Grace MD Orlick, Martin MD Patel, Nandesh MD Orthopaedic Surgery Chaudhri, Tahir MD Pediatric Pulmonology Verma, Shivani MD Pediatrics Brar, Sardul MD Kahlon, Harpreet MD Kharbanda, Monica MD Palta, Anoop MD Pruthi, Jagdeep MD Shamim, Tabassum MD Tabassum, Rana MD Urology Rehman, Jamil MD

Infectious Disease Suciu, Lavinia MD Obstetrics/Gynecology Teodorescu, Dumitru-Dan MD Ophthalmology Cook, Brittany MD Cope, Winston MD Desai, Neel MD Diakonis, Vasilios MD Greenidge, Kevin MD Hairston, Richard MD Ho, Janie MD Kirsch, Leonard MD Mohadjer, Yasaman MD Schwartz, Jeffrey MD Swann, Forrest MD Weinstock, Stephen MD Optometry Anderson, Nicholas OD Barreiro, Francis OD Cothran, Nora OD Gruszka, Melinda OD Johnson, Douglas OD Laplume, Jeffery OD Panchal, Priti OD Sacksteder, Ryan OD Smith, Mary OD Wilcoxon, Dennis OD Pediatrics Chiritescu, Cristian MD Lucero, Heather ARNP Porcelli, Monica MD Umeh, Ifeyinwa MD Russian Behavioral Health Counseling Christova, Albena LMHC

www.wellcare.com/Florida | 797

Cooney, Patricia LCSW Rojas, Paola LMHC Cardiology Raxwal, Vinod MD Community Mental Health Center Suncoast Center Inc Diagnostic Imaging Tampa Bay Diagnostic Imaging Durable Medical Equipment Medi Health Care Inc Endodontics Gittess, Robert DDS Family Practice Stoyanov, Veselin MD Gastroenterology Zalepuga, Rimantas MD General Dentistry Arnedo, Johanna DDS Atkinson, William DDS Attie, Abelardo DMD Baez Henry, Carlianette DMD Baez, Tomas DDS Chase, Kely DMD Das, Shilpa DDS Decambra, Nicole DMD Diaz, Jany DMD Dire, Anthony DMD Dolce, Vincent DMD Durve, Aparna DMD Fornos, Jorge DDS Fuller, Ellis DDS Goldstein, Alexander DDS Gonzalez, Yanela DMD Green, George DDS Gutu, Elena DMD Immadi, Lakshmi DDS Inaba, Caroline DDS Kiani, Kamran DMD Kohn, Heather DDS Kopynets, Viktor DDS Krasnov, Rostislav DDS Kuntsmann, Vivian DDS Lipton, Barry DDS Lopez, Grace DMD

ALTERNATE LANGUAGES INDEX Russian - cont. General Dentistry - cont. Manzur, Kasim DDS Marshall, Kristine DDS Martinez, Gustavo DMD Matthews, Irina DMD Morell, Omar DMD Mutawalli, Khalid DDS Nguyen, David DMD Pansuriya, Dharmendra DMD Pham, Thi DDS Prato-Guia, Yelena DDS Qadri, Subuhi DMD Quevedo, Fernando DDS Quevedo, Rachel DDS Reed, Samantha DDS Ribot, Aliana DMD Uzunova-Dimova, Kalina DDS Valdman, Vadim DDS Weisser, Ettie DDS Williams, Tosha DDS Woo, Kyung DDS Zand, Maximus DMD Zariffard, Ehsan DMD Hematology Glick, Alexander MD Knipe, Richard MD Home Health Care Access Home Health Care Inc DBA Preferre Internal Medicine Amato, Frank ARNP Arkhipenko, Tatiana MD Kurtsikidze, Nino MD Saprounova-Hopf, Vera MD Interventional Cardiology Raxwal, Vinod MD Medical Oncology Glick, Alexander MD Knipe, Richard MD Neurology Chichkova, Rossita MD Neurosurgery Mokin, Maxim MD

Obstetrics/Gynecology Doyle-Vallery, Deanna MD Easterling, Gary MD

Sign Family Practice Malone, Donna DO

Orthodontics Nelson, Stephen DMD Parsa, Mitra DDS

Slovak

Orthopaedic Surgery Nofsinger, Charles MD

General Practice Snyder, Donald MD

Pediatrics Strum, Neta MD

Infectious Disease Vega, Vilma MD

Pedodontics Bui, Loananh DDS Busciglio, Dana DMD Edwards, Jenny DMD Larkin, Brandon DDS Makram, Christina DDS Naoom, Jennifer DDS Pinero Correa, Rosario DDS Sirage, Mohamed DMD

Internal Medicine Vega, Vilma MD

Plastic & Reconstructive Surgery Lo, Percy MD Psychiatry Polur, Marina MD Pulmonary Disease Furman, Alexandre MD Retail Bayshore Pharmacy Gulf Gate Pharmacy Manatee Discount Pharmacy Medical Arts Pharmacy North Port Family Health Center Pharmacy RX Solutions Inc Salhab Pharmacy Sarasota Pharmacy Sv Co Bee Ridge Pharmacy Town Pharmacy Urology Belilovskiy, Elina ARNP Serbo-Croation Pediatric Hematology/Oncology Petrovic, Aleksandra MD

www.wellcare.com/Florida | 798

Gastroenterology Mompi, Emmanuel MD

Spanish Adolescent Medicine Marcelin, Jackie ARNP Meyer, Laura MD Advance Registered Nurse Practitioner Psychiatrist Christian III, Claiborne LMHC Allergy & Immunology Dominguez, Jose MD Downes, Sandra MD Rohatgi, Nalini MD Sanka, Madhurima DO Weiss, William MD Windom, Hugh MD Ambulatory Surgery Center Armenia Ambulatory Surgery Center Inc Brandon Ambulatory Surgery Center Brandon Outpatient Surgery Center Davenport Ambulatory Surgery Center LLC North Pinellas Surgery Center Tampa Bay Surgery Center Westchase Surgery Center LTD Behavioral Health Counseling Allen, Sarah LCSW Bunton, Miriam LCSW Chila, J Patricia LMHC Claudio Torres, Angela LMHC

ALTERNATE LANGUAGES INDEX Spanish - cont. Behavioral Health Counseling cont. Cooney, Patricia LCSW De Armas, Odalys LMHC Kassed, Marvin LMHC Kroll, Linda LCSW Lewis, Rayna LMHC Lyublanovits, Deborah LMHC Mercuri, Danielle LCSW Musselwhite-Weaver, Patricia LMHC Odio, Francine LMHC Olivares, Alicia LMHC Porter, Margaret LCSW Rojas, Paola LMHC Santiago, Karmivis LMHC Van Kleeck, Phillip LMHC Behavioral Health Facility Adoption Related SVS - Pinellas, Inc Bay Area Behavioral Services Inc Centerstone of Florida Inc Directions For Living Family Preservation Service Gulf Coast Jewish Family and Community S Neuropsychiatric Institute LLC Resilience Counseling Center Inc Sequelcare of Florida LLC St Josephs Hospital The Florida Center For Early Childhood Birthing Center Countryside Birthing Place Inc Cardiac Electrophysiology Annoni-Suau, Luis MD Cassidy, Dennis MD Jimenez, Raul MD Cardiology Akella, Jagan MD Annoni-Suau, Luis MD Arroyo, Luis MD Bartell, Lisa ARNP Bayron, Carlos MD Betzu, Robert MD

Bhandare, Deepti MD Bugni, William MD Cardona, Francisco MD Codolosa, Jose MD Cook, William MD Dagher, George MD Delgado, Francisco DO Di Martino, Peter MD Doud, Debra MD Feliz De LA Cruz, Victor MD Fernandez, Joel MD Gallardo, Ignacio MD Georgiev, Maria MD Goldman, Stephen MD Gowda, Umesh MD Hernandez, Felix MD Jimenez, Raul MD Khadim, Ghazanfar MD Khamare, Chetan MD Khant, Ranchhod MD Kokolis, Rodamanthos MD Kunhardt, Rene MD Leche, Carlos MD Maniscalco, Benedict MD Marques, Vasco MD Mester, Stephen MD Michel, Alejandro MD Mokotoff, David MD Nunez, Boris MD Patel, Darshan MD Pitarys II, Christos MD Ramirez, John MD Rao, Ramanath MD Reddy, Mohan MD Rivera, Enrique MD Roca, Jose MD Rodriguez, Rolando MD Rogal, Philip MD Rosenthal, Andrew MD Roy, Bipul MD Saiyad, Saleem MD Salazar, Manuel MD Sanchez, Robert MD Stauffer, Marc MD Talit, Uzi MD Tamboli, Hoshedar MD Torres, Ramon MD Wilson, Christopher DO

www.wellcare.com/Florida | 799

Win, Moethu MD Zaki, Khaja MD Certified Nurse Midwife McMorris Soucy, Sally CNM Smith, Karla CNM Whipple, Judith CNM Child Neurology Arroyo, Lizbeth ARNP Ferreira, Carmen MD Ferreira, Jose MD Jacinto, Sergio MD Nguyen, Colin MD Sadlowski, Yolanta PA Chiropractic Altman, James DC Barry, Scott DC Brecher, Matthew DC Byrne, Steven DC Caez, Brian DC Cox, Stephen DC Golden, Robert DC Grappin, Linda DC Price-Mccarthy, Staci DC Puentes, David DC Raemisch, Christopher DC Rodriguez, Robert DC Santana, Jorge DC Wages, David DC Williams, Christopher DC Colon & Rectal Surgery Sanchez, Jamie MD Community Mental Health Center Childrens Home Society of Florida Coastal Behavioral Healthcare Inc Dacco Impower Inc Jewish Family and Childrens Svcs Lifeshare Management Group LLC Mgm Case Management Services Inc Mts Health Services LLC Operation Par Inc Peace River Center For Personal Developm Personal Enrichment Through Mental Healt

ALTERNATE LANGUAGES INDEX Spanish - cont.

Durable Medical Equipment Community Mental Health Center Activstyle Inc - cont. Airlife Medical LLC Suncoast Center Inc Ally Medical Services LLC Tri County Human Services Inc Express Orthotics and Prosthetics Inc Dermatology Medi Health Care Inc Armstrong, Frank DO Medical Systems of Central Florida Belongie, Iriana MD Inc Caban, Francis MD Mercury Medical Funieru, Iulia MD MS Supply and Home Health Co Garcia Cardona, Maria MD National DME LLC Gutierrez, Michael MD Qualimed Respiratory and Mobility Leto, Melissa PA Inc Quintero, Yaquelin ARNP Solarus Enterprises LLC Romagnolo, Stephen MD Ear, Nose & Throat Sable, David MD Berrios, Jose MD Shulstad, Raymond ARNP Dipasquale, Paul DO Taylor, Thomas MD Lingamallu, Ratnamani MD Thareja, Sumeet MD Matallana, Herman DO Vasiloudes, Panos MD Robinson, Kevin MD Dermatopathology Shea, Roger MD Belongie, Iriana MD Stuart, Menachem MD Eng, William MD Tabesh, Amanollah MD Rodriguez Waitkus, Paul MD Endocrinology, Diabetes, Diagnostic Imaging Metabolism Advanced Diagnostic Group Aquino, Sheila ARNP Advanced Technological Radiology Chaykin, Louis MD Baycare Outpatient Imaging Gilling, Lucia MD Baycare Outpatient Imaging Center Penabad, Jesus MD Pinero-Pilona, Antonio MD Carlisle Imaging Center Endodontics Gateway Radiology At McEr Baker, James DDS Gateway Radiology Consultants Cherian, Shiju DDS Manatee Diagnostic Center Gargasz, Bret DDS MRI Associates of St Pete Partners Imaging Center of Naples Kan, Elena DDS Kellogg, David DDS Rose Radiology Centers Inc Millstein, Ashley DMD Stjosephs Diag Cntr Susan Cheek Needler Breast Center Mir, Hamza DDS Schwartz II, William DDS Sreekantaiah, Kiran DDS Tampa Bay Diagnostic Imaging Tower Imaging Inc Family Practice Westcoast Radiology LTD Antigua-Suarez, Nathaly PA Dialysis American Dialysis Center Inc

Arias, Carlos MD Brand, Andrea MD Casler, Viva ARNP

www.wellcare.com/Florida | 800

Chintakayala, Durga MD Confident, Leonard MD Cruz, Jose MD Curtis, Lindsay ARNP Dean, Byron DO Denzer, Lisa ARNP Desai, Sanjiv MD Diwadkar, Vijay MD Espinoza, Daniel MD Fleener, Carola MD Gaik, Shane ARNP Garrido Jr, Eduardo PA Greenfield, Adam DO Greenfield, Steven MD Guzman, Andrew MD Hoefferle, Claudia PA Murphy, William DO Negrete, Latosha ARNP Noorani, Nazneen MD Nystrom, Joseph MD O'Brien, James DO O'Brien, Rhonda ARNP Olton, Robert PA Parker, Vicki ARNP Patel-Elio, Bhiru MD Pinilla, Sandra MD Pollan, Alina MD Pothiawala, Yakub MD Rodriguez, Carlos MD Rodriguez, Madali ARNP Sangosanya, Tatiana ARNP Shaub, Brian DO Soni, Ambica MD Urso, Gaetano DO Valdes, Ruben DO Valez Gaetan, Jelexza MD Velasco Segarra, Luis MD Woodyard, John PA Gastroenterology Delgado, John MD Ekici, Sedat MD Freedland, Curtis DO Ghanekar, Dilip MD Grauer, Leopoldo MD Heiman, David MD Iyunni, Venkata MD Jacobs, John MD

ALTERNATE LANGUAGES INDEX Spanish - cont. Gastroenterology - cont. Kero, Shawkat MD Lopez, Luis MD Luckey, Lisa DO Mendoza, Alfredo MD Mohiuddin, Muhammad MD Mompi, Emmanuel MD Rosario, Angel MD Staffetti, Joseph MD Steckler, Eric MD Vargas, David MD General Dentistry Abreu, Edward DMD Acquaro, Ronald DMD Adderly, Erica DDS Adewunmi, Mopelola DDS Adibi, Farnaz DMD Akel, Amir DMD Alonso, Zenaida DDS Alter, Jason DMD Alvarez, Juan DDS Alviani, Clay DMD Amaro, David DDS Amrooei, Danoosh DMD Antony, Archana DDS Arditi, Sibel DMD Arora, Payal DDS Austin, Deborah DDS Avila, Daira DMD Azadi, Anthony DDS Bacchelli, Lara DMD Baghdadi-Gegati, Marcel DDS Baker, Wayne DDS Barinas-Duval, Froilan DDS Barlow, Kathleen DDS Barrett, Steven DDS Barzyk, Jeffrey DMD Beach, Christopher DDS Beers, Eda DDS Beitscher, Stan DDS Belaunzaran, Pedro DDS Berk, Madeline DMD Bessada, Ashraf DMD Biandudi, Odessa DDS Boswell, Gibson DMD Boyett, Kimberly DDS

Brachowicz, Maria DDS Bradley, Ashley DMD Branscombe, Tyler DMD Brattain, Andrew DMD Brito, Daryl DMD Brown, Troy DDS Budzinski, Volha DDS Bushati, Ivo DMD Calcagno, Manuel DDS Calderon, Nadia DDS Canizares, Carina DMD Caputo, Michael DDS Carbonell, Kevin DMD Cardenas, Carlos DDS Carter, Jade DDS Chan, Stacey DMD Chapagain, Shweta DDS Charles, Jay II DDS Chasko Jr., Joseph DDS Chekan, Theodore DDS Cherkinsky, Jordan DDS Cherry, Jerry DDS Childers, Seldon DDS Chou, Victor DMD Cisneros, Aura DMD Cocchieri, Richard DDS Colon, Agdha DDS Cook, Patricia DDS Cooper, Angela DDS Correal, Juliana DMD Coughlin, Lauren DMD Crandall, James DDS Daccache, Danny DDS Dacunha, Andrew DMD Dao, Thieu DDS Das, Shilpa DDS Davidson, Timothy DMD Decambra, Nicole DMD Desinor, Darlene DDS Dietz, Rodney DDS Dinh, Lan DMD DO, Tutrinh DMD Dockus, Matthew DMD Doherty, Nicole DDS Dos Passos II, John DMD Doshi, Amit DDS Dougherty, Erin DMD Earnhardt, Charles DDS

www.wellcare.com/Florida | 801

Ebner, Stephen DDS Eckels, Shane DDS Edwards, Jesse DMD El-Sherbini, Sara DDS Engelman, Sharon DDS Espinal, Licette DDS Farrell, Thomas DDS Fawcett, Ian DDS Feng, Connie DMD Ferreira, Stephanie DDS Fidy, Ramez DDS Figaro, Mark DDS Fowler, Charlotte DMD Fox, Julie DDS Franceschi, Marisa DDS Frankel, Manuel DDS Freeman, Michael DDS Gabel, James DDS Gagnon, Robyn DMD Gallagher, Megan DMD Gannon, Robert DDS Garcia, Maritza DDS Gatons, Yelena DDS Genninger, Jasen DMD Gollob, Harrison DDS Golomb, Alyson DMD Gomara, Denise DDS Gonzalez, Lisset DDS Goodwin, Aaron DMD Gottipati, Padmalatha DDS Grace, Willie DDS Graddy, Nathan DDS Greenberg, Andrew DDS Greer, Lucia DDS Grier, Carrol DDS Guarnieri, Sam DDS Guerra, William DDS Haggerty, Megan DMD Hale, Jonathan DDS Hall, Joshua DMD Hanna, Mina DMD Hernandez, Celia DDS Hernandez, Gredell DDS Holzman, William DDS Homayouni, Siavash DDS Howard, Belisa DMD Howe, Douglas DDS Howell, Dina DDS

ALTERNATE LANGUAGES INDEX Spanish - cont. General Dentistry - cont. Hua, Yang DDS Immadi, Lakshmi DDS Jackson, Anthony DDS Jakubiec, Jacqueline DMD Jenkins, James DDS Jenkins, Tawana DDS Jensen, Stephen DDS Jimenez, Baltasar DDS Johnson, Jonathan DDS Jourdan, Myriam DMD Kamat, Amit DDS Kanach, Paul DMD Kanner, Leah DMD Karapasha, Christopher DDS Karthik, Aneetha DDS Kasem, Shovon DDS Katsur, Justin DDS Keo, Phanith DMD Koren, Daniel DMD Lazar, Adam DDS Le, Nhu DDS Le, Nhu DMD Lee-Loy, Ingrid DDS Lense, Pedro DDS Leon, Ana DDS Lepore, Krystina DDS Leung, Melanie DDS Lombana-Cano, Edward DDS Lopez, Grace DMD Lopez, Kenia DDS Lopez, Sergio DDS Luce, Amy DMD Magazine, Joanna DMD Mahdavieh, Sadaf DMD Malik, Chander DDS Manibo, Lourdes Alexandra DDS Mantel, David DDS Marin Jimenez, Laura DDS Marti Bagfasarov, Anjelika DDS Martinez, Gustavo DMD Martinez, Magela DMD Martinez, Susana DDS Mauricio, Margaret DDS Mazariegos, Stephanie DMD McKenzie, Karen DDS

McLaughlin, Matthew DMD McNair, Clarence DDS Mejias, Karen DDS Melean, Alfonso DMD Mickelson, Nicholas DMD Miller, Dwayne DDS Minias, Andrew DDS Misischia, William DDS Modaff, Michelle DDS Moore, Alicia DDS Moore, Edith DDS Mora, Viviana DMD Morelli, Karen DDS Nakarmi, Bibek DDS Nalley, Brittany DMD Nasseri, Sanaz DMD Nazco Batista, Maria DDS Ngo, Denise DDS Nguyen, Duy DDS Nguyen, Dzung DDS Nguyen, Hoang DMD Nguyen, Phuc-Hau DMD Nunez, Erick DDS Ogunbameru, Aderonke DDS Ortiz-Pimentel, Edgar DMD Painter, Lisa DDS Pardo, Maria DDS Park, James DDS Parker, David DDS Patel, Asha DMD Patel, Janisha DDS Patel, Kinjalben DMD Patel, Ripal DDS Patel, Yesha DMD Paula, Kelly DMD Penland, Edina DMD Peralta, Johnny DMD Peralta, Jose DDS Perez Diaz, Elizabeth DMD Perez, Monica DDS Peters, Edward DDS Pham, Quyen DMD Pham, Thanh DDS Phan, Christine DMD Polite, Leroy DMD Ponce, Rolando DDS Porro, Guillermo DMD Porter, Thomas DDS

www.wellcare.com/Florida | 802

Prabhakar, Ankita DDS Pratt, Frederick DDS Prendiville, Mary DDS Priemer, Ryan DMD Raju, Stevy DMD Reinhart, Joel DMD Rivera, Abneris DDS Rivera, Jade DMD Rizner, Amanda DMD Rizziello, Derrick DDS Robbins, Jeremy DDS Rodriguez, Ana DDS Romero- Quevedo, Margarita DDS Rosario, Jesse DMD Rostami, Maryam DMD Ruiz, Hugo DDS Rumbel, Richard DDS Sanchez-Diu, Monica DMD Sander, Marc DDS Santos, Luis DMD Saraydar, Haychell DDS Scalercio, John DMD Schaffner, Daniel DDS Schutt, Charles DDS Seifert, Thomas DDS Selz, Amrita DMD Seoane, Andres DMD Serrano, Yahaira DDS Shafii, Fariba DDS Sider, Brian DDS Siemiet, Erika DDS Sierra-Nieves, Elsie DMD Simeoni, Anna DDS Simon, Keith DMD Skordas, Fotios DDS Smillie, Joseph DMD Smith, Daryl DDS Smith, David DDS Snyder, Kirk DMD Spouh, Mohammad DDS Stein, Paul DDS Stilian, Douglas DMD Stoici, Ioana DMD Suri, Niki DDS Taylor, Lindsey DMD Teresi, Kirsten DMD Thomas, Kelly DMD Tiwary, Alka DDS

ALTERNATE LANGUAGES INDEX Spanish - cont. General Dentistry - cont. Tran, Faye DDS Tran, Ivy DMD Trivedi, Mehulkumar DMD Turhan, Mine DDS Tutay, John DMD Twiggs, Rudolph DMD Valdez, Harvey DMD Van, Tim DMD Vanoverbeke, Allen DMD Varela, Monica DDS Vasquez, Kristine DMD Vergara, Claudia DDS Viera, Gretel DDS Vo, Jossette DMD Voaonsri, Nopparat DMD Vu, Clara DMD Wade, Brianne DMD Walding III, Stephen DMD Walker, Aaron DDS Ward, Michael DDS Ward, Tasha DDS Weiskopf, Mark DDS Wells, Rachelle DDS Whittington, Candace DDS Wong, Elaine DDS Wright, Carl DDS Yu, Lina DMD Zapert, Edward DDS Zariffard, Ehsan DMD General Practice Aime Celian, Beatrice MD Alvarez, Edel MD Back, Kendra ARNP Blanco, Adolfo MD Correa, Raul MD Cruz Diaz, Ana MD De Vera, Melva MD Fernandez, Juan MD Folkner, James ARNP Gagot-Rivera, Mirza MD Garcia, Nestor MD Gomez Cordoba, Gerardo MD Heinrichs, Richard MD Jean Francois Benoit, Gladys MD Larson, Danelle ARNP

Mason, Stephanie MD Miranda-Genaro, Luis MD Nusbaum, Lana MD Parsley, Chandra ARNP Patel, Mangesh MD Pierre, Jean MD Rucker, Elsy MD Sanchez, Ramon MD Seralde, Cirilo MD Snyder, Donald MD Talero, Guillermo MD Vasquez, Kimber MD Virella Guzman, Vivian MD General Surgery Albrink, Michael MD Arniella, Alvaro MD Barrios, Juan MD Cox, Charles MD Deshpande, Vilas MD Escalante, Pamela PA Fernandez, Alfredo MD Fikry, Driss PA Gabordi II, Robert MD Gonzalvo, John DO Haslup, Forrest MD Logan, Melissa MD Patel, Ajay MD Patel, Ravindra MD Patel, Sharad MD Pecoraro, Joseph MD Quinones, Rafael MD Reintgen, Douglas MD Sobowale, Olumide MD Vaikunth, Sachin MD Vanterpool, Clyde MD Wall, Ward MD Wright, Alene MD Geriatric Psychiatry Monosiet, Frederic MD Hand Surgery Halpern, David MD Hematology Knipe, Richard MD Mendez, Pedro MD Samper-Pena, Carolina MD

www.wellcare.com/Florida | 803

Hematology & Oncology Arevalo-Araujo, Roberto MD Ayub, Jorge MD Bergier, Gregoire MD Diaz, Michael MD Dorsey, Hazel ARNP Gadiyaram, Vijayakrishna MD Garcia, Rodrigo MD Ho, Vu Tran MD Lubiner, Eric DO Luong, Don MD Mace, Joseph MD Marte, Idelfia MD Nakka, Sushma MD Rocha, Rafael MD Soriano, Andres MD HIV/AIDS Prieto, Jose MD Home Health Care Access Home Health Care Inc DBA Preferre Aclaris Home Health LLC Alere Womens and Childrens Health Allure Home Health Corp Apollo Advanced Home Health Corp Assisting Hands Gulf Coast Avian Home Health Corp Best Care Providers Inc Better At Home LLC Care and Life Home Health Services Easy Living Inc. Esperanza Home Health Services Inc Family First Homecare LLC Fusion Healthcare Genesis Healthcare DBA Origin Home Healt Healthy Services of Tampa Inc Medical Personnels Services Inc Medicor Healthcare Inc MS Supply and Home Health Co Philadelphia Professionals Inc Pro Med Healthcare Services LLC Senior Helpers

ALTERNATE LANGUAGES INDEX Spanish - cont. Hospice Compassionate Care Hospice of Central Florida Good Shepherd Hospice Inc Gulfside Hospice and Pasco Palliative Ca Lifepath Hospice Inc Hospital Johns Hopkins All Childrens Hospital Inc St Josephs Hospital Infectious Disease Balcacer-Estevez, Nery MD Barbour, Ronald MD Bush, Jennifer ARNP Cancio, Margarita MD Casanas, Beata DO Duharte Vidaurre, Luis MD Gordillo, Manuel MD Holt, Douglas MD Khan, Nadeem MD Klauber-Choephel, Enid MD Lacson, J Agustin MD Levenson, Jeffrey MD Martinez, Juan MD Mercado, Roberto MD Montero, Jose MD Morano, Jamie MD Offner, Lenka MD Prieto, Jose MD Varda, Janice ARNP Vasquez, Jose MD Vega, Vilma MD Internal Medicine Ackley, Karen MD Acuna, Jose MD Amato, Frank ARNP Amin, Mukund MD Beltre, Miguel MD Bhadja, Kantilal MD Bhandare, Deepti MD Bilella, Mark MD Brinn, Nathan MD Cabrera, Camilo MD Casanas, Beata DO

Choe, Leo DO Cook, William MD Cuevas, Hiram MD Deray, Dipesh MD Di Martino, Peter MD Estrada, Paul ARNP Farooqui, Zubair MD Fernandez, Rodolfo MD Garcia Jr, Jose MD Grace, David MD Guerra, Lucy MD Hall, Lois ARNP Hardiman, James MD Henry, Myrtle ARNP Holt, Douglas MD Jacob, Nirmala MD Jones, Jennifer ARNP Karkare, Rajendra MD Kattan, Halide MD Khadim, Ghazanfar MD Korbaj, Rabee MD Kurtyka, Donald ARNP Machado, Francisco MD Maniscalco, Benedict MD Mardones, Osvaldo MD Marmolejos Baez, Euclides MD Mehta, Shital DO Mena Perez, Raysa MD Midence, Robert MD Montero, Jose MD Mora Rasquin, Georges MD Narvarte, Hugo MD Nguyen, Thieu MD Nnadi, Chinyere MD Obrien, Kevin MD Pagan, Carlos MD Paredes, August MD Paredes, Augusto MD Patel, Chandravadan MD Patel, Krunal MD Patel, Pritesh MD Perez-Arce, Jose MD Pitarys II, Christos MD Ramiro, Lucila MD Rivera, Miriam MD Rodriguez Mendoza, Carlos MD Roy, Bipul MD Ruch, James PA

www.wellcare.com/Florida | 804

Samper-Pena, Carolina MD Sanchez-Ponce, Rafael MD Saprounova-Hopf, Vera MD Shires-Waldron, Sarah MD Silva, Luis MD Smith, Vevian ARNP Stutzman, Sandra ARNP Talakkottur, Charles MD Tanyous, Walid MD Toribio, Fiordaliza MD Trevino, Miguel MD Vega, Vilma MD Ventura, Hugo MD Win, Moethu MD Interventional Cardiology Sanchez-Ponce, Rafael MD Laboratory Pathology Testing Tampa Pathology Lab Licensed Clinical Social Worker Acosta, Cary LCSW Sutter, Kara LCSW Licensed Mental Health Counselor Huertas, Erica LMHC Lopez, Marianne LMHC Mammography Tower Imaging Inc Maternal Fetal Medicine Belogolovkin, Victoria MD Raimer, Karen MD Rao, Kiran MD Medical Oncology Guerra Arias, Laura ARNP Haider, Kamal MD Horrell, Cindy Jo ARNP Knipe, Richard MD Lautersztain, Julio MD Mendez, Pedro MD Miranda, Edgar MD Mizrachi, Alberto MD Patel, Manish MD Peterson, John MD Trindade, Antonio MD Van Der Wall, Ana MD Zayas, Egberto MD

ALTERNATE LANGUAGES INDEX Spanish - cont. Mental Health Counselor Ferreira, Felicia LMHC Mobile Diagnostic Cardiovascular Mobile Ultrasound Inc Radiance Radiology Vascular Ultrasound Services Nephrology Aguayo, Jose MD Badillo, Linda MD Brucculeri, Michael MD Campbell, Hannah ARNP Castillo, Orlando MD Dessani, Nehal MD Fabelo II, Edward MD Hernandez, Cecilio MD Maldonado-Colon, Bermily MD Numrungroad, Visal MD Oliveros, Fabio MD Palomino, Celestino MD Pinzon, Ernesto MD Ramirez, German MD Read, Sonia MD Rodriguez, Fernando MD Vilches, Ricardo MD Zeledon, Jorge MD Neurology Bazargan, Sadaf MD Berges, Eddy MD Delgado, Alain MD Esparza, Francisco MD Franklin, Michael MD Joy, Juan MD Kalidas, Kavita MD Lexow, Stephen MD Pizaro Otero, Jose MD Rosario-Prieto, Michael MD Yathiraj, Sanjay MD Neuropsychology Artreches Camacho, Tahirin PsyD Neuroradiology Lefler, James MD Neurosurgery Agazzi, Siviero MD

Gonzales Portillo, Gabriel MD Olivera, Raul MD Shulman, Carrie MD Tiesi, James MD Uribe, Juan MD Valdivia Valdivia, Juan MD Nurse Midwife Brown, Delrose CNM Grinnell, Michelle CNM Lorenz, Kelly CNM Stephens, Pamela CNM Obstetrics Alvarez, Pedro MD Armas, Ignacio MD Arnold, Heidi MD Baron, James MD Chamorro Roberts, Zayda MD Damian, Gracia MD Den-Haese, Greg MD Diner, Beth MD Fallen, Tina ARNP Fernandez-Boratti, Maruja MD Gallagher, James MD Granger, Steven MD Jones, Allyson MD Lopez Troy, Jennifer MD McNeill, Thomas MD Pitt, Catherine MD Reyes, Alexandria DO Reyes, Carlos MD Tijerino, Linda MD Obstetrics/Gynecology Abiose, Olufunke MD Acosta Jr, Romeo MD Alvarez, Pedro MD Baill, I Cori MD Belogolovkin, Victoria MD Betancourt, Fernando MD Boyette, Suzette ARNP Branch, Mia MD Brumley, Jessica ARNP Calderon, Guillermo MD Caltenco, Elias MD Doyle-Vallery, Deanna MD Easterling, Gary MD Fanarjian, Nicole MD

www.wellcare.com/Florida | 805

Ferlita, John MD Fitzgerald, Frederick MD Fuentes, Armando MD Goodman, Jerry MD Guerra, David MD Hardy-Hunter, Eleanine MD Hernandez, Lazaro MD Howard, Arthur MD Igel, G MD Javate, Emanuel MD Khan, Nasim MD King III, Joseph MD Levine, Paul MD Lewis, Michael MD Lopez-Rosa, Magda ARNP Marsh Dinham, Keddie MD Mashandure, Mercy ARNP McNeill, Thomas MD Micklavzina, Connie MD Nixon, Jennifer MD Ortiz, Edwin MD Palazzolo, Mark DO Palmer, James MD Perez, Hugo MD Prabhakaran, Sujatha MD Rao, Kiran MD Ray, Tanya ARNP Riestra, Jorge MD Rivera-Ortiz, Wilfredo MD Rodriguez-Benitez, Jose MD Romero, Stephanie MD Rosa, Hector MD Rotunda-Patino, Mariel DO Salamanca, Edwin MD San Martin, Julio MD Sanchez, Mark MD Santos, Ramon MD Shafii, Sohrab MD Small, Sheri CNM Spellacy, William MD Stephens, Pamela CNM Suarez, Adriana MD Torres, Wanda MD Umstead, Thomas MD Upadhyaya, Dipakkumar MD Vallejo, Elvia MD Vaughn-Kerns, Karen CNM Vazquez, Carlos MD

ALTERNATE LANGUAGES INDEX Spanish - cont. Obstetrics/Gynecology - cont. Walker, Christopher MD Wattenbarger, John MD Weiss, Michael MD Wilkinson, Donna ARNP Occupational Therapy Geimer, Kristie OT Gomez, Ivette OT Kirchberg, Cynthia OT Perez, Kristina OT Sanchez Ortiz, Margarita OT Thal, Julie OT Vazquez, Maribel OT Ophthalmology Ahn, Byung-Joon MD Allarakhia, Liaquat MD Anthony, Charles MD Berger, Todd MD Davis, Jeffrey MD Edelman, Robert MD El-Jabali, Fayssal DO Espana, Edgar MD Foster, John MD Friedberg, Murray MD Friedman, Robert MD Friedman, Scott MD Gamell, Lisa MD Garruto, Bryan MD Guggino, Giacomo MD Hauber, Frederick MD Hector, Richard MD Kasper, Jeffrey MD Khator, Pooja MD Landy, Jennifer MD Levitt, Michael MD Levy-Clarke, Grace MD Mali, Joshua MD McCabe, Cathleen MD Menezes, Allison MD Newsom, Thomas MD Oberlander, Mark MD Orlick, Martin MD Patel, Nandesh MD Perez Gonzalez Deapodaca, Jose MD Perich, Larry DO

Plous, Oren MD Prado, Antonio MD Rosanelli, Edward MD Rowan, Carey MD Sambursky, Robert MD Sanchez, Juan MD Shah, Geeta MD Shane, Anita MD Silverman, Scott MD Srivastava, Vinita MD Urban, Jr, Robert MD Optician Cef Vision Inc Optometry Alvarez, Dennis OD Anderson, Clinton OD Aronson, Barry OD Barrido, Kevin OD Berdeal, Rogelio OD Billings, Rick OD Birnbaum, Suzanne OD Buzzett, Jennifer OD Campbell, Christopher OD Carlson, Ruben OD Carr, William OD Chai, Sook OD Chavez, Claudia OD Ciccarello, Jim OD Clough, Scott OD Cuva, Philip OD Day, Paul OD De LA Torre, Miguel OD Demarco, Leo OD Detweiler, Edwin OD Dominguez, Vymarys OD Esperanza, Michelle OD Fazio, Eric OD Feliciano, Emy OD Fernandez, Sonia OD Ferris, Anthony OD Flanagan, Thomas OD Forde, Jessica OD Furman, Adam OD Fusselman, John OD Glassberg, Steven OD Glasser, Jay OD Goldstein, Stacey OD

www.wellcare.com/Florida | 806

Gres, Stephen OD Haffner, George OD Havens, Alicia OD Heaps, Eric OD Hernandez, Madeline OD Herriott, Michael OD Hetherington, Mark OD Hidalgo, Janet OD Honeyblue, Shamika OD Ingham, Richard OD Ismail, Esaam OD Jacoby, Leonard OD Jones, Douglas OD Joshi, Neha OD Kanicky, Jee OD Kanicky, Luc OD Krumbholz, Gerald OD Kudryk, John OD LA Rosa, Robb OD Lappano, Alfred OD Lascaibar, Albert OD Lewenson, Robert OD Lieb, Gregory OD Long, Lori OD Luu, Jessica OD Malde, Elyse OD Mann, Clare OD McKnight, Jaclyn OD Meer, Henry OD Merlino, Brian OD Miller, Barbara OD Miller, Matthew OD Morrison, Caryn OD Musumeci, Salvatore OD Ngar, Lucie OD Nguyen, Quyen OD Ocasio, John OD Olson, Arlese OD Passaro, Jr, Vincent OD Patel, Deepa OD Payne, Tessa OD Petit, Mitchell OD Pham, Kim OD Plante, Parker OD Pradilla, Sergio OD Radeke, Amanda OD Ramesar, Denyse OD Ramos, Becky OD

ALTERNATE LANGUAGES INDEX Spanish - cont. Optometry - cont. Ramsay, William OD Raney, Dennis OD Saint Jean, Caleb OD Scamard, David OD Schatz, Scott OD Schoneck, Katie OD Scott, Christopher OD Shea, Daniel OD Smith, Kevin OD Stoneburner, Jon OD Stupp, Elliott OD Sudbury, Glenn OD Ton, Kim-Oanh OD Tran, Baotram OD Tran-Lockwood, Julie OD Tuerkheimer, Barry OD Tyler, Eric OD Vo, Mai OD Vu, Anthony OD Vu, Bonnie OD Wachter, John OD Weisbond, Steven OD Williams, John OD Woolwine, Joshua OD Yancey, April OD Oral & Maxillofacial Surgery Ricalde, Pat DDS Orthodontics Brockway, Chelsea DDS Chin, Leo DMD Guzman, Ulises DDS McDowell, Ernest DMD Turke, Eric DDS Orthopaedic Surgery Arango, David MD Bhat, Anjali PA Buscemi, Michael DO Chan, John MD Farino, Gregory MD Goldsmith, Stuart MD Hess, Alfred MD Higgins, Michael DO Hill, Nathan MD Knight, Randolph MD

Moreno, Anthony MD Morgan, Jesse MD Moulton, Andrew MD Neustadt, Jeffrey MD Pinkas, Daphne MD Orthotics & Prosthetics Cranial Technologies Inc Express Orthotics and Prosthetics Inc Florida Brace & Limb Inc Pediatric Orthotic and Prosthetic Servic Tampa Bay Orthopaedic Designs Inc Pain Management De LA Garza, Miguel MD Egas, Juan MD Grana, Erick MD Rivera, Abraham MD Pediatric Allergy & Immunology Jerez, Diana MD Pediatric Cardiology Arrillaga, Frances MD Ballal, Natraj MD Bernus, Anna MD Freire, Grace MD Garcia, Jorge MD Gonzalez, Javier MD Huhta, James MD John, Jonathan MD Martinez, Richard MD McCormack, Jorge MD McKenna, Daniel MD Mehta, Mary MD Ramos, Agustin MD Suh, Elsa MD Zussman, Matthew MD Pediatric Ear, Nose & Throat Andrews, Thomas MD Cressman, Wade MD Pediatric Endocrinology Declue, Terry MD Dougan, Grace MD Rodriguez, Henry MD Root, Allen William MD

www.wellcare.com/Florida | 807

Pediatric Gastroenterology Beltroy Cornejo, Eduardo MD Cuenca, Rosa MD Ignacio, Joseph MD Irizarry, Karina MD Rook, Michelle MD Pediatric Hematology/Oncology Ayala, Irmel MD Grana, Nanette MD Hale, Gregory MD Reed, Damon MD Rico, Juan MD Pediatric Infectious Disease Dumois III, Juan MD Rodriguez, Carina MD Pediatric Nephrology Ayestaran Cassani, Frank MD Pediatric Neurosurgery Navarre, Nicole ARNP Rodriguez, Luis MD Tuite, Gerald MD Pediatric Orthopaedics Benfanti, Paul MD Carney, Jacquelyn PA Deignan, Brian MD Hahn, Gregory MD Neustadt, Jeffrey MD Warnick, Drew MD Pediatric Orthopedic Surgery Bradley, Timothy MD Kortright, Luis MD Pediatric Psychiatry Morales, Miguel MD Pediatric Pulmonology Livingston, Floyd MD Penugonda, Madhuri MD Pediatric Surgery Kassira, Noor MD Martinez, Luis MD Paidas, Charles MD Pediatrics Ackley, Karen MD

ALTERNATE LANGUAGES INDEX Spanish - cont. Pediatrics - cont. Adnan, Khan MD Aime, John MD Albanna, Issam MD Alfaro, Carmen MD Allison, Joanna MD Anchundia, Maria MD Arango, Jan MD Armstrong, Christine MD Arvelo-Velez, Beatriz MD Asis, Maria Belina MD Barriga, Julia MD Bartelt, Erica MD Berio Alvarez, Marta MD Bharucha, Corrie MD Bilella, Mark MD Bou-Gauthier, Salvador MD Brinn, Nathan MD Bryant, June ARNP Buchholz, Emily PA Camilo, Raisa MD Cano, Carlos MD Capote-Dishaw, Jessica MD Cendana, Elisa MD Chachad, Sairah MD Chiritescu, Cristian MD Cibran, Mariano MD Colon, Yaritza MD Cosic, Sanja MD De Brigard, Tomas MD Dembinksi, Karolina DO Depadua, Maria MD Dondero, Aldo MD Donkor, Cynthia MD Emara, Magdi MD Everett, Kari MD Fauber, Dean MD Fleener, Barbara MD Fleener, Carola MD Frias, Frederico MD Garcia, Rolando MD Gaud, Rosa MD Gomez-Luengas, Alexander MD Gonzalez, Francelis MD Gonzalez-Abello, Lisa MD Gordon, Jessica ARNP

Grant, Stewart MD Grimes, Amy PA Guastavino, Ella MD Gulati, Rachna MD Harrison, Krystin MD Hartlage, Kiersten MD Hernandez, Ana MD Hernandez, Sheridan MD Herrero, Vivian MD Hidalgo, Carlos MD Holt, Jayne MD Jara, Audrey MD Jindal, Mayuri MD Johnson-Towson, Michele MD Jones, Courtney ARNP Kanarek, Mark MD Khan, Maria MD Kiluk, Vinita MD Kosoff, Peter MD Lin, Kathryn MD Lopez Dominguez, Maria MD Lopez-Mccormack, Celia MD Lopez-Molina, Norma MD Lucero, Heather ARNP Luna, Juan MD Marcelin, Jackie ARNP Martin, Agustin MD Martinez, Sofia ARNP Masterman, Wendy MD Mathis, Karen PA Mehta, Saumeel MD Mendez, Carlos MD Meyer, Ernesto MD Meyer, Laura MD Miranda, Elinor MD Montane, Jorge MD Muniz-Verrando, Lorena MD Munoz, Avilio MD Nadal, Florencio MD Nelson, Stephen MD Palacio, Liliana MD Pelaez, Robert MD Perez, Maria MD Perez, Maribelis MD Perez, Richard MD Pillai, Anantha MD Plasencia, Daniel MD Raghuveera, Anavatti MD

www.wellcare.com/Florida | 808

Raguthu, Lalitha MD Ramos-Collazo, Yesenia MD Ranganathan, Radhika MD Rau, Sathyanarayan MD Rico, Juan MD Rippy, Steven MD Rivera, Ever MD Rivera, Stephanie ARNP Rodriguez, Carina MD Rolland, Lilivette MD Rommel, Duane MD Samter, Jordan MD Savino, Tarah PA Shamim, Tabassum MD Smith, Elizabeth MD Snow, Rodney ARNP Sonni, Rajeswari MD Strum, Neta MD Szafranski, Christy MD Tabassum, Rana MD Tayao, Maria Concepcion MD Tayao, Maria MD Torres De Carlo, Rita MD Umeh, Ifeyinwa MD Valencia, Diana MD Valencia-Serafini, Maria DO Van Buren, George MD Villanueva, Pedro MD Weinberger, Alyssa MD Williams, Stephen MD Wolfson, James PA Yakubu, Elizabeth MD Zuniga-Pedrianes, Danilo MD Pedodontics Bezerra, Francisco DDS Black, Harrison DMD Blake, Richard DDS Blankenship, Susan DMD Bowles, David DDS Bui, Loananh DDS Cobbe, Michael DDS Cortes, Lourdes DMD Gonzalez, William DMD Gyles, Richard DDS Harrell, Laurie DDS Iyer, Priyanka DDS Jafarnia, Bahareh DDS

ALTERNATE LANGUAGES INDEX Spanish - cont. Pedodontics - cont. Lapresti, Lisa DMD Lasanta, Denisse DMD Lee, Sara DMD Lewis, Andre DDS Marcano, Zaida DDS Montgomery, Nancy DMD Naoom, Jennifer DDS Nensey, Zara DDS Newcity, Amanda DDS Perez, Marina DDS Poustchi-Amin, Farah DDS Rosen, David DMD Ruelf, Michael DDS Sierra, Frank DMD Theogene, Dorothy DDS Vales, Ana-Marai DDS Van, Vincent DDS Yeung, Vincent DDS Young, Kera DDS

Dipasquale, Paul DO Lo, Percy MD Podiatry Abady, Robert DPM Colaluce, Marc DPM Diaz, Nannette DPM Donate, Guillermo DPM Ebsworth, Gloried DPM Giannone, Louis DPM Howard, Daniel DPM Johnson, Brandi DPM Kaplan, Stanley DPM Krawetz, Leo DPM Kussel, Ferdinand DPM Kussel, Fred DPM Marsh, Naomi DPM Port, Martin DPM Richter, Paul DPM Rivero, Evaristo DPM Valins, Robert DPM Wong, William DPM

Periodontics Bardsley, Norman DDS Cherry, Elizabeth DDS Perelmuter, Steven DMD Sabzehei, Bahareh DDS

Prosthetics Tampa Bay Artificial Limbs In

Physical Medicine & Rehabilitation Beard, Margita MD Guzman-Villar, Brenda MD Kallins, Marc MD Ocasio Silva, Maria MD Radecki, Richard MD

Psych Hospital Centerstone of Florida Inc

Physical Therapy Core Rehabilitation Inc Cortinas-Small, Maria PT Doris, Kevin PT Kane, Susan PT Knight, Carrie PT Le, Hoang PT Lester, Lawrence PT Warne, Hannah PT Watson, Maxine PT Westervelt, Lindley PT Plastic & Reconstructive Surgery Dayicioglu, Deniz MD

Prosthodontics Galindo-Ramirez, Ricardo DDS

Psychiatry Agustines, Rachel MD Botros-Mikhail, Hany MD Corzo, Hector MD Dempsey, Donna ARNP Jones, Karl MD Lluch, Roberto MD Monosiet, Frederic MD Morales, Miguel MD Murray, Ingrid PA Rodriguez, Mauro MD

Amin, Devendra MD Argeles, Horacio MD Arias Howard, Guillermo MD Axel, Jonathan MD Bassetti, Dennis MD Bernal, Ellen ARNP Bernal, Hernando MD Britos-Bray, Martin MD Cardona, Jerges MD Castro, Alfonso MD Cosmo, Leonard MD Furman, Alexandre MD Giraldo, Hernan MD Griggs, Adam DO Kreitzer, Stephen MD Lama, Maximo MD Lucio, James MD Mandaliya, Naishadh MD Martinez, Rafael MD Masson Jr, John MD Mikulic, Lucas MD Modh, Ashok MD Nazario, Rhoderick MD Patel, Nirav MD Romano-Buckner, Jana ARNP Urdaneta-Jaimes, Jose MD Zanchi, Dragos MD Radiation Oncology Cotman, Henry MD Guerrier, Kris MD Heysek, Randy MD Hochman, Lawrence MD Kepes, Kathryn MD Matzkowitz, Arthur MD Pena-Ponson, Max MD Sokol, Gerald MD Tralins, Kevin MD Vazquez, Eduardo PA Radiation Therapy Solc, Zucel MD

Psychology Gimon, Alexander PHD Kirkpatrick Justice, Kimberly PsyD

Radiology - Interventional & Vascular Lefler, James MD

Pulmonary Disease Ackerman, Ivan MD Ameh, Joseph MD

Rehabilitation Facility Beth Ingram and Associates Inc Childrens Therapy Solutions Inc

www.wellcare.com/Florida | 809

ALTERNATE LANGUAGES INDEX Spanish - cont.

Chen Neighborhood Medical E Tampa Rehabilitation Facility - cont. Childrens Health Center Pharmacy Ewing and Thomas Inc Choice Pharmacy Physical Therapy Specialists of Pine Community Specialty Pharmacy Cas Curant Health Florida True Blue Therapy LLC Davids Pharmacy Retail Davidson Drug Ab Specialty Pharmacy Inc Davidson Drugs Inc Advance Pharmacy Service Davis Islands Pharmacy Advanced Medical Pharmacy Inc Doctors Choice Pharmacy AHF Pharmacy - Safety Harbor East Manatee Pharmacy Alpha-Omega Pharmacy Embassy Pharmacy Amen Pharmacy Empath Health Pharmacy American Care of Tampa Inc Express Specialty Pharmacy Lakeland Extra Care Pharmacy Inc American Care of Tampa IncFairway Pharmacy Ntampa Family Care Pharmacy American Care of Tampa Inc W Fast and Friendly Pharmacy American Care of Tampa Winter First Choice Pharmacy Haven First Choice Pharmacy, Zocalo Plaza American Care Tampa Haines City Americas Pharmacy First Choice Specialty Pharmacy Anclote Pharmacy Fletcher Medical Center Pharmacy Apollo Beach Pharmacy Florida Med Clinic Pharmacy of Axcess Pharmacy Wiregrass Bartow Pharmacy Med Supply FMC Pharmacy Services Bay Discount Pharmacy Foundational Health Pharmacy Bay Life Pharmacy II Freedomed Pharmacy Baycare Pharmacy Genoa-QOL Healthcare Baydoun Pharmacy Germaine Pharmacy Compounding Bayshore Pharmacy Inc Bearss Pharmacy Good Health Pharmacy Best Deal RX Pharmacy Grace RX Pharmacy Bills Prescription Center Harbor Behavioral Health Care Brandon Community Health Center Havana LTC Pharmacy Inc Health Pro Pharmacy Brandon Pharmacy Healthlink Pharmacy Busch Pharmacy LLC Healthmed Pharmacy Careplus Pharmacy Healthwise Pharmacy Inc Carrollwood Pharmacy Heartland Pharmacy Ccm Pharmacy, LLC Heartland Pharmacy Lake Placid Central Florida Health Care Hedges Healthmart Pharmacy Pharmacy Highlands Pharmacy Central Florida Health Care Hillsboro Specialty Pharmacy Blood Pharmacy Lakeland Prss Central Pharmacy Hillsborough River Pharmacy Inc Chen NBHD Medical Clearwater Holiday Pharmacy Inc Chen NBHD Medical St Petersburg Hudson Pharmacy

www.wellcare.com/Florida | 810

Idel Pharmacy Imed Pharmacy J S RX Pharmacy Js Pharmacy K M Drugs Kabs Pharmacy Kay Pharmacy Land O Lakes Pharmacy Lawton Chiles Childfamily Health Center Life Saverx, LLC Lincourt Assisted Living, Inc Lincourt Pharmacy Logos Pharmacy Macdill Pharmacy Mail Meds Clinical Pharmacy Maxxycom RX Pharmacy Medicine Place Medina-Meds Pharmacy Medrock Pharmacy Meds To Home Memorial Family Pharmacy Meridian Pharmacy My Pharmacy of Big Bend My Pharmacy of Tampa North Manatee Pharmacy North Port Family Health Center Pharmacy Northdale Pharmacy Novopharm of Tampa, LLC Oaks Community Pharmacy Olson Liggett Drug Omnicare of Tampa Onestop RX Pharmacy Palm River Community Health Center Palmetto Drug Mart Palms Pharmacy Patient RX Solutions Pharmacy Peak Pharmacy Inc Pegasus RX Pharmacy Peoples Pharmacy Pharmaco Med Shop Pharmacore RX Pharmacy One Pro Specialty Care Ph Pharmacy Pros Corporation Pharmexpress Pharmacy

ALTERNATE LANGUAGES INDEX Spanish - cont. Retail - cont. Pharmscript Plant City Discount Pharmacy Plant City Family Care Precision RX Premier Pharmacy LLC Prime Pharmacy Services Promise Pharmacy Quick N Save Pharmacy Quick Pharmacy Rite RX Care Ritemed Pharmacy Royal Pharmacy Royal RX Pharmacy Ruskin Health Center RX Care Pharmacy RX Care Pharmacy Kwik Mart RX Discount Pharmacy RX Express Pharmacy RX Oasis RX Solutions Inc Rxperts Pharmacy Tampa Inc Salhab Pharmacy Sallykay Pharmacy Sarasota County Health Dept Sarasota Discount Pharmacy Save N Care Pharmacy Save-Rite Pharmacy Scripts Direct LLC Seffner Pharmacy Seniorcare Comm Pharmacy Shamrock Pharmacy Shields Pharmacy Smart RX Pharmacy South Lake Pharmacy Southeast Pharmacy St Josephs Pharmacy Summerfield Pharmacy Inc Summergate Pharmacy Sun Discount Pharmacy Sun Pharmacy of Venice Sunrise Pharmacy Super Discount Pharmacy Supreme RX Tampa Drugs Diabetic Center Tampa Family Health CentersFlorida Hospital

Tampa General Hospital OP Pharmacy Tampa Palms Pharmacy Tarpon Discount Drugs Temple Terrace Pharmacy Tfhc 16 Pharmacy Tfhc 30 - Fletcher Ave Tfhc- Sligh 31 The Apothecary Shop The Medicine Shoppe Times Pharmacy Tom Lee Community Health Center Town Pharmacy Vcare Pharmacy Veracity Pharmacy Village Pharmacy Vistacare Pharmacy Vistara Pharmacy Watsons Pharmacy Wauchula Pharmacy Wecare Pharmacy LLC Wellness Pharmacy Inc West Coast Pharmacy LLC West Shore Pharmacy Winter Haven Pharmacy Rheumatology McIlwain, Harris MD Torres, Alexander MD Skilled Nursing Facility Accentia Health and Rehab Center of Tamp Advanced Care Center Apollo Health and Rehabilitation Center Avon Park Royal Holdings Lld DBA Royal C Bartow Center Bay Pointe Nursing Pavilion Bay Village of Sarasota Bear Creek Nursing Center Bon Secours Maria Manor Nursing Care Cen Carrington Place of St Pete Carrollwood Care Center CHC of Bayonet Point CHC of Brandon Community Convalescent Center

www.wellcare.com/Florida | 811

Consulate Health Care At Lake Parker Consulate Health Care of Lakeland Consulate Health Care of New Port Richey Consulate Health Care of Safety Harbor Consulate Health Care of Sarasota Consulate Health Care of St Petersburg Consulate Health Care of Winter Haven Countryside Healthcare Center Fletcher Health and Rehabilitation Center Florida Presbyterian Homes Inc Glen Oaks Health and Rehabilitation Cent Greenbriar Nursing & Rehab Haines City Health Care Center Hawthorne Health And Rehab of Brandon Heather Hill Nursing Home-Pcs Heritage Health Care Center Heritage Park Health and Rehabilitation Kenilworth Care and Rehabilitation Center Lake Placid Health and Rehabilitation C Lakeland Hills Center Lakeland Nursing And Rehabilitation Largo Rehab and Spa Lexington Health & Rehab Ctrs Oak Manor Healthcare & Rehab Center Oakbridge Healthcare Center Palm Garden of Clearwater Palm Garden of Pinellas- NHC Palm Garden of Tampa Palm Terrace of Lakeland Palmer Ranch Rehab& Healthcare Rehabilitation Center of St Petersburg Solaris Healthcare Bayonet Point Solaris Healthcare Plant City South Tampa Health and Rehab Center

ALTERNATE LANGUAGES INDEX Spanish - cont. Skilled Nursing Facility - cont. St Petersburg Nursing and Rehabilitation Surrey Pl Convalescent Center of Bradenton Sylvan Health Center The Health and Rehabilitation Centre At The Springs At Lake Pointe Woods Trinity Regional Rehab Center Westminster Suncoast Wrights Healthcare & Rehab Center Sleep Diagnostic Studies Sleep Associates of Florida Sleep Medicine Livingston, Floyd MD Masson Jr, John MD Speech & Language Pathology Lopez, Sharon SLP Speech Therapy Andersen, Bailey SLP Ayala, Indira SLP Barth, Jeanne SLP Brewer, Staci Beth SLP Coleman, Laci SLP Comkowyez, Sharon SLP Crespo, Shannon SLP Gier, Terry SLP Gonzalez Soldevilla, Hilda SLP Hamor, Marianne SLP Murby, Nicole SLP Reales, Vicky SLP Victores, Rebeca SLP Wallace, Davina SLP Substance Abuse Childrens Home Society of Florida Coastal Behavioral Healthcare Inc Impower Inc Operation Par Inc Peace River Center For Personal Developm Tri County Human Services Inc

Thoracic & Cardiovascular Surgery Psychology Chapa, Liberato MD Trancik, Anika PHD Duarte, Ignacio MD Tagalog Golino, Alessandro MD Cardiology Transplant Hepatology Remo Platt, Elizabeth ARNP Mendoza, Alfredo MD Family Practice Urgent Care Center Concepcion, Maria MD 1st Care Medical Espinoza, Daniel MD A Plus Family Urgent Care, LLC Tangunan, Ray MD Doctor Today Urgent Care LLC Doctors Express General Practice Florida Hospital Centra Care Seralde, Cirilo MD University General Surgery Healthnow Urgent Care LLC Ochotorena Garrovillo, Mel MD Late Hours Urgent Care Center Now Care Walk In Clinic Inc Internal Medicine Premium Health Services of Tampa Ranon, Eric MD Bay Roa, Antonio MD Shires-Waldron, Sarah MD Urology Tamayo, Percival MD Carrion, Rafael MD Hodge Jr, Gameel Byron MD Nephrology Patel, Mahesh MD Caintic, Alberto MD Perry, Matthew MD Pain Management Vascular Surgery Honculada, Allan MD Martin, Samuel MD Pediatrics Valentin, Marlene MD Asis, Maria Belina MD Swahili Sia, Edwin Michael MD Tayao, Maria MD Adolescent Medicine Derasari, Kalyani MD Pulmonary Disease Wong, Philip MD Gastroenterology Mehta, Ashwin MD Tamil Internal Medicine Allergy & Immunology Amin, Mukund MD Chamarthy, Latha MD Obstetrics/Gynecology Cardiology Mashandure, Mercy ARNP Velusamy, Muthusamy MD Pediatrics Child Neurology Derasari, Kalyani MD Rao, Radhakrishna MD Swedish Gastroenterology Sanjeevi, Arthi MD Orthopaedic Surgery Nofsinger, Charles MD General Surgery Menon, Meera MD

www.wellcare.com/Florida | 812

ALTERNATE LANGUAGES INDEX Tamil - cont. Hematology & Oncology Visweshwar, Nathan MD

Nephrology Adla Reddy, Mahathi MD Matcha, Mrinalini MD

Infectious Disease Aneja, Parul MD

Neurology Borra, Sujatha MD

Internal Medicine Aneja, Parul MD Mathan, Sukumar MD Nirmalan, Nadarajah MD Rao, Kavita MD Velusamy, Muthusamy MD

Ophthalmology Perez Gonzalez Deapodaca, Jose MD Prado, Antonio MD

Pulmonary Disease Furman, Alexandre MD

Optometry Cuva, Philip OD Lieb, Gregory OD

Allergy & Immunology Iqbal, Shahid MD Salim, Nauman MD

Pediatrics Duggirala, Sita MD Kamisetty, Sudarsan MD Kondabala, Rajani MD Raguthu, Lalitha MD Roscher, Elizabeth ARNP

Ambulatory Surgery Center St Petersburg Endoscopy Center

Medical Oncology Avashia, Jaydev MD Pediatric Cardiology Babu, Keshava MD Pediatrics Kamisetty, Sudarsan MD Telugu Allergy & Immunology Chamarthy, Latha MD

Psychiatry Vangala, Vidyasagar MD Thai

Cardiology Bhashyam, Siva MD

Allergy & Immunology Tang, Nathan MD

Family Practice Korivi, Praveen MD Kurakula, Satya MD

Internal Medicine Somboonwit, Charurut MD

Gastroenterology Degala, Gourisankar MD Iyunni, Venkata MD Reddy, Tiyyagura MD Sanjeevi, Arthi MD Hematology & Oncology Dandamudi, Uday MD Nadiminti, Yallappa MD Internal Medicine Atluri, Tej MD Bhashyam, Siva MD Mathan, Sukumar MD Medical Oncology Telukuntla, Koteshwar MD Venigalla, Madhavi MD

Nurse Midwife Reneau, Carolyn CNM Pediatric Allergy & Immunology Tang, Nathan MD Pediatrics Sriaroon, Panida MD

Gastroenterology Ekici, Sedat MD Plastic & Reconstructive Surgery Dayicioglu, Deniz MD Ukrainian

Urdu

Cardiac Electrophysiology Ahmed, Safi MD Cardiology Javeed, Najam MD Khan, Tehreen MD Khan, Wali MD Shah, Abid MD Tai, Zaheed DO Community Mental Health Center Suncoast Center Inc Family Practice Khan, Kashan MD Noorani, Nazneen MD Pothiawala, Yakub MD Soni, Ambica MD Gastroenterology Mohiuddin, Muhammad MD Saeed, Farrukh MD

Speech Therapy Boonyathitisuk, Pisami SLP Byrd, Michelle SLP Henke, Robyn SLP Petrick, Christina SLP Vizzi, Lindsay SLP

Geriatric Medicine Hussain, Sayyed MD

Turkish

Infectious Disease Khan, Nadeem MD

Cardiovascular Surgery Ilercil, Arzu MD

www.wellcare.com/Florida | 813

Hematology & Oncology Jooma, Nurruddin MD Riaz, Wasif MD

Internal Medicine Farooqui, Zubair MD

ALTERNATE LANGUAGES INDEX Urdu - cont. Internal Medicine - cont. Quadri, A H Zehra MD Sandhu, Jagdeep MD Zaffar, Nauman MD

Hematology & Oncology Diaz, Michael MD Ho, Vu Tran MD Luong, Don MD

Medical Oncology Haider, Kamal MD

Home Health Care Access Home Health Care Inc DBA Preferre

Nephrology Niaz, Nabila MD

Hospice Lifepath Hospice Inc

Neurology Qureshi, Mussarat MD

Internal Medicine Mai, Cuc MD

Obstetrics/Gynecology Khan, Nasim MD Qadri, Syed MD

Nephrology Huynh, Bao-Chau MD

Orthopaedic Surgery Chaudhri, Tahir MD Pediatrics Kahlon, Harpreet MD Lokesh, Haravu MD Pai, Rajendra MD Pruthi, Jagdeep MD Shamim, Tabassum MD Tabassum, Rana MD Wolfson, James PA Plastic & Reconstructive Surgery Mir, Haaris MD Urgent Care Center Tampa Urgent Care Urology Rehman, Jamil MD Vietnamese Behavioral Health Facility Adoption Related SVS - Pinellas, Inc Ear, Nose & Throat Dang, Hoc PA Family Practice Chase, Stacy DO Hendren, Beatrice ARNP Vu, Tan MD

Neurology Vu, Tuan MD Neuromuscular Medicine Vu, Tuan MD Obstetrics/Gynecology Ta, Alyssa MD Optometry Alvarez, Dennis OD Aronson, Barry OD Barrido, Kevin OD Beiler, Mark OD Berdeal, Rogelio OD Birnbaum, Suzanne OD Buzzett, Jennifer OD Carr, William OD Chai, Sook OD Ciccarello, Jim OD De LA Torre, Miguel OD Demarco, Leo OD Dominguez, Vymarys OD Esperanza, Michelle OD Feliciano, Emy OD Fernandez, Sonia OD Ferris, Anthony OD Flanagan, Thomas OD Glassberg, Steven OD Glasser, Jay OD Goldstein, Stacey OD Haffner, George OD Heaps, Eric OD Hernandez, Madeline OD

www.wellcare.com/Florida | 814

Herriott, Michael OD Hidalgo, Janet OD Ingham, Richard OD Ismail, Esaam OD Jacoby, Leonard OD Jones, Douglas OD Joshi, Neha OD Kanicky, Jee OD Kanicky, Luc OD Krumbholz, Gerald OD Lascaibar, Albert OD Lewenson, Robert OD Luu, Jessica OD Malde, Elyse OD Mann, Clare OD Meer, Henry OD Miller, Barbara OD Morrison, Caryn OD Ngar, Lucie OD Nguyen, Quyen OD Ocasio, John OD Olson, Arlese OD Patel, Deepa OD Pham, Kim OD Plante, Parker OD Pradilla, Sergio OD Ramesar, Denyse OD Ramos, Becky OD Raney, Dennis OD Saint Jean, Caleb OD Scamard, David OD Schatz, Scott OD Schoneck, Katie OD Scott, Christopher OD Smith, Kevin OD Stoneburner, Jon OD Stupp, Elliott OD Sudbury, Glenn OD Ton, Kim-Oanh OD Tran, Baotram OD Tran-Lockwood, Julie OD Tuerkheimer, Barry OD Tyler, Eric OD Vo, Mai OD Vu, Anthony OD Vu, Bonnie OD Weisbond, Steven OD Woolwine, Joshua OD

ALTERNATE LANGUAGES INDEX Vietnamese - cont. Optometry - cont. Yancey, April OD Pain Management Le, Thanh MD Pediatrics Le, Yen MD McHugh, Sara ARNP Nguyen, Kenny MD Pham, Thuy MD Tran, Thein MD Physical Medicine & Rehabilitation Le, Thanh MD Physical Therapy Le, Hoang PT Pulmonary Disease Newan, Michael MD Retail Alexander Pharmacy Danang Pharmacy Harbor Behavioral Health Care Healthnow Pharmacy Hedges Healthmart Pharmacy Hp Pharmacy Lily Care Pharmacy Medilink Pharmacy My Pharmacy of Big Bend My Pharmacy of Tampa New Waters Pharmacy Precision RX Script Choice Pharmacy Staywell Pharmacy Sun Discount Pharmacy V T Pharmacy Valued Choice Pharmacy Urgent Care Center Healthnow Urgent Care LLC Yoruba Infectious Disease Buhari, Mudathiru MD

www.wellcare.com/Florida | 815

Specialty Provider At-A-Glance You can find a specific kind of provider in this index. First look for the type of care you need. Then check the county and page number. You can go to that page to get the provider's information. Un vistazo a los proveedores especializados: En este índice, usted puede encontrar un tipo específico de proveedor. Primero busque el tipo de cuidado que necesita, y luego verifiqe el condado y el número de página. Consulte esa página para obtener la información del proveedor

A

Polk Sarasota

Addiction Psychiatry Hillsborough

562

Adolescent Medicine Hillsborough Pinellas

99, 654 349

Advance Registered Nurse Practitioner Psychiatrist Hillsborough Manatee Pinellas Polk

562 575 584 594

Advanced Registered Nurse Practioner Pasco

688

Allergy & Immunology Hillsborough Pasco Pinellas Sarasota

99, 100 309 349, 350 521

Ambulatory Surgery Center Hillsborough Manatee Pasco Pinellas Polk Sarasota

611 623 626 631 640 645

Art Therapy All

606

Audiology Hillsborough Manatee Pasco Pinellas

654 683 688 696

722 Manatee 276, 683 736 Pasco 309, 310, 311, 312, 313, 314, 315, 688 B Pinellas Behavioral Health Counseling 351, 352, 353, 354, 355, 356, 357, 358, Highlands 561 696, 697 454, 455, 722 Hillsborough 562, 563, 564 Polk 521 Manatee 575 Sarasota Pasco 580 Cardiovascular Surgery Pinellas 584, 585, 586, 587 Hillsborough 113 Polk 594 Polk 455 Sarasota 600, 601 Certified Nurse Midwife Behavioral Health Facility Hillsborough 655 Hillsborough 564, 565 Pasco 688 Manatee 575 Pinellas 697 Pasco 581 Sarasota 736 Pinellas 587 Polk 594 Child Neurology 113, 114, 655, 656 Sarasota 601 Hillsborough Pasco 315 Birthing Center Pinellas 358, 359, 697 Hillsborough 611 Polk 456, 722 Pinellas 631 Sarasota 521 Sarasota 645 Chiropractic C De Soto 83 Hardee 85 Cardiac Electrophysiology 90 Hillsborough 100, 101 Highlands Hillsborough 114, 115 Pasco 309 276, 277 Pinellas 350, 351, 696 Manatee Pasco 315, 316 Polk 454 Pinellas 359, 360, 361 Cardiology Polk 456 Hardee 85 Sarasota 521, 522 Highlands 89, 90 Colon & Rectal Surgery Hillsborough Hillsborough 115, 116, 656 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 654, 655 Pinellas 361

www.wellcare.com/Florida | 816

Specialty Provider At-A-Glance C - cont.

Manatee 623 Pasco 627 Colon & Rectal Surgery - cont. Pinellas 633, 634 Polk 456 Polk 640, 641 Community Mental Health Center Sarasota 645, 646 Hardee 560 Highlands 561 Distinct Part Unit Psych 581 Hillsborough 565, 566 Pasco Manatee 575 Durable Medical Equipment Pasco 581 All 606 Pinellas 587, 588 Highlands 609 Polk 594, 595 Hillsborough 615 Sarasota 601 Manatee 623, 624 Pasco 627 Convenient Care Clinic Pinellas 634 Hillsborough 611, 612 641 Pasco 626 Polk Sarasota 646 Pinellas 631, 632 Polk

640 E

Critical Access Hospital Hardee

Highlands 4, 652 Hillsborough 7, 8, 9, 10, 11, 122, 657, 658, 659 Manatee 30, 277, 278, 683, 684 Pasco 35, 36, 37, 318, 690 Pinellas 43, 44, 45, 46, 47, 365, 698, 699, 700, 701, 702, 703, 704, 705 Polk 66, 67, 460, 722, 723, 724 Sarasota 79, 522, 736 Federally Qualified Health Center Pinellas 705 Food and Lodging All

606

G Gastroenterology Highlands 90 Hillsborough 122, 123, 124, 125, 659 Manatee 278 Pasco 318, 319 Pinellas 365, 366, 367, 368, 705 Polk 460, 724 Sarasota 523

Ear, Nose & Throat 551 Highlands 90 Hillsborough 119, 120, 657 D Manatee 277 Dermatology Pasco 317 Hillsborough 116, 117, 118, 656, 657 Pinellas 363 Manatee 277 Polk 457, 458, 722 Gastroenterology & Hepatology Pasco 316, 317, 688, 689 Sarasota 522 Pinellas 368 Pinellas 361, 362, 363, 698 Diabetes, General Dentistry Polk 456, 457, 722 Endocrinology, Metabolism De Soto 83 Hillsborough 120, 657 Dermatopathology Hardee 85, 86 317, 318, 689 Hillsborough 118, 119 Pasco Highlands 90, 91 363, 364, 698 Pasco 317 Pinellas Hillsborough 522 Pinellas 363 Sarasota 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, Endodontics Diagnostic Imaging 120, 121, 122 143, 144, 145, 146, 147, 148, 149, 150, 151, Highlands 609 Hillsborough 277 152, 153, 154, 155, 156, 157, 158, 159, 160 Hillsborough 612, 613, 614 Manatee 318 Manatee Manatee 623 Pasco 279, 280, 281, 282, 283, 284, 285, 364, 365 278, Pasco 626, 627 Pinellas 286 458, 459, 460 Pasco Pinellas 632, 633 Polk 522 Polk 640 Sarasota 319, 320, 321, 322, 323, 324, 325 Sarasota 645 Equine Therapy Pinellas Dialysis De Soto Hardee Highlands Hillsborough

All 607 F 608 609 Family Practice 614 De Soto Hardee

606 368, 369, 370, 371, 372, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384 1, 649 2, 651

www.wellcare.com/Florida | 817

Specialty Provider At-A-Glance G - cont. General Dentistry - cont. Polk 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478 Sarasota 523, 524, 525, 526 General Practice De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota

1, 649 2, 86 4, 91, 652 11, 12, 160, 659 30 38 47, 384, 705 67, 68, 69, 478 80, 526, 736

General Surgery De Soto 83 Hardee 86 Highlands 91, 92 Hillsborough 160, 161, 162, 163, 164, 165, 659, 660 Manatee 287, 684 Pasco 326, 690, 691 Pinellas 384, 385, 386, 387, 705, 706 Polk 479, 480, 481, 724, 725 Sarasota 526 Genetic Counseling Pinellas Geriatric Medicine Hillsborough Pasco Sarasota Geriatric Psychiatry Hillsborough Pasco Sarasota

387 165, 660 327 526 566 581 601

Gynecological Oncology Hillsborough 660 Pinellas 387, 706 Polk 481 Gynecology Hillsborough

165

Polk Sarasota

481 Hospice 527, 736 De Soto 607 H Highlands 609 Hillsborough 617 Hand Surgery Manatee 624 Highlands 92 Pasco 628 Hillsborough 165, 166 Pinellas 635 Manatee 287 Polk 641, 642 Hearing Aid Supplier Sarasota 646 De Soto 607 Hospice and Palliative Care Highlands 609 Hillsborough 169 Hillsborough 615, 616 Manatee 624 Hospital Pasco 627 De Soto 550 Pinellas 634 Highlands 552 Sarasota 646 Hillsborough 553 Manatee 554 Hearing Aid Therapy & Specialist Pasco 555 Hillsborough 660 Pinellas 556 Hematology Polk 557 Hillsborough 166 Sarasota 558 Pasco 327 I Pinellas 387 Sarasota 527 Infectious Disease De Soto 649 Hematology & Oncology Highlands 92 Highlands 92 Hillsborough 169, 170, 171, 660 Hillsborough 166, 167, 168, 660 Manatee 288, 289, 684 Manatee 288 Pasco 328 Pasco 327, 328 Pinellas 390, 391, 392, 707 Pinellas 388, 389, 390, 706, 707 Polk 481, 725 Polk 481 Sarasota 528, 529, 737 Sarasota 527, 528 Infusion Therapy HIV/AIDS Hillsborough 617 Hillsborough 168 Pinellas 635 Pinellas 390 Internal Medicine Home Health Care De Soto 1, 83, 649 All 606 Hardee 2, 86 Highlands 609 Highlands 5, 92, 93, 652 Hillsborough 616, 617 Hillsborough Manatee 624 12, 13, 14, 15, 16, 17, 18, 171, 172, 173, 174, Pasco 628 175, 661 Pinellas 634, 635 Manatee 31, 32, 289, 684 Polk 641 Pasco 38, 39, 328, 329 Sarasota 646 Pinellas 47, 48, 49, 50, 392, 393, 707, 708 Polk 69, 70, 71, 72, 482, 725

www.wellcare.com/Florida | 818

Specialty Provider At-A-Glance I - cont.

Maternal Fetal Medicine Internal Medicine - cont. Hillsborough 175, 176, 177, 178 Sarasota 80, 81, 530, 737 Pasco 330 Pinellas 393, 394 Interventional Cardiology 482, 483 Highlands 93, 652 Polk Sarasota 530 Hillsborough 175, 661 Pasco Pinellas Polk L

329, 330 Meals 393 All 482, 725, 726 Medical Genetics Hillsborough

Neurology Hillsborough Manatee Pasco Pinellas 606 Polk Sarasota

588 Mental Health 595 De Soto 602 Manatee

397

183, 184, 185, 186, 663 291, 684 332 397, 398, 708 485, 486 532

178 Neuromuscular Medicine Hillsborough

Laboratory Pathology Testing Medical Oncology All 606 Highlands 93 Hillsborough 617 Hillsborough 178, 179, 180, 662 Manatee 289, 290 Licensed Clinical Social Worker Pasco 330 De Soto 559 394, 395 Hillsborough 566, 567 Pinellas Polk 483, 484, 726 Manatee 575, 576 530, 531 Pasco 581, 582 Sarasota Pinellas Polk Sarasota

Neuro Psychiatrist MD Pinellas

186

Neuro-Oncology Polk

486

Neuropsychology Hillsborough Pinellas

567 589

Neuroradiology Hillsborough

186

649 Neurosurgery 684 Hillsborough 186, 187, 188, 663 Manatee 291 Pasco 332, 333, 691 662 Pinellas 398, 399, 708 Polk 486, 726 618 Non-Emergency Transportation 635 All 606

Licensed Marriage and Family Mental Health Counselor Therapist Hillsborough Hillsborough 567 Pasco 582 Mobile Diagnostic Pinellas 588 Hillsborough Pinellas Licensed Mental Health Counselor Highlands 652 MRI Open 646 Hillsborough 661, 662 Sarasota Pinellas 708 N Polk 726 Sarasota 737, 738 Neonatal Perinatal Medicine Hillsborough 180, 181, 662 Licensed Professional Counselor Pinellas 395, 396 Pasco 582 Polk 484, 726 M Nephrology De Soto 83 Magnetic Resonance Imaging 93, 652 Hillsborough 617 Highlands Hillsborough 182, 183, 663 Mammography Manatee 290, 291 Hillsborough 618 Pasco 331 Manatee 624 Pinellas 396, 397, 708 Pasco 628 Polk 484, 485 Sarasota 646 Sarasota 531, 738

www.wellcare.com/Florida | 819

Nuclear Medicine Sarasota

532

Nurse Midwife Hardee Hillsborough Pasco Pinellas Polk Sarasota

651 663, 664 691 708, 709 726, 727 738

Nurse Practitioner Hillsborough Pinellas Polk Sarasota

664, 665 709 727 738

Nurse Practitioner Acute Care Hillsborough 665

Specialty Provider At-A-Glance N - cont.

Occupational Medicine Nurse Practitioner Acute Care Manatee 685 cont. Polk 727 Occupational Therapy De Soto 649 Nurse Practitioner Family Medicine Highlands 652 Hillsborough 665 Hillsborough 618, 672, 673 Sarasota 738 Manatee 685, 686 Pasco 692 Nurse Practitioner Orthopedics 713, 714 Hillsborough 665 Pinellas Polk 730, 731 Nurse Practitioner Pediatric Sarasota 739, 740 Hillsborough 665 Ophthalmology Nurse Practitioner Psychiatric Hardee 87 Mental Health Highlands 94, 95 Manatee 684 Hillsborough 210, 211, 212, 213, 214 Manatee 294, 295, 296, 297 Nutritional Counseling Pasco 336, 337 All 606 Pinellas 408, 409, 410, 411, 412, 413 O Polk 494, 495, 496, 497, 498 Sarasota 535, 536, 537 Obstetrics Hillsborough Optician 188, 189, 190, 191, 192, 193, 665, 666 Hillsborough 214, 215 Pasco 333, 334, 691 Manatee 297 Pinellas 399, 400, 709, 710 Pasco 337 Polk 487 Pinellas 413, 414 Obstetrics/Gynecology De Soto 83 Hardee 86, 87 Highlands 93, 94 Hillsborough 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 666, 667, 668, 669, 670, 671, 672 Manatee 291, 292, 293, 294, 684, 685 Pasco 334, 335, 336, 691 Pinellas 401, 402, 403, 404, 405, 406, 407, 408, 710, 711, 712, 713 Polk 487, 488, 489, 490, 491, 492, 493, 494, 727, 728, 729, 730 Sarasota 81, 532, 533, 534, 535, 738, 739

Oral & Maxillofacial Surgery Hillsborough Pasco Orthodontics Hillsborough Manatee Pinellas

233 341

233, 234 303 427

Orthopaedic Surgery De Soto 84 Highlands 96, 97 Hillsborough 234, 235, 236, 237, 673 Manatee 303 Pasco 341, 692 Pinellas 714 Polk 507, 508, 731 Sarasota 539, 540, 740 Orthotics & Prosthetics Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota

609 618, 619 624 628 635, 636 642 646, 647

P 498 537 Pain Management Hillsborough 237, 673 Optometry Pasco 341 De Soto 83 Pinellas 427, 714 Hardee 87 Polk 508 Highlands 95, 96 Hillsborough Pediatric Allergy & Immunology 215, 216, 217, 218, 219, 220, 221, 222, Hillsborough 237 223, 224, 225, 226, 227, 228, 229, 230, Pinellas 428, 714 231, 232, 233 Pediatric Behavioral Medicine Manatee 576 297, 298, 299, 300, 301, 302, 303 Manatee Pasco 337, 338, 339, 340, 341 Pediatric Cardiology Pinellas Highlands 97 414, 415, 416, 417, 418, 419, 420, 421, Hillsborough 422, 423, 424, 425, 426 237, 238, 239, 240, 241, 242, 674 Polk Manatee 303, 304 498, 499, 500, 501, 502, 503, 504, Pasco 342, 692 505, 506, 507 Pinellas Sarasota 537, 538, 539 428, 429, 430, 431, 432, 433, 714 Polk Sarasota

www.wellcare.com/Florida | 820

Specialty Provider At-A-Glance P - cont.

Polk

513

Pediatric Cardiology - cont. Pediatric Neurosurgery Polk 508, 509, 510, 511, 731 Hillsborough Sarasota 540, 541, 740 Pinellas Polk Pediatric Cardiovascular Surgery

248 439, 715 513

Hillsborough Pinellas

242 Pediatric Orthopaedics 433 Hillsborough 248, 249, 674, 675 Pasco 342, 343, 692, 693 Pediatric Dermatology 439, 440, 715 Pinellas 433, 434 Pinellas Sarasota 542, 740 Pediatric Ear, Nose & Throat Hillsborough 242, 243 Pediatric Orthopedic Surgery 249 Manatee 304 Hillsborough Pinellas 440 Pasco 342 542 Pinellas 434 Sarasota Polk 511 Pediatric Psychiatry De Soto 559 Pediatric Endocrinology Hardee 560 Hillsborough 243, 244 567, 568 Pinellas 434, 435 Hillsborough Manatee 576 Sarasota 541 Pasco 582 Pediatric Gastroenterology Pinellas 589 Hillsborough 244, 245, 246, 674 Polk 595, 596 Manatee 304 Sarasota 602 Pasco 342, 692 Pinellas 435, 436, 715 Pediatric Pulmonology 249, 250, 675 Polk 511, 512, 731 Hillsborough Pinellas 440, 441 Sarasota 541, 740 Polk 513, 514, 731 Pediatric Genetics Hillsborough 246 Pediatric Rheumatology 441, 716 Pinellas 436 Pinellas Pediatric Sports Medicine Pediatric Hematology/Oncology 441 Hillsborough 246, 247 Pinellas Pinellas Polk Sarasota

436, 437, 438, 715 Pediatric Surgery 512 Hillsborough 541 Manatee Pinellas Pediatric Infectious Disease Hillsborough 247, 248, 674 Polk Manatee 304 Sarasota Pasco Pinellas Sarasota Pediatric Nephrology Hillsborough Pinellas

342 Pediatric Urology 438, 439 Hillsborough 542 Pasco Pinellas 248 Polk 439 Sarasota

Pediatrics De Soto 1 Hardee 2, 3, 87, 651 Highlands 5, 6, 97, 652, 653 Hillsborough 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 252, 253, 675, 676, 677 Manatee 32, 33, 34, 686, 687 Pasco 39, 40, 41, 42, 693 Pinellas 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 442, 443, 444, 716, 717, 718 Polk 72, 73, 74, 75, 76, 77, 78, 514, 515, 731, 732, 733 Sarasota 81, 82, 542, 543, 740, 741 Pediatrics Behavioral and Developmental Hillsborough 568, 569 Manatee 576 Pinellas 589 Sarasota 602 Pedodontics Hillsborough 253, 254, 255, 256, 257, 258, 259 Manatee 305 Pasco 343, 344 Pinellas 444, 445 Polk 515 Sarasota 543, 544

Periodontics Hillsborough 259 Manatee 305 Pinellas 445 250, 251, 675 Polk 515, 516 304 Sarasota 544 441, 716 514 PET Therapy 606 542 All Physical Medicine & Rehabilitation 259, 260, 677 251, 252 Hillsborough 305 343 Manatee Pasco 344 442 445 514 Pinellas Polk 516 542 Sarasota 544

www.wellcare.com/Florida | 821

Specialty Provider At-A-Glance P - cont. Physical Therapy De Soto Hardee Hillsborough Manatee Pasco Pinellas Polk Sarasota Physician Assistant Hillsborough Manatee Pinellas

649 651 619, 677, 678 687 628, 693 636, 718 642, 733 647, 741 678 687 719

Plastic & Reconstructive Surgery Hillsborough 260, 261 Manatee 305 Pasco 344 Pinellas 446, 719 Polk 516 Podiatry De Soto Hardee Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota Preventive Medicine Hardee Highlands Polk Prosthetics Hillsborough Pinellas Prosthodontics Polk Psych Hospital Manatee Pinellas Sarasota

84 87 97 261, 262, 263 305, 306 344, 345 446, 447 516 544, 545

Psychiatry De Soto Hardee Hillsborough Manatee Pasco Pinellas Polk Sarasota

Polk 559 560 569, 570, 571, 572 576, 577 582, 583 589, 590, 591, 592 596, 597 602, 603, 604

Psychology Hillsborough Manatee Pasco Pinellas Polk Sarasota

733

Radiology - Interventional & Vascular Hillsborough 268, 269 Pinellas 450 Polk 518 Sarasota 547 Rehabilitation Facility Highlands Hillsborough Manatee Pasco Pinellas Polk Sarasota

609 619, 620 624 628 636 642 647

Rheumatology Highlands Hillsborough Manatee Pinellas Sarasota

98 269, 270 307 451 547

572, 573, 574 577, 578, 579 583 592 597 604 Reproductive Endocrinology Hillsborough 269, 679 Psychosomatic Medicine Pasco 347 Highlands 561 451 Polk 597, 598 Pinellas Sarasota 547 Pulmonary Disease De Soto 84 Retail 744 Highlands 97, 98 Hardee Highlands 745 Hillsborough Hillsborough 263, 264, 265, 266, 678, 679 Manatee 306 746, 747, 748, 749, 750, 751, 752, 753, Pasco 345, 346 754, 755, 756, 757, 758, 759 760, 761, 762 Pinellas 447, 448, 449 Manatee 763, 764, 765, 766 Polk 517, 518 Pasco Pinellas Sarasota 545, 546, 741 767, 768, 769, 770, 771, 772, 773, 774, Pulmonary Medicine 775 Hillsborough 679 Polk 776, 777, 778, 779, 780 Sarasota 781, 782, 783, 784 R

87 97 516, 517 Radiation Oncology De Soto 84 Highlands 98 263 266, 267, 268, 679 447 Hillsborough Manatee 306, 307 Pasco 346 517 Pinellas 449, 450 Polk 518 Sarasota 546, 547 576 589 Radiation Therapy 602 Hillsborough Pinellas

S

Skilled Nursing Facility Highlands Hillsborough 268 Manatee 450 Pasco

www.wellcare.com/Florida | 822

609, 610 620, 621 624, 625 628, 629

Specialty Provider At-A-Glance S - cont.

Sarasota

604, 605

Skilled Nursing Facility - cont. Surgical Oncology Pinellas 636, 637, 638 Polk 734 Polk 642, 643 Sarasota 647, 648 T Thoracic & Cardiovascular Surgery Sleep Diagnostic Studies 98 Pasco 629 Highlands Hillsborough 270, 271, 681, 682 Pinellas 638 307 Polk 643 Manatee Pasco 347 Sleep Medicine Pinellas 451, 452, 720, 721 Hillsborough 270 Polk 518, 519 Manatee 307 Pasco 347 Thoracic Surgery 271, 272 Pinellas 451 Hillsborough 452, 721 Polk 518 Pinellas Transplant Hepatology Specialty 272 Hillsborough 759 Hillsborough Speech & Language Pathology Hillsborough 679, 680 Manatee 687 Pasco 693, 694 Pinellas 719 Polk 733 Sarasota 741, 742 Speech Therapy De Soto Hardee Hillsborough Manatee Pasco Pinellas Polk Sarasota Sports Medicine Hillsborough Pasco Pinellas Substance Abuse Hardee Highlands Hillsborough Pasco Pinellas Polk

U Urgent Care Center Highlands Hillsborough Pasco Pinellas Polk Sarasota

610 621, 622 629, 630 638, 639 643, 644 648

650 651 680, 681 687 694, 695 719, 720 733, 734 742, 743

Urology De Soto 84, 650 Hardee 87, 88 Highlands 98 Hillsborough 272, 273 Manatee 307, 308 Pasco 347, 348 Pinellas 452 Polk 519, 734, 735 547, 548, 549, 743 270, 681 Sarasota 347 V 451 Vascular Surgery Highlands 98 560 Hillsborough 273, 274, 275, 682 561 Pasco 348 574 Pinellas 452, 453, 721 583 Polk 519, 520 592, 593 598, 599

www.wellcare.com/Florida | 823

EXTENDED HOURS INDEX You can find a provider who has longer office hours in this index. First look for the provider’s name. Then check the county and page number. You can go to that page to get the provider’s office hours. Indice de horarios extendidos: En este índice, usted puede encontrar un proveedor con horario más prolongado de atención en el consultorio. Primero busque el nombre del proveedor, y luego verifique el condado y el número de página. Consulte esa página para obtener el horario de atención del proveedor.

De Soto Chiropractic Sweat, Steven DC Dialysis Arcadia Dialysis Center Family Practice Cetin, Kenan PA Kasten, Camille ARNP Persons, Mylissa PA Hospice Tidewell Hospice Inc

Psychiatry Lopez, Rafael MD 83

Urology Bilik Jr, Alfred MD 607 Williams, Thomas MD Hardee 649 649 Chiropractic 649 Altman, James DC Critical Access Hospital 607 Florida Hospital Wauchula

Pediatrics 559 Anchundia, Maria MD 2 Brar, Sardul MD 2 Cosic, Sanja MD 2 84 D'Aunoy, Mary MD 2 84 Mathis, Karen PA 651 Mueller-Battaglia, Denise ARNP 651 Perez, Maria MD 3 Polk, Sara MD 3 85 Sonni, Rajeswari MD 3 551

Preventive Medicine Senatorov, Vladimir MD

Dialysis Retail Fresenius Medical Care Wauchula 550 CVS 608 Heartland Pharmacy Internal Medicine Walmart Pharmacy Blackmon, Jennifer ARNP 649 Family Practice Amin, Sapnalaxmi MD 2 Wauchula Pharmacy Patel, Mahendrakumar MD 1 Delikat, Terrence DO 2 Speech Therapy Licensed Clinical Social Worker Geldart, Donald MD 2 Oliver Fulse, Joyce SLP Brantley, Diane LCSW 559 Hein, Andrew DO 2 Reimer, Donald LCSW 559 Knight, Amelia ARNP 651 Urology Schau, Regina LCSW 559 Metts, Huey ARNP 651 Tingle, William MD Sirak, Laura ARNP 651 Williams, Thomas MD Mental Health 2 Schackman, Cynthia ARNP 649 Thomas, Rebecca MD Highlands Wright, Melissa ARNP 651 Obstetrics/Gynecology Behavioral Health Counseling Teodorescu, Dumitru-Dan MD 83 General Practice Aboul-Hosn, Nawal LMHC Aime Celian, Beatrice MD 86 Wolford, Dale DO 83 Del Sol, Rene LMHC Bhatia, Gitashree MD 2 Van Kleeck, Phillip LMHC Pediatric Psychiatry Vasquez, Kimber MD 2 Lopez, Rafael MD 559 Chiropractic Nurse Midwife Boersma, David DC Pediatrics Russell, Laura ARNP 651 Danzey, Patrick DC Rucker, Rajivi MD 1 Obstetrics/Gynecology Marinock, David DC Villanueva, Pedro MD 1 Qadri, Syed MD 86 Family Practice Physical Therapy Turnquest, Merse MD 86, 87 Amin, Sapnalaxmi MD Babilonia, Gerardo PT 649 Hospital Desoto Memorial Hospital

www.wellcare.com/Florida | 824

87 744 744 744 744 651 88 88

561 561 561 90 90 90 4

EXTENDED HOURS INDEX Highlands - cont. Family Practice - cont. Lim, Donnabelle MD Louisville, Tommy MD Sirak, Laura ARNP General Practice Aime Celian, Beatrice MD Vasquez, Kimber MD Hospice Good Shepherd Hospice Inc Hospital Florida Hospital Heartland Highlands Regional Medical Internal Medicine Bhatia, Gitashree MD Nephrology Pinzon, Ernesto MD Obstetrics/Gynecology Best, Erin MD Turnquest, Merse MD Optometry Buffano, Roxanne OD Dixon, Dustin OD Lopez, Viviana OD Naqvi, Zarrin OD Parrish, Gregory OD Patel, Binal OD Phillips, Stephen OD Puzzo, Melissa OD Roberts, David OD Roberts, Elizabeth OD Salomon, Brad OD Salomon, Katie OD Salomon, Teresa OD Thai, Pauline OD Pediatrics Asis, Maria Belina MD Brar, Sardul MD Camilo, Raisa MD Cosic, Sanja MD D'Aunoy, Mary MD Depauda, Maria MD Grimes, Amy PA

Krishnadas, Praveen MD 6 Candis, Lavasaous LMHC 562 Mueller Barker, Denise ARNP 652 Casanova, Anthia LMHC 562 Mueller-Battaglia, Denise ARNP Claudio Torres, Angela LMHC 562 4 653 Davidson, Wayne LMHC 562 4 Perez, Maria MD 6 De Armas, Odalys LMHC 562 652 Sonni, Rajeswari MD 6 Divico, Alicia LMHC 562 Dulcio, Magdala LMHC 563 91 Preventive Medicine Gerling, Tiffany LMHC 563 97 4 Senatorov, Vladimir MD Hager, Kristina LMHC 563 Psychosomatic Medicine Hassan, Mahmoud LMHC 563 Sadowsky, MD, William MD 561 Lewis, Rayna LMHC 563 609 Lyublanovits, Deborah LMHC 563 Retail Marshall, Marta LMHC 563 745 552 Avon Pharmacy McGrew, Lasandra LCSW 563 745 552 CVS Mercuri, Danielle LCSW 563 Gilbert Drugs 745 Merritt, Casandra LMHC 563 Heartland Pharmacy 745 Moir, Stephanie LMHC 563 5 Heartland Pharmacy Lake Placid Monteleone, Joseph LMHC 563 745 Moore, Audrea LMHC 563 745 93 Highlands Pharmacy Odio, Francine LMHC 564 Jares Pharmacy 745 Papadakis, Mary Frances LMHC 564 K M Drugs 745 Parker, Patricia LCSW 564 93 Sebring Pharmacy 745 Porter, Margaret LCSW 564 94 Shamrock Pharmacy 745 Rojas, Paola LMHC 564 Walmart Pharmacy 745 Rudzewicz, Marianne LCSW 564 745 95 Winn-Dixie Pharmacy Sims, Susan LMHC 564 95 Skilled Nursing Facility Stilson, Johnna LMHC 564 95 Kenilworth Care and Rehabilitation Teixeira, Milton LMHC 564 95 Center 610 Van Pelt, Teresa LMHC 564 95 Lake Placid Health and Williams, Kelly LCSW 564 95 Rehabilitation C 610 Wilson Henton, Shaana LMHC 564 96 The Oaks At Avon Park 610 Behavioral Health Facility 96 Bay Area Behavioral Services Inc 96 Urgent Care Center First Help Urgent Care Clinic 610 564 96 Baycare Life Management 564 96 Urology Family Preservation Service 565 96 Clark, Randall MD 98 Neuropsychiatric Institute LLC 565 96 Hillsborough Northside Mental Health Center 96 Inc 565 Allergy & Immunology South Florida Baptist Hospital 565 99 5 Dominguez, Jose MD St Josephs Hospital 565 99 5 Downes, Sandra MD 100 Birthing Center 5 Gerrish, Prianka MD 100 Sweet Child O Mine LLC 611 6 Salim, Nauman MD 6 Behavioral Health Counseling Cardiology 6 Averoff, Lisa LMHC 562 Saiyad, Saleem MD 652 Brooks, Joel LCSW 562

www.wellcare.com/Florida | 825

110

EXTENDED HOURS INDEX Hillsborough - cont. Child Neurology Arroyo, Lizbeth ARNP Chung, Elizabeth MD Ferreira, Carmen MD Ferreira, Jose MD Green, April ARNP Mukalel, Ninon MD Soto, Adelene ARNP

Dialysis Brandon Artificial Kidney Center 655 113 113 113 656 114 656

Sun City Center Dialysis USF Dialysis Center

614 614 614

Durable Medical Equipment American Homepatient Inc Bioscrip Infusion Services LLC

615 615

Endodontics 120, 121 114 Gargasz, Bret DDS Millstein, Ashley DMD 121, 122 114 114 Family Practice 114 Antigua-Suarez, Nathaly PA 657 114 Asuncion, Melissa MD 122 114 Beagle, Linda ARNP 658 114 Coronica, Helen ARNP 658 115 Frazier, Brett MD 8 115 Harper, William PA 658 115 Medidi, Subhakararao MD 8, 9 115 Noorani, Nazneen MD 9 115 O'Brien, James DO 9 115 Rahman, Farhana MD 10 115 Santiago, Sylvia MD 10 115 Shaub, Brian DO 10, 11 115 115 Gastroenterology Al-Nakshabendi, Imad MD 122 Community Mental Health Center Kero, Shawkat MD 124 Baycare Life Management 565 Ward, Eugene MD 125 Mental Health Care Inc 566 Tampa Crossroads Inc 566 General Dentistry Adderly, Erica DDS 125, 126 Convenient Care Clinic Adibi, Farnaz DMD 126 Minuteclinic LLC 611, 612 Amrooei, Danoosh DMD 126 Take Care Health 612 Ankalikar, Satish DDS 126 Arnedo, Johanna DDS 127 Dermatology 127 Caban, Francis MD 116 Atkinson, William DDS Attie, Abelardo DMD 127 Taylor, Thomas MD 118 Austin, Deborah DDS 127 Diagnostic Imaging Bacchelli, Lara DMD 127, 128 Advanced Diagnostic Group 612 Baez Henry, Carlianette DMD 128 Baycare Outpatient Imaging 612 Baez, Tomas DDS 128 Bayview Radiology 612 Barlow, Kathleen DDS 128 Stand Up MRI of Tampa 613 Barrett, Steven DDS 128 Tower Imaging Inc 613 Biandudi, Odessa DDS 129 University Diagnostic 613 Boswell, Gibson DMD 129 Brachowicz, Maria DDS 129 Chiropractic Barry, Scott DC Brecher, Matthew DC Caez, Brian DC Cheatwood, Janice DC Cox, Stephen DC Jones, Nathan DC Mohr, Travis DC Rice, Charles DC Rodriguez, Robert DC St. Hilaire, Nicholas DC Stangherlin, Michael DC Trussell, Kenneth DC Venturino, Nicholas DC Wages, David DC Williams, Christopher DC Williams, Gregory DC Willmitch, Martin DC

www.wellcare.com/Florida | 826

Bradley, Ashley DMD Branscombe, Tyler DMD Brito, Daryl DMD Bushati, Ivo DMD Caputo, Michael DDS Carbonell, Kevin DMD Chase, Kely DMD Cisneros, Aura DMD Diaz, Jany DMD Dietz, Rodney DDS Dinh, Lan DMD Dire, Anthony DMD Dockus, Matthew DMD Dolce, Vincent DMD Durve, Aparna DMD Eckels, Shane DDS Espino, Derek DDS Fornos, Jorge DDS Fuller, Ellis DDS Genninger, Jasen DMD Goldstein, Alexander DDS Gonzalez, Yanela DMD Green, George DDS Greenberg, Andrew DDS Hall, Joshua DMD Hamblen, Terry DMD Immadi, Lakshmi DDS Inaba, Caroline DDS Jackson, Anthony DDS Jakubiec, Jacqueline DMD Johnson, Jonathan DDS Kanach, Paul DMD Kapadia, Mukesh DDS Katsur, Justin DDS Kiani, Kamran DMD Kohn, Heather DDS Kopynets, Viktor DDS Krasnov, Rostislav DDS Kuntsmann, Vivian DDS Lee-Loy, Ingrid DDS Lepore, Krystina DDS Lipton, Barry DDS Lopez, Grace DMD Mahdavieh, Sadaf DMD Manzur, Kasim DDS Marshall, Kristine DDS Martinez, Gustavo DMD Martinez, Magela DMD

130 130 130 131 131 131 131 132 133 134 134 134 134, 135 135 135 135 136 136 136 137 137 137 137 138 139 139 141 141 141 142 142 143 144 144 144 144 144 145 145 145 146 146 146 146 146 147 147 147

EXTENDED HOURS INDEX Hillsborough - cont. General Dentistry - cont. Matthews, Irina DMD 147 Mazariegos, Stephanie DMD 147 Moore, Alicia DDS 148 Moore, Edith DDS 148 Morell, Omar DMD 148 Mutawalli, Khalid DDS 149 Nalley, Brittany DMD 149 Ngo, Denise DDS 149 Nguyen, David DMD 149 Nguyen, Phuc-Hau DMD 150 Pansuriya, Dharmendra DMD 151 Parker, David DDS 152 Patel, Kinjalben DMD 152 Perez Diaz, Elizabeth DMD 153 Pham, Thi DDS 153 Phan, Christine DMD 153 Prato-Guia, Yelena DDS 154 Qadri, Subuhi DMD 154 Quevedo, Fernando DDS 154 Quevedo, Rachel DDS 154 Reed, Samantha DDS 154 Ribot, Aliana DMD 155 Rivera, Jade DMD 155 Rizner, Amanda DMD 155 Robbins, Jeremy DDS 155 Sanchez-Diu, Monica DMD 155 Selz, Amrita DMD 156 Slement, Gaby DMD 156 Spouh, Mohammad DDS 156 Stilian, Douglas DMD 157 Taylor, Lindsey DMD 157 Teresi, Kirsten DMD 157 Trivedi, Mehulkumar DMD 157 Uzunova-Dimova, Kalina DDS 158 Valdez, Harvey DMD 158 Valdman, Vadim DDS 158 Wade, Brianne DMD 158, 159 Weisser, Ettie DDS 159 Williams, Tosha DDS 160 Woo, Kyung DDS 160 Zand, Maximus DMD 160 Zariffard, Ehsan DMD 160 General Practice Miranda-Genaro, Luis MD

General Surgery Fernandez, Alfredo MD

162

Hematology & Oncology Crescentini, Robert MD

167

Home Health Care Accurate Health Services Corp Assisting Hands Gulf Coast Avian Home Health Corp Fusion Healthcare Harmony Home Health LLC Maxim Healthcare Services Inc Preferred Touch Home Care Inc

Poblete, Sarah Jessica MD Ramiro, Lucila MD Reddivari, Venkata MD Ritchie, Tera ARNP Sandhu, Jagdeep MD Saprounova-Hopf, Vera MD Shires-Waldron, Sarah MD Sinnott, John MD Spoor, Lori DO Warner, Elizabeth MD

17 17 174 661 174 17 17 174 18 18

616 616 616 616 616 Laboratory Pathology Testing 617 Tampa Pathology Lab 617

Licensed Clinical Social Worker 617 Coons, Audra LCSW 566 Senior Helpers 617 Coughlin, Jacquelyn LCSW 566 Visiting Nurse Association of Daniels, Nikki LCSW 566 Florida In 617 Jordan, Cassandra LCSW 566 Hospice Small, Frankie LCSW 567 Lifepath Hospice Inc 617 St Vil, Islaine LCSW 567 Thomas, Rosalyn LCSW 567 Hospital Waters, Robin LCSW 567 Brandon Regional Hospital 553 Columbia South Bay Hospital 553 Licensed Marriage and Family Florida Hospital Carrollwood 553 Therapist 567 Florida Hospital Tampa 553 Danser, Laura LMFT 567 Memorial Hospital of Tampa 553 Monteleone, Joseph LMHC Shriners Hospitals For Children Tpa Licensed Mental Health Counselor 553 Huertas, Erica LMHC 661 South Florida Baptist Hospital 553 McKenzie, Amy LMHC 661 St Josephs Hospital 553 Towey, Brigit LMHC 662 Tampa Community Hospital 553 Treadway, Benjamin LMHC 662 Tampa General Hospital 553 Mammography Infusion Therapy Tower Imaging Inc 618 Bioscrip Infusion Services LLC 617 Mental Health Counselor Internal Medicine Ferreira, Felicia LMHC 662 Ackley, Karen MD 12 Marteli, Rosalia LMHC 662 Asuncion, Melissa MD 172 Towey, Brigit LMHC 662 Bilella, Mark MD 12 Datta, Indrani MD 13 Mobile Diagnostic 618 Demery, Frank MD 14 Vascular Ultrasound Services Durojaiye, Babatola MD 14 Neonatal Perinatal Medicine Hardiman, James MD 14 Ferry, Jenelle MD 181 Jeyabarath, Ananthi MD 172 Foster, Cherie MD 181 Maningo, Evelyn MD 15 Houin, Satya MD 181 Parker, Glenda MD 16 Martinasek, Dushan MD 181 12 Patel, Ankit MD 16 Parilla, Erin MD 181

www.wellcare.com/Florida | 827

EXTENDED HOURS INDEX Hillsborough - cont. Neonatal Perinatal Medicine cont. Rabenstein, Eric DO Sheridan, Richard MD Solomon, Kenneth MD Vargas, Alfonso MD Wyble, Lance MD Nephrology Reddivari, Venkata MD Neuropsychology Mehra, Rahul MD Nurse Practitioner Mulder, Joanna Np Zambito, Ashlie ARNP

Occupational Therapy Blacker, Julie OT Douglas, Rodney OT Ferreyra, Stephanie OT Independent Living Inc Lamke, Kimberly OT Larussa, Suzette OT Riley-Naylor, Erin OT Thal, Julie OT

673 673 673 618 673 673 673 673

183 Ophthalmology Fouraker, Bradley MD 567 Henderson Sr, Gregory MD Levy-Clarke, Grace MD

211 212 212

181 181 181 181 181

664 Optician 214 665 Cef Vision Inc Eye Doctors Optical Outlets PA Nurse Practitioner Family Medicine 214, 215 Seneque, Renette ARNP 665 Visionworks Inc 215 Villar, Nelson ARNP 665 Optometry Nurse Practitioner Pediatric Adler, Shepard OD 215 Dittmer, Amy ARNP 665 Alvarez, Dennis OD 215 Anderson, Clinton OD 216 Obstetrics/Gynecology Austin, Bradley OD 216 Bainbridge, Megan CNM 667 216 Dyer, Diana ARNP 668 Barrido, Kevin OD Berdeal, Rogelio OD 216, 217 Fanarjian, Nicole MD 197 217 Felski, Emil DO 197 Bernatsky, Sylvia OD Buffano, Roxanne OD 217 Frazier, Cathy ARNP 668 217 Holmstrom, Shelly MD 198, 199 Buzzett, Jennifer OD Carlson, Ruben OD 217 Lopez-Rosa, Magda ARNP 669 217 Mashandure, Mercy ARNP 669 Clough, Scott OD Cochran, John OD 217 McGinty, Susanne ARNP 669 217 McKinnie, Cynthia ARNP 669 Custred, Jeffrey OD Day, Paul OD 217 Mondaca, Astrid MD 202 218 Nash, Michelle ARNP 670 Dixon, Dustin OD Dominguez, Vymarys OD 218 Ortiz, Edwin MD 203 218, 219 Paine, Lisa ARNP 671 Fernandez, Sonia OD Ferris, Anthony OD 219 Prabhakaran, Sujatha MD 204 219 Reames, Amanda ARNP 671 Furman, Adam OD Fusselman, John OD 219 Redlin, Jacqueline ARNP 671 220 Rosa, Hector MD 205 Gill, Jonell OD Glassberg, Steven OD 220 Shreve, Tanya PA 671 220 Staal, Jacqueline ARNP 672 Goldstein, Stacey OD Gonzalez, Heidi OD 220 Valentin, Socorro ARNP 672 220 Ward, Leslie ARNP 672 Gres, Stephen OD Haffner, George OD 220 Waterman II, Philip MD 209 220 Wattenbarger, John MD 210 Heaps, Eric OD

www.wellcare.com/Florida | 828

Hernandez, Madeline OD Hetherington, Mark OD Hidalgo, Janet OD Honeyblue, Shamika OD Jones, Douglas OD Kanicky, Jee OD Kanicky, Luc OD Krumbholz, Gerald OD LA Rosa, Robb OD Lappano, Alfred OD Lewenson, Robert OD Lopez, Viviana OD Luu, Jessica OD Mann, Clare OD Merlino, Brian OD Morrison, Caryn OD Murphy, Kenneth OD Neal, Terry OD Ngar, Lucie OD Ocasio, John OD Palmisano, Daniel OD Parrish, Gregory OD Patel, Binal OD Pham, Kim OD Phillips, James OD Phillips, Stephen OD Pradilla, Sergio OD Puzzo, Melissa OD Ramesar, Denyse OD Raney, Dennis OD Roberts, David OD Roberts, Elizabeth OD Salomon, Brad OD Salomon, Katie OD Salomon, Teresa OD Scamard, David OD Schatz, Scott OD Scott, Christopher OD Smith, Kevin OD Sudbury, Glenn OD Thai, Pauline OD Ton, Kim-Oanh OD Tran, Baotram OD Tyler, Eric OD Vo, Mai OD Vu, Bonnie OD Walker, Stacey OD Weisbond, Steven OD

221 221 221, 222 222 222 222 222 222 222, 223 223 223 223 223, 224 224, 225 225 225, 226 226 226 226 226 226 226 226 226, 227 227 227 227, 228 228 228 229 229 229 229 229 229 229 229, 230 230 230, 231 231 231 231 231 231 231, 232 232 232 232

EXTENDED HOURS INDEX Hillsborough - cont. Optometry - cont. Williams, John OD Wilson, Mark OD Woolwine, Joshua OD

232 232 232, 233

Oral & Maxillofacial Surgery Langston, Andrew DMD

233

Orthodontics Chin, Leo DMD Guzman, Ulises DDS Nelson, Stephen DMD Parsa, Mitra DDS Turke, Eric DDS

233 233 234 234 234

Orthopaedic Surgery Bhat, Anjali PA Cronen, Geoffrey MD Jester, Adam MD Maciel, Maureen MD Nieuwenhoff, Fawn ARNP Remaley, Delbert DO Sanders, Roy MD

673 235 236 236 673 236 236

Orthotics & Prosthetics Tampa Bay Orthopaedic Designs Inc 619 Pediatric Cardiology Hardin, Joel MD Pediatric Endocrinology Bollepalli, Sureka MD Gomez, Danielle MD

239 243 243

Pediatric Hematology/Oncology Rossbach, Hans-Christoph MD 247 Pediatric Orthopedic Surgery Bradley, Timothy MD 249 Pediatric Psychiatry Ali, Muhammad MD Feinstein, Harris MD Kanfer, Steven MD

568 568 568

Pediatric Pulmonology Houin, Paul MD Prpich, John MD Rosenberg, David MD

250 250 250

Pediatrics Ackley, Karen MD 18 Adnan, Khan MD 18 Alfaro, Carmen MD 19 Allison, Joanna MD 19 Arango, Jan MD 19 Armstrong, Christine MD 19 Bartelt, Erica MD 20 Bilella, Mark MD 20 Bryant, June ARNP 675 Buchholz, Emily PA 676 Buckley, Janet ARNP 676 Cibran, Mariano MD 20 Couluris, Marisa DO 252 Demery, Frank MD 21 Desai, Ajay DO 252 Donkor, Cynthia MD 21 Fauber, Dean MD 21 Garcia, Rolando MD 21 Grant, Stewart MD 22 Hiben, Eugene MD 22 Hicks, Mary MD 22 Johnson-Towson, Michele MD 22 Kamisetty, Sudarsan MD 22 Kanarek, Mark MD 22 Kilaru, Anusha MD 22, 23 Kilbride, Pamela MD 23 Kosoff, Peter MD 23 Levitt, Laura MD 23 Mak, Sheila DO 24 Martinez, Sofia ARNP 676 Murphy, Melinda MD 253 Nadal, Florencio MD 25 Ong, Alicia MD 25 Pai, Rajendra MD 25 Preston, Marilyn MD 25, 26 Ranganathan, Radhika MD 26 Rau, Sathyanarayan MD 26 Reilly Hays, Elizabeth MD 26 Rivera, Ever MD 26 Sabia, Francesca MD 27 Santa Maria, Ramon MD 27 Smith, Elizabeth MD 27 Szafranski, Christy MD 27 Tayao, Maria Concepcion MD 28 Tayao, Maria MD 28 Torres De Carlo, Rita MD 28

www.wellcare.com/Florida | 829

Torres, Luz MD Tran, Thein MD Wildcatt, Lisa MD Williams, Chandra MD Yakubu, Elizabeth MD Young, Joyce ARNP Zhao, Wenying MD

28 29 29 29 29 677 29

Pedodontics Black, Harrison DMD 254 Bui, Loananh DDS 254 Edwards, Jenny DMD 254 Gyles, Richard DDS 255 Iyer, Priyanka DDS 255 Lasanta, Denisse DMD 256 Lee, Sara DMD 256 Makram, Christina DDS 256 Naoom, Jennifer DDS 257 Newcity, Amanda DDS 257, 258 Pinero Correa, Rosario DDS 258 Sirage, Mohamed DMD 259 Theogene, Dorothy DDS 259 Young, Kera DDS 259 Periodontics Bardsley, Norman DDS

259

Physical Medicine & Rehabilitation Radecki, Richard MD 260 Physical Therapy Arrigo, Christopher PT Coronado, Zaida PT Corrick, Kyle PT Cortinas-Small, Maria PT Guida, Meghan PT Independent Living Inc Neiswender, Holly PT Quinones, Lourdes PT Watson, Ashlyn PT

677 677 677 677 677 619 678 678 678

Podiatry Ebsworth, Gloried DPM Johnson, Brandi DPM Krawetz, Leo DPM Leitner, Mark DPM Richter, Paul DPM

261 262 262 262 263

Psychiatry Ali, Muhammad MD Chandy, Joshua DO

569 569, 570

EXTENDED HOURS INDEX Hillsborough - cont. Psychiatry - cont. Chowdhury, Quamrul MD Desai, Devyani MD Feinstein, Harris MD Feldman, Alan MD Kanfer, Steven MD Lluch, Roberto MD Patel, Pragnesh MD Patel, Shodhan MD

570 570 570 571 571 571 571 572

Psychology Hoover, Kurt PHD Patz, Daniel PsyD Taormina, Rochelle PHD

572 573 574

Radiation Oncology Miller, Robert MD

268

Radiation Therapy Solc, Zucel MD

268

Rehabilitation Facility Beth Ingram and Associates Inc 619 Total Therapy 620 Reproductive Endocrinology Mayer, James MD

269

Retail Acme Pharmacy 746 Advance Pharmacy Service 746 American Care of Tampa IncNtampa 746 American Care of Tampa Inc W 746 Apollo Beach Pharmacy 746 Bay Discount Pharmacy 746 Baycare Pharmacy 746 Bearss Pharmacy 746 Benzer Pharmacy 746 Best Deal RX Pharmacy 746 Bills Prescription Center 746 Brandon Pharmacy 747 Busch Pharmacy LLC 747 Careplus Pharmacy 747 Carrollwood Pharmacy 747 Ccm Pharmacy, LLC 747 Choice Pharmacy 747 City Care Pharmacy 747

City Pharmacy 747 Coram Healthcare Corp of Florida 747 Crestmark Pharmacy Services LLC 747 CVS 747, 748, 749, 750 Davids Pharmacy 750 Davis Islands Pharmacy 750 Dollex Pharmacy 750 Exactus Pharmacy Solutions Inc 750 Extra Care Pharmacy Inc 750 Family Care Pharmacy 750 Fast and Friendly Pharmacy 750 Fletcher Medical Center Pharmacy 750 Freedomed Pharmacy 750 Friends Pharmacy 750 Grace RX Pharmacy 750 Hillsboro Specialty Pharmacy Blood Prss 751 Hillsborough River Pharmacy Inc 751 Hoyes Pharmacy 751 Idel Pharmacy 751 J S RX Pharmacy 751 Jrx Pharmacy 751 Kabs Pharmacy 751 Kay Pharmacy 751 King Pharmacy 751 Logos Pharmacy 751 Lutz Pharmacy 751 Macdill Pharmacy 751 Maxxycom RX Pharmacy 752 Medicine Place 752 Meds To Home 752 Meridian Pharmacy 752 Michaels Pharmacy 752 Moffitt Cancer Center PUBLIX 752 My Pharmacy of Tampa 752 New Waters Pharmacy 752 North Tampa Pharmacy 752 Northdale Pharmacy 752 Omega Drugs 752 Omnicare of Tampa 752 Onestop RX Pharmacy 752 Ousia Pharmacy Corp 753

www.wellcare.com/Florida | 830

Palma Ceia Health Mart Pharmacy 753 Palms Pharmacy 753 Pharma-Ville RX Medical Supply 753 Pharmax Specialty Pharmacy 753 Pharmscript 753 Plant City Discount Pharmacy 753 Plant City Family Care 753 Precision RX 753 Pronto Pharmacy 754 Quick N Save Pharmacy 754 Rite RX Care 754 Riverview Pharmacy 754 Royal RX Pharmacy 754 Ruskin Health Center 754 RX Express Pharmacy 754 RX Oasis 754 RX Solutions Inc 754 Rxperts Pharmacy Tampa Inc 754 Salhab Pharmacy 754 Sallykay Pharmacy 754 SAMS CLUB 754 Save-Rite Pharmacy 754 Script Choice Pharmacy 754 Scruples Pharmacy 755 Seffner Pharmacy 755 Seniorcare Comm Pharmacy 755 St Joseph Pharmacy 755 Staywell Pharmacy 755 Summerfield Pharmacy Inc 755 Sunrise Pharmacy 755 Super Discount Pharmacy 755 Tampa Drugs Diabetic Center 755 Tampa General Hospital OP Pharmacy 755 Tampa Palms Pharmacy 755 The Drug Shoppe 756 The Medicine Shoppe 756 Times Pharmacy 756 Tom Lee Community Health Center 756 Total Care Pharmacy of Bloomingdale 756 Total Care Pharmacy of Brandon 756 Univ Pain Management Center 756 V T Pharmacy 756

EXTENDED HOURS INDEX Hillsborough - cont. Retail - cont. Valrico Pharmacy Valued Choice Pharmacy Veracity Pharmacy Vistacare Pharmacy Vistara Pharmacy Walmart Pharmacy Wecare Pharmacy LLC West Shore Pharmacy Williams Pharmacy Winn-Dixie Pharmacy Xtra Care Pharmacy Rheumatology Kramer, Leni MD

Whispering Oaks 621 Woodbridge Rehab & Health 621 756 Center 756 Specialty 756 Exactus Pharmacy Solutions Inc 756 759 756 757, 758 Speech & Language Pathology 679 758 Federico, Jeanne SLP 679 758 Mueller, Pamela SLP Sanders, Sherra SLP 679 758 679 758, 759 Stipe, Denise SLP Thomas Allen, Tequesta SLP 679 759 White, Laura SLP 680

Now Care Walk In Clinic Inc 622 Premium Health Services of Tampa Bay 622 Tampa Urgent Care 622 Urgent Care USA LLC 622 Urology Rehman, Jamil MD

273

Vascular Surgery De Jesus Gomez, Gustavo MD 273 Manatee

Behavioral Health Counseling Allen, Sarah LCSW Gibala, Virginia LMHC Kroll, Linda LCSW 680 Russell, Constance LCSW 680 White, Kathy LMHC 680 680 Behavioral Health Facility 680 Palm Shores Behavioral Health 680 Center 680 Chiropractic 680 Rowe, Keri DC 680 680 Dialysis 680 FMC Southwest Florida Dialysis 680 Center 681 Durable Medical Equipment 681 Hoveround Corporation 681 Manatee County Rural Health 681 Services,Inc 681 681 Endodontics 681 Gargasz, Bret DDS Millstein, Ashley DMD

269 Speech Therapy Amurgis, Christie SLP Skilled Nursing Facility Andersen, Bailey SLP Accentia Health and Rehab Center Barth, Jeanne SLP of Tamp 620 Boonyathitisuk, Pisami SLP Brandon Health Rehabilitatio 620 Booth, Kimberly SLP Carrollwood Care Center 620 Breedlove, Megan SLP Central Park Healthcare and Byrd, Michelle SLP Rehabilitati 620 Cobb Dewitt, Mary SLP CHC of Brandon 620 Genuardi, Sharon SLP Community Convalescent Center Grana, Jamira SLP 620 Hamor, Marianne SLP Excel Care Center 620 Joplin, Tennille SLP Fletcher Health and Rehabilitation Jung, Gina SLP Center 620 Leigh, Jennifer SLP Habana Health Care Center 620 Porreca, Tina SLP Hawthorne Health And Rehab of Shafii Campbell, Alyssa SLP Brandon 620 Victores, Rebeca SLP Manor Care of Carrollwood #443 Vought, Jill SLP 620 Wallace, Davina SLP Palm Garden of Sun City Center 620 Urgent Care Center Palm Garden of Tampa 620 A Plus Family Urgent Care, LLC 621 Rehabilitation & Healthcare Center After Hours Pediatrics Practices Inc 621 of Tampa 620 Solaris Healthcare Plant City 620 Avant Garde Urgent Care LLC 621 Boyette Walk In Clinic 621 South Tampa Health and Rehab 621 Center 621 Doctors Express Doctors Walk-In Clinics 621, 622 Sovereign Healthcare of Tampa LLC 622 DBA Ba 621 Evening Pediatrics Inc Express Care of Tampa Bay 622 The Home Association 621 First Care Walk In Clinic LLC 622 The Nursing Center At University Late Hours Urgent Care Center 622 Village 621 Night Owl Pediatrics, PA 622

www.wellcare.com/Florida | 831

Family Practice Bollegraf, Morris DO Brochu, Robert MD Cowan, Nena ARNP Delaney, Janet ARNP Fishco, Robert MD Greenfield, Steven MD Kouka, Nabeel DO Krueger, Leroy PA Persad, Farah PA

575 575 575 575 575

575 277

623 623 624 277 277

277 30 683 683 30 30, 278 30 683 683

EXTENDED HOURS INDEX Manatee - cont.

Wade, Brianne DMD 286 Ward, Clifford DDS 286 General Dentistry Ward, Tasha DDS 286 Acquaro, Ronald DMD 278 Adderly, Erica DDS 278 Home Health Care Adibi, Farnaz DMD 278 A Life At Home 624 Alviani, Clay DMD 279 Arditi, Sibel DMD 279 Hospice 624 Bacchelli, Lara DMD 279 Tidewell Hospice Inc Barrett, Steven DDS 279 Hospital Boswell, Gibson DMD 279 Blake Medical Center 554 Bradley, Ashley DMD 279 Lakewood Ranch Medical Center Branscombe, Tyler DMD 280 554 Brito, Daryl DMD 280 Manatee Memorial Hospital 554 Bushati, Ivo DMD 280 Canizares, Carina DMD 280 Internal Medicine 31 Caputo, Michael DDS 280 Ali, Asad MD Perez, Sergio MD 31 Carbonell, Kevin DMD 280, 281 31 Cherkinsky, Jordan DDS 281 Rao, Sukhdeep MD Srivastava, Sunit MD 289 Cherry, Jerry DDS 281 Dockus, Matthew DMD 281 Licensed Clinical Social Worker Eckels, Shane DDS 281 Quinton, Cynthia LCSW 576 Fowler, Charlotte DMD 282 Genninger, Jasen DMD 282 Mental Health 684 Greenberg, Andrew DDS 282 Schackman, Cynthia ARNP Hall, Joshua DMD 282 Nurse Practitioner Psychiatric Kanach, Paul DMD 282, 283 Mental Health 684 Katsur, Justin DDS 283 Reuter, Ilona ARNP Keo, Phanith DMD 283 Obstetrics/Gynecology Martinez, Magela DMD 283 Caltenco, Elias MD 292 Martinez, Susana DDS 283 Dolskaya, Elena MD 292 Mazariegos, Stephanie DMD Fanarjian, Nicole MD 292 283, 284 Frazier, Cathy ARNP 684 Melean, Alfonso DMD 284 Lopez-Rosa, Magda ARNP 684 Mickelson, Nicholas DMD 284 Mashandure, Mercy ARNP 684 Nalley, Brittany DMD 284 McGinty, Susanne ARNP 685 Ngo, Denise DDS 284 McKinnie, Cynthia ARNP 685 Pardo, Maria DDS 284 Ortiz, Edwin MD 292 Patel, Kinjalben DMD 284 Prabhakaran, Sujatha MD 293 Peralta, Johnny DMD 284 Reames, Amanda ARNP 685 Phan, Christine DMD 284 Redlin, Jacqueline ARNP 685 Rivera, Jade DMD 285 Rivera-Ortiz, Wilfredo MD 293 Rizner, Amanda DMD 285 Rosa, Hector MD 293 Simon, Keith DMD 285 Saborido Battaglia, Francisco MD Teresi, Kirsten DMD 285 293 Trivedi, Mehulkumar DMD 285 Shreve, Tanya PA 685 Turhan, Mine DDS 285, 286 Staal, Jacqueline ARNP 685 Vanoverbeke, Allen DMD 286 Stephens, Shawn MD 293

www.wellcare.com/Florida | 832

Valentin, Socorro ARNP Vazquez, Carlos MD Ward, Leslie ARNP Waterman II, Philip MD Wolford, Dale DO Woods, Reginald MD

685 294 685 294 294 294

Occupational Medicine Halliday, Megan OT

685

Occupational Therapy Newingham, Lorin OT Perez, Kristina OT Pogan, Cara OT Reinbolt, Elizabeth OT Thoresen, Lena OT

685 685 685 686 686

Optician Eye Doctors Optical Outlets PA 297 Optometry Carr, William OD Chai, Sook OD Daka, Dedrix OD Esperanza, Michelle OD Feliciano, Emy OD Flanagan, Thomas OD Foster, Thomas OD Glassberg, Steven OD Glasser, Jay OD Goldstein, Stacey OD Ingham, Richard OD Ismail, Esaam OD Jacoby, Leonard OD Jones, Douglas OD Joshi, Neha OD Kanicky, Jee OD Kanicky, Luc OD LA Rosa, Robb OD Lascaibar, Albert OD Lewenson, Robert OD Lewis, John OD Malde, Elyse OD Mann, Clare OD Marrotte, Richard OD Meer, Henry OD Miller, Barbara OD Nguyen, Quyen OD Olson, Arlese OD

297, 298 298 298 298 298 298 298 299 299 299 299 299 299 299 299 299 299 300 300 300 300 300 300 300, 301 301 301 301 301

EXTENDED HOURS INDEX Manatee - cont. Optometry - cont. Plante, Parker OD Pradilla, Sergio OD Ramos, Becky OD Raney, Dennis OD Saint Jean, Caleb OD Shin, Susan OD Stoneburner, Jon OD Stupp, Elliott OD Sudbury, Glenn OD Tran-Lockwood, Julie OD Tuerkheimer, Barry OD Weisbond, Steven OD Yancey, April OD Pediatric Cardiology Arrillaga, Frances MD Gonzalez, Javier MD John, Jonathan MD Martinez, Richard MD McKenna, Daniel MD Pediatric Psychiatry Halder, Ranjay MD

Linares-Flor, Jesus MD 577 Rabines Burga, Marco MD 577 Rhyne, Dennis MD 577 301 301 Psychology 301 Hopson, Derek PHD 578 301 Padronaggio, Joseph PHD 579 302 302 Rehabilitation Facility 302 Childrens Therapy Solutions Inc 624 302 302 Retail 302 Bayshore Pharmacy 760 302 CVS 760 302 East Manatee Pharmacy 760 303 Ellenton Discount Pharmacy 761 Fairway Pharmacy 761 303 Familycare Discount Pharmacy 761 761 303 Lakewood Ranch Pharmacy 761 303 Manatee Discount Pharmacy Manatee Family Pharmacy 761 304 761 304 Palmetto Drug Mart Pelots Pharmacy 761 SAMS CLUB 761 576 Southeast Pharmacy 761 Truecare Pharmacy 761 University Pharmacy 761 32 32 Vanguard Advanced Pharmacy 761 32 Systems 761, 762 686 Walmart Pharmacy Winn-Dixie Pharmacy 762 686

Pediatrics Blackman, Edward MD Capote-Dishaw, Jessica MD Cendana, Elisa MD Eddy Gennocro, Erin ARNP Hernandez, Martha PA Herrygers, Canaan MD 33 Jngilles, Josie MD 33 Kondabala, Rajani MD 33 Ladines, Cecilia MD 33 Montes, Luis MD 33 Soeker, Linda ARNP 686 Strum, Neta MD 34 Victor-Linkenhoker, Vanessa MD 34 Physical Therapy Kaminski, Jessica PT Scully, Karrin PT Psychiatry Burcenski, Holleen ARNP Jasa, Luis MD Lasebny, Deborah ARNP

Skilled Nursing Facility Braden River Rehabilitation Center LLC 624 Bradenton Health Care 625 Casa Mora Rehabilitation Extended Care 625 Greenbriar Nursing & Rehab 625 Heritage Park Care & Rehabilitation Cent 625 IHS- At Riverfront 625 625 687 LLC of Sarasota Surrey Pl Convalescent Center of 687 Bradenton 625

Urology Tingle, William MD Williams, Thomas MD Pasco Ambulatory Surgery Center Pediatric Surgery Center LLC Odessa

626

Behavioral Health Counseling Bielitz, Robert LMHC Bjorkman, Tara LMHC Corradini, Frank LCSW Edwards II, Stephen LMHC Erickson, Shannon LCSW Fogleman, Ruthann LMHC Gadouas, Cassandra LMHC Henning, Trish LCSW Kassed, Marvin LMHC Nikla, Richard LMHC Sparrowhawk, Paloma LMHC Stemble, Kelly LMHC Tranum, Megan LMHC Visalli, Alyssa LMHC

580 580 580 580 580 580 580 580 580 580 580 580 580 580

Behavioral Health Facility Morton Plant North Bay Hospital 581 Chiropractic Bell, Roger DC Blanco, Allisha DC Conner, Kevin DC Craven, Michael DC Decubellis, Chase DC Horne, Leslie DC Kinkead, Laura DC Patel, Anish DC Pease, Michael DC Santana, Jorge DC Scheu, William DC Shontz, Michael DC Williams, Gregory DC Willis, Steven DC

Convenient Care Clinic Minuteclinic LLC 576 Speech & Language Pathology Flores, Anita SLP 687 Take Care Health 577 687 577 Humphrey, Chelsey SLP

www.wellcare.com/Florida | 833

308 308

315 315 315 315 315 315 315 315 315 315 316 316 316 316 626 626

EXTENDED HOURS INDEX Pasco - cont. Diagnostic Imaging Excel Medical Imaging 626 Radiology Associates of West Pasco 626 Dialysis Gulf Coast Kidney Center-NPR 627 TRC Bayonet Point Dialysis 627 Durable Medical Equipment Lincare Inc

627

Endocrinology, Diabetes, Metabolism Plazarte, Monica DO

318

Endodontics Millstein, Ashley DMD

318

Family Practice Azank, Karina MD Gavino, Belinda MD Greenfield, Adam DO Heron, Delisa MD John, Tobin MD Rehman, Farhan MD Renelus, Deborah MD Rodriguez, Madali ARNP

35 35 35 36 36 37 37 690

General Dentistry Bacchelli, Lara DMD Baghdadi-Gegati, Marcel DDS Barinas-Duval, Froilan DDS Berk, Madeline DMD Bessada, Ashraf DMD Branscombe, Tyler DMD Calcagno, Manuel DDS Crandall, James DDS Dockus, Matthew DMD Farrell, Thomas DDS Figaro, Mark DDS Frankel, Manuel DDS Genninger, Jasen DMD Gottipati, Padmalatha DDS Grace, Willie DDS Graddy, Nathan DDS Greenberg, Andrew DDS Grier, Carrol DDS Hall, Joshua DMD Homayouni, Siavash DDS

Howe, Douglas DDS Kanach, Paul DMD Karapasha, Christopher DDS Katsur, Justin DDS Lee-Loy, Ingrid DDS Mauricio, Margaret DDS Mazariegos, Stephanie DMD McLaughlin, Matthew DMD McNair, Clarence DDS Modaff, Michelle DDS Peralta, Jose DDS Peters, Edward DDS Pham, Thanh DDS Polite, Leroy DMD Pratt, Frederick DDS Scalercio, John DMD Schutt, Charles DDS Smith, Daryl DDS Tiwary, Alka DDS Trivedi, Mehulkumar DMD Vo, Jossette DMD Wright, Carl DDS Home Health Care Visiting Nurse Association of Florida In

322 322 323 323 323 323 323 323 323 323 324 324 324 324 324 325 325 325 325 325 325 325

Licensed Marriage and Family Therapist Jaramillo, Kate LMFT 582 Licensed Professional Counselor Slickers, Albert LPC 582 Obstetrics/Gynecology Connors, Donna MD Efemini, Ese MD Harper, Jennifer MD King III, Joseph MD Marsh Dinham, Keddie MD Ray, Tanya ARNP

334 334 334 335 335 691

Occupational Therapy Beck, Sandra OT Ferreyra, Stephanie OT Fitzgerald, Jennifer OT Lamke, Kimberly OT Riley-Naylor, Erin OT Zdrubecky, Carrie OT

692 692 692 692 692 692

Ophthalmology Perich, Larry DO Shah, Geeta MD

336 337

628 Optician Eye Doctors Optical Outlets PA

Hospice Gulfside Hospice and Pasco 628 319 Palliative Ca 320 Hospital 320 Bayfront Health Dade City 555 320 CRMC At Bayonet Point 555 320 Florida Hospital At Connerton 320 Long Term 555 320 Florida Hospital Wesley Chapel 321 555 321 Florida Hospital Zephyrhills 555 321 Morton Plant North Bay Hospital 321 555 321 321 Internal Medicine 38 322 Kashlan, Ghiath MD 322 Licensed Clinical Social Worker 322 Cortes Ramirez, Luz LCSW 582 322 Jordan, Cassandra LCSW 582 322 Misiaszek-Boser, Joann LCSW 582 322 322

www.wellcare.com/Florida | 834

337 Optometry Anderson, Clinton OD 337 Argiropoulos-Dhima, Margaret OD 337 Beiler, Mark OD 338 Causey, Michael OD 338 Clough, Scott OD 338 Day, Paul OD 338 Demarco, Leo OD 338 Ferris, Anthony OD 338 Furman, Adam OD 338 Hernandez, Madeline OD 338 Herriott, Michael OD 339 Hetherington, Mark OD 339 Honeyblue, Shamika OD 339 Jones, Douglas OD 339 Kudryk, John OD 339 Lappano, Alfred OD 339 Lewenson, Robert OD 339 Linsey, Dennis OD 339

EXTENDED HOURS INDEX Pasco - cont. Optometry - cont. Meer, Henry OD Merlino, Brian OD Miller, Matthew OD Murphy, Kenneth OD Ocasio, John OD Parsons, Brent OD Parsons, Nicole OD Passaro, Jr, Vincent OD Payne, Tessa OD Ruckman, Carli OD Saint Jean, Caleb OD Scamard, David OD Shah, Shital OD Smith, Kevin OD Sterling, Peggy OD Tran-Lockwood, Julie OD

339 340 340 340 340 340 340 340 340 341 341 341 341 341 341 341

Pediatric Cardiology Hardin, Joel MD

342

Pediatrics Alvarez, Alfred MD 39 Arroyo, Fernando MD 39 Booth, Christine MD 39 Clark, Louann ARNP 693 Desai, Rupal MD 39 Flynn, Lynn ARNP 693 Gaud, Rosa MD 39 Gomez-Luengas, Alexander MD 40 Griffen, Michael DO 40 Grover, Alpana MD 40 Hughes, Natasha MD 40 Jara, Audrey MD 40 Lokesh, Haravu MD 40 Mitchell, Paul MD 41 Pham, Thuy MD 41 Pineiro, Alisha DO 41 Porcelli, Monica MD 41 Ramappa, Gogi MD 42 Sampang, Reginald MD 42 Savino, Tarah PA 693 Valencia, Diana MD 42 Vindhya, Naveena MD 42 Physical Therapy Guida, Meghan PT Westervelt, Lindley PT

693 693

Podiatry Donate, Guillermo DPM

345

Psychiatry Hart, Marlene MD Patel, Shodhan MD

582 583

Psychology Cameron, Rhonda PHD

583

Rehabilitation Facility Ewing and Thomas Inc 628 The Back To Wellness Center LLC 628 Welch and McLoy Therapy Services PA 628 Retail 1st Choice Pharmacy 763 Aum Pharmacy 763 Axcess Pharmacy 763 Benzer Pharmacy 763 Blake Pharmacy 763 CVS 763, 764 Doctors Choice Pharmacy 764 Drug Store Healthmart 764 Elfers Pharmacy Healthmart 764 Embassy Pharmacy 764 Empire Pharmacy 764 Florida Med Clinic Pharmacy of Wiregrass 764 Florida Medical Clinic 764 Florida Pharmacy 764 Hudson Pharmacy 764 Jacks Pharmacy 764 Js Pharmacy 764 Land O Lakes Pharmacy 765 Lily Care Pharmacy 765 Little Road Pharmacy 765 Magnolia Pharmacy 765 Maxcare Pharmacy 765 Medicine Shoppe Pharmacy 765 Medilink Pharmacy 765 Medsource Pharmacy 765 Nimoh Pharmacy Compounding LLC 765 Rays Pharmacy 765 Ricx Pharmacy 765 Rowan Discount Pharmacy 765

www.wellcare.com/Florida | 835

Royal Pharmacy RX Care Pharmacy RX Care Pharmacy Kwik Mart RX Discount Pharmacy SAMS CLUB Save N Care Pharmacy South Lake Pharmacy Starcare Pharmacy Summergate Pharmacy Suntrust Pharmacy The Medicine Shoppe Walmart Pharmacy Winn-Dixie Pharmacy Xtra Discount Drugs Z Orange Pharmacy

765 765 765 765 765 765 765 766 766 766 766 766 766 766 766

Skilled Nursing Facility Bear Creek Nursing Center 628 CHC of Bayonet Point 629 Consulate Health Care of New Port Richey 629 Heartland of Zephyrhills 629 Heather Hill Nursing Home-Pcs 629 Heritage Park Health and Rehabilitation 629 Life Care Center of New Port Richey 629 Orchard Ridge Rehab & Nursing 629 Solaris Healthcare Bayonet Point 629 Southern Pines Healthcare Center 629 Trinity Regional Rehab Center 629 Sleep Medicine Comprehensive Medical Care

347

Speech & Language Pathology Blankinship, Louellen SLP 693 Mueller, Pamela SLP 694 Speech Therapy Beer, Jamie SLP Breedlove, Megan SLP Cichra, Deborah SLP Danner, Erin SLP Fitzpatrick, Laura SLP Gillham, Nicole SLP Gillin, Kelly SLP

694 694 694 694 694 694 694

EXTENDED HOURS INDEX Pasco - cont. Speech Therapy - cont. Henke, Robyn SLP Ivanov, Maria SLP Kernaghan, Kelly SLP Knobloch, Jacquelyn SLP Moore, Amanda SLP Orlando, Dana SLP Pennell, Sara SLP Porreca, Tina SLP Pursino, Heather SLP Reales, Vicky SLP Tager, Madisen SLP Vizzi, Lindsay SLP Vought, Jill SLP Willis, Kathleen SLP Yankeloff, Kristina SLP

694 694 694 694 694 695 695 695 695 695 695 695 695 695 695

Substance Abuse North Tampa Behav Health

583

Childers, Eleanor LCSW Christova, Albena LMHC Clare, John LMHC Clark, Louisa LMHC Davenport, Glenda LCSW Erickson, Shannon LCSW Fine, Frank LMHC Fogleman, Ruthann LMHC Gibson, Angela LCSW Hall, Sandra LMHC Henning, Trish LCSW Holland, Cynthia LCSW Ingram, Jennifer LMHC Kerwin, Joan LMHC Knop, Karen LCSW Lambert, John LCSW Leanes, Mary LMHC Lenz, Kristen LMHC Lewis, Deborah LMHC Mack, Teresa LMHC Mayorca, June LMHC Moore, Victoria LCSW Morel, Mary LCSW Morris, Richard LMHC Oneil, Susan LMHC Pierce, Tyne LMHC Santiago, Karmivis LMHC Williamson, Blake LMHC Wingert, Frank LCSW

Urgent Care Center After Hours Pediatrics Practices Inc 629 Doctors Urgent Care 629 Doctors Walk-In Clinics 629 Florida Hospital Centra Care University 629 Gulf View Medical and Urgent Care Inc 630 Wee Care Clinic Inc 630 Behavioral Health Facility Your Family Walk In Clinic LLC 630 Boley Centers Inc Directions For Living Pinellas Mease Countryside Hospital Allergy & Immunology Morton Plant Hospital Gubernick, Samuel DO 349 Kornfeld, Stephen MD 350 Birthing Center Countryside Birthing Place Inc Ambulatory Surgery Center Cardiology Largo Surgery LLC DBA West Bay Surgery C 631 Kokolis, Rodamanthos MD Certified Nurse Midwife Behavioral Health Counseling Arredondo, Andra LCSW 584 Ambler, Kathleen CNM Bajor, Jane LMHC Barnes, Wanda LMHC Bishop, Harold LCSW Bulla, Angela LCSW Carini, Andrew LCSW

584 584 584 584 584

Child Neurology Nazario, Margaret PA Chiropractic Bryan, Vincent DC Burke, James DC

584 584 584 584 585 585 585 585 585 585 585 585 585 585 586 586 586 586 586 586 586 586 586 586 586 586 586 587 587

Byrne, Steven DC Collector, Murray DC Crandall, Charles DC Didonato, Louis DC Farkas, Frank DC Frattalone, Sam DC Golden, Robert DC Goodman, Jamie DC Gowing, Roy DC Grimmel, Stanley DC Hayes, Christopher DC Hollstrom II, Gregory DC Horton-Bender, Kimberly DC Jennings, John DC Krippendorf, Donald DC Leverone, Andrew DC Marcell, Mike DC McBride, Paul DC McCutcheon, Mark DC McGeehan, Cornelius DC Melilli, Steven DC Price-Mccarthy, Staci DC Raveling, Paul DC Rebori, Brian DC Schoeffel-Hayes, Diane DC Thorpe, Lorraine DC Venis, Monte DC

359 359 359 359 359 359 359 360 360 360 360 360 360 360 360 360 360 360 360 360 360 361 361 361 361 361 361

Community Mental Health Center Operation Par Inc 587 Personal Enrichment Through 587 Mental Healt 588 587 Suncoast Center Inc 588 587 Convenient Care Clinic 587 Minuteclinic LLC 631, 632 Take Care Health 632 631 Dermatology Garcia Cardona, Maria MD 362 354 Diagnostic Imaging Gateway Radiology Consultants 697 632 MRI Associates of St Pete 633 Open MRI of Pinellas Inc 633 697 Palm Harbor MRI 633 Susan Cheek Needler Breast Center 359 633 359

www.wellcare.com/Florida | 836

EXTENDED HOURS INDEX Pinellas - cont. Dialysis FMC Pinellas Park Gulf Breeze Dialysis Center RAI - 9th Street North - St Petersburg RAI-US 19 N-Clearwater/Palm Harbor

634 634 634 634

Durable Medical Equipment Austin Respiratory Equipment Inc 634 Endocrinology, Diabetes, Metabolism Budharaju, Venkata MD

363

Endodontics Gargasz, Bret DDS Gittess, Robert DDS Kan, Elena DDS Millstein, Ashley DMD

364 365 365 365

Family Practice Babbs, Garrett PA Barasch, Marc DO Burns, Craig DO Faulkner, Kim MD Folsom, Martha ARNP Gaik, Shane ARNP Hendren, Beatrice ARNP Hendren, Debra ARNP Jordan, Rosalind ARNP Lungren, Hillary DO Oyekoya, Adebola MD Rankin, Trevan MD Renelus, Deborah MD Renshaw, Linda ARNP Rollins, Ebony ARNP

698 43 43 44 699 700 700 700 701 45 46 46 46 703 704

General Dentistry Adderly, Erica DDS 368 Adewunmi, Mopelola DDS 369 Alonso, Zenaida DDS 369 Arnedo, Johanna DDS 369 Atkinson, William DDS 369 Attie, Abelardo DMD 369 Bacchelli, Lara DMD 369, 370 Baez Henry, Carlianette DMD 370 Baez, Tomas DDS 370

Barrett, Steven DDS Beach, Christopher DDS Beers, Eda DDS Bradley, Ashley DMD Branscombe, Tyler DMD Caputo, Michael DDS Carbonell, Kevin DMD Carter, Jade DDS Chase, Kely DMD Chekan, Theodore DDS Diaz, Jany DMD Dire, Anthony DMD Dockus, Matthew DMD Dolce, Vincent DMD Dougherty, Erin DMD Durve, Aparna DMD Engelman, Sharon DDS Fornos, Jorge DDS Fuller, Ellis DDS Gatons, Yelena DDS Genninger, Jasen DMD Goldstein, Alexander DDS Gonzalez, Yanela DMD Green, George DDS Gutu, Elena DMD Hall, Joshua DMD Halttunen, Arthur DDS Hanna, Mina DMD Helmy, George DDS Immadi, Lakshmi DDS Inaba, Caroline DDS Kanach, Paul DMD Kiani, Kamran DMD Kohn, Heather DDS Kopynets, Viktor DDS Krasnov, Rostislav DDS Kuntsmann, Vivian DDS Lense, Pedro DDS Lipton, Barry DDS Lopez, Grace DMD Luce, Amy DMD Manzur, Kasim DDS Marshall, Kristine DDS Martinez, Gustavo DMD Matthews, Irina DMD Mazariegos, Stephanie DMD Miller, Dwayne DDS Morell, Omar DMD

370 370 370 371 371 372 372 372 372 373 373 373 373 374 374 374 374 374 374 375 375 375 375 375 376 376 376 376 376 376 376 377 377 377 377 377 377 377 378 378 378 378 378 378 378 379 379 379

www.wellcare.com/Florida | 837

Nguyen, David DMD 379 Pansuriya, Dharmendra DMD 379 Patel, Guarangi DDS 379 Pham, Thi DDS 380 Prato-Guia, Yelena DDS 380 Qadri, Subuhi DMD 380 Quevedo, Fernando DDS 380 Quevedo, Rachel DDS 380 Reed, Samantha DDS 380 Ribot, Aliana DMD 380 Saraydar, Haychell DDS 380 Selz, Amrita DMD 381 Stoici, Ioana DMD 381 Thomas, Kelly DMD 381 Trivedi, Mehulkumar DMD 382 Uzunova-Dimova, Kalina DDS 382 Valdman, Vadim DDS 382 Wade, Brianne DMD 382, 383 Ward, Tasha DDS 383 Weiskopf, Mark DDS 383 Weisser, Ettie DDS 383 Williams, Tosha DDS 383 Wong, Elaine DDS 383 Woo, Kyung DDS 384 Worlinsky, Courtney DMD 384 Zand, Maximus DMD 384 Zariffard, Ehsan DMD 384 General Practice Santiago Perez, Jose MD

47

Hematology Knipe, Richard MD

387

Hematology & Oncology Diaz, Michael MD Ho, Vu Tran MD Mace, Joseph MD

389 389 390

Home Health Care Access Home Health Care Inc DBA Preferre 634 Best Care Providers Inc 635 Fusion Healthcare 635 Harmony Home Health LLC 635 Maxim Healthcare Services Inc 635 Right At Home Central Pinellas 635 Hospital Baycare Alliant Hospital

556

EXTENDED HOURS INDEX Pinellas - cont. Hospital - cont. Bayfront Medical Center 556 Florida Hospital North Pinellas 556 Johns Hopkins All Childrens Hospital Inc 556 Largo Medical Center 556 Largo Medical Center Indian Rocks 556 Mease Countryside Hospital 556 Mease Hospital Dunedin 556 Morton Plant Hospital 556 Northside Hospital 556 Palms of Pasadena Hospital 556 St Petersburg General Hospital 556 Infectious Disease Asare, Kinglsey DO Internal Medicine Kaszuba, Robert MD Kurtsikidze, Nino MD Morgan, Robert DO Munoz, Lorenzo MD

390 48 49 49 49

Licensed Clinical Social Worker Acheson, Kimberly LCSW 588 Jordan, Cassandra LCSW 588 Vagedes, Marie LCSW 588 Wheeler, Cynthia LCSW 588

Obstetrics/Gynecology Acosta Jr, Romeo MD Bainbridge, Megan CNM Calderon, Guillermo MD Dyer, Diana ARNP Fanarjian, Nicole MD Felski, Emil DO Frazier, Cathy ARNP Jackson, Darwin MD Javate, Emanuel MD Jones, Malcolm MD Keene, Jamie ARNP Kuebel, Joseph MD Mashandure, Mercy ARNP McGinty, Susanne ARNP McKinnie, Cynthia ARNP Ortiz, Edwin MD Prabhakaran, Sujatha MD Reames, Amanda ARNP Redlin, Jacqueline ARNP Rosa, Hector MD Salter, Jennifer DO Shamas, Christina MD Shreve, Tanya PA Staal, Jacqueline ARNP Valentin, Socorro ARNP Ward, Leslie ARNP Waterman II, Philip MD

Occupational Therapy Licensed Marriage and Family Burks, Nicole OT Therapist Grimm, Mariann LMFT 588 Riveros, Ashley OT Sims, Mary OT Maternal Fetal Medicine Velett, Kristen OT Raimer, Karen MD 394 Optician Medical Oncology Eye Doctors Optical Outlets PA Knipe, Richard MD 395 Optimart St Petersburg Peterson, John MD 395 Optometry Mobile Diagnostic Adler, Shepard OD Symphony Diagnostic Services No1 Aronson, Barry OD LLC DBA 635 Birnbaum, Suzanne OD Trident Mobile Clinical Services Branin, Leslie OD 635 Camargo, Tara OD Ultra Healthcare Services 635 Campbell, Christopher OD Case, Barry OD Obstetrics Biss, Kimberly MD 399 Chavez, Claudia OD Gallagher, James MD 399 Ciccarello, Jim OD

401 710 401 711 402 402 711 403 403 404 711 404 712 712 712 405 405 712 712 406 406 407 712 712 713 713 408 713 713 714 714 413 413 414 414 414 414 414 415 415 415 415

www.wellcare.com/Florida | 838

Clough, Scott OD 415 Cochran, John OD 415, 416 D'Alesio, Michael OD 416 Day, Paul OD 416 De LA Torre, Miguel OD 416, 417 Demarco, Leo OD 417 Ferris, Anthony OD 417 Flanagan, Deborah OD 417 Flanagan, Thomas OD 417 Furman, Adam OD 417 Furman, Megan OD 417 Graham, Ben OD 417 Hernandez, Madeline OD 418 Herriott, Michael OD 418 Hetherington, Mark OD 418, 419 Honeyblue, Shamika OD 419 Ingham, Richard OD 419 Jones, Douglas OD 419 Kuan, Sujey OD 420 Lappano, Alfred OD 420 Lewenson, Robert OD 420 Mason, John OD 420 McKnight, Jaclyn OD 420 Meer, Henry OD 420, 421 Merlino, Brian OD 421 Miller, Joseph OD 421 Patel, Deepa OD 422 Plante, Parker OD 422 Pradilla, Sergio OD 422 Rosenfeld, Jay OD 423 Ryczek, Dennis OD 423 Saint Jean, Caleb OD 423, 424 Schatz, Scott OD 424 Schoneck, Katie OD 424 Scott, Christopher OD 424 Stroud, Sandra OD 425 Tran, Baotram OD 425 Tran-Lockwood, Julie OD 425, 426 Vu, Anthony OD 426 Yee, Daniel OD 426 Orthodontics Nelson, Stephen DMD Parsa, Mitra DDS Pediatric Cardiology Hardin, Joel MD

427 427 429, 430

EXTENDED HOURS INDEX Pinellas - cont. Pediatric Endocrinology Begum Hasan, Jahanara MD

434

Pediatric Gastroenterology Gursky, Beverly ARNP

715

Pediatrics Acker Lense, Beverly MD 50 Arango, Jan MD 51 Arvelo-Velez, Beatriz MD 51 Aungst, Cary MD 51, 442 Banks, Elizabeth MD 51 Beetler, June DO 52 Berio Alvarez, Marta MD 52 Bharucha, Corrie MD 52 Black, Janet MD 53 Booth, Christine MD 53 Cano, Carlos MD 53 Cibran, Mariano MD 53 Colon, Yaritza MD 54 Conde, Nicole DO 54 Freed, Heather ARNP 716 Geddes, Carol MD 55 Herrero, Vivian MD 56 Hicks, Mary MD 56 Hidalgo, Carlos MD 56 Hughes, Natasha MD 56 Jackson-Curtis, Danuta MD 56 Johnson-Milas, Audrey DO 57 Jordan, Michael MD 57 Kelleher, Erin MD 443 Kelley, Sarah MD 57 Kilbride, Pamela MD 57 Kim, Jennifer MD 57, 58 Kitterman, Christopher DO 58, 443 Klein, Jay MD 58 Kober, Terry PA 716 Leal, Jennifer ARNP 716 Lopez Dominguez, Maria MD 59 Lopez-Mccormack, Celia MD 59 Luna, Juan MD 60 Mallett, Lesley ARNP 716 McHugh, Sara ARNP 716 Migliore, Heidi ARNP 716, 717 Moore, Steven MD 60 Nelson, Stephen MD 60 Pai, Rajendra MD 60

Pantages, Efstratios MD 60 Petitfils, Lisa MD 61 Reilly Hays, Elizabeth MD 61 Salib, Magda MD 61 Sawka, Jennifer MD 61 Schey, Nicholas MD 61, 62 Shine, Leetoria ARNP 717 Smith, Jessica MD 62, 443 Sterling, Fran DO 62 Szafranski, Christy MD 62, 63 Threadgill, Nichelle MD 63 Tran, Thein MD 64 Weinberger, Alyssa MD 64 Wesnofske, Cassandra ARNP 718 Zhao, Wenying MD 64, 65 Pedodontics Blankenship, Susan DMD Edwards, Jenny DMD Makram, Christina DDS Pinero Correa, Rosario DDS Sirage, Mohamed DMD

444 444 444 444 445

Physical Medicine & Rehabilitation Lockett, Ricky DO 445 Physical Therapy Kokemohr, Deann PT Lester, Lawrence PT

718 718

Podiatry Delellis, Salvatore DPM

446

Psych Hospital Windmoor Healthcare Inc

589

Psychiatry Chamberlain, Andrea MD Dougherty, Phyllis ARNP Jones, Karl MD Martin, Andres MD

590 590 590 590

Psychology Cohen, Benjamin PHD Futch, Emily PHD Gimon, Alexander PHD Hemsath, Randolph PsyD Lunden, Judy PsyD Smith, Jeffrey PHD

592 592 592 592 592 592

Pulmonary Disease Chandarana, Himanshu MD

448

www.wellcare.com/Florida | 839

Radiation Oncology Franzese, Frank MD Miller, Robert MD Radiation Therapy Solc, Zucel MD

449 449, 450 450

Retail 4th Street Pharmacy 767 Alexander Pharmacy 767 All Childrens Outpatient Pharmacy 767 Anclote Pharmacy 767 Asap Pharmacy 767 Bay Life Pharmacy 767 Bay Life Pharmacy II 767 Bay Life Pharmacy III 767 Baycare Pharmacy 767 Baydoun Pharmacy 767 Bayview Pharmacy 768 Benzer Pharmacy 768 Care Plus Pharmacy 768 Community Specialty Pharmacy 768 Curlew Pharmacy 768 CVS 768, 769, 770 Danang Pharmacy 770 Edwards Pharmacy 770 Empath Health Pharmacy 771 G and H Pharmacy 771 Good Samaritan Pharmacy 771 Healthmed Pharmacy 771 Hp Pharmacy 771 Jk Care Pharmacy 771 King Pharmacy Compounding LLC 771 Lincourt Assisted Living, Inc 771 Lincourt Pharmacy 771 Main Street Pharmacy 771 McAre Pharmacy 772 Medrock Pharmacy 772 Michaels Pharmacy 772 Pegasus RX Pharmacy 772 Pharmaco Med Shop 772 Pharmacy Innovations 772 Pharmalabs 772 Pharmerica 772 Prime RX Pharmacy 772

EXTENDED HOURS INDEX Pinellas - cont. Retail - cont. Promise Pharmacy 772 Quick Pharmacy 772 SAMS CLUB 772 Scotts RX 772 Scripts Pharmacy 772 Shields Pharmacy 772 Southcare Pharmacy Inc 773 St Luke Pharmacy 773 St Marks Pharmacy 773 St Mary Pharmacy 773 St Mary Pharmacy II 773 St Petersburg Pharmacy 773 Sun Pharmacy 773 Sunlife Pharmacy 773 Tampa Road Pharmacy 773 Tarpon Discount Drugs 773 The Medicine Shoppe 773 The Prescription Shop 773 Tri Med Medical Pharmacy 773 Trinity Pharmacy 773 Vcare Pharmacy 773 Walmart Pharmacy 773, 774 Wecare Pharmacy 774 Winn-Dixie Pharmacy 774, 775 Wize Pharmacy 775 Skilled Nursing Facility Advanced Care Center 636 Alhambra Health & Rehab Center 636 Alpine Health Rehabilitation Center 636 Apollo Health and Rehabilitation Center 636 Bay Pointe Nursing Pavilion 636 Bay Tree Care and Rehabilitation Center 636 Bayside Rehab & Nursing 636 Baywood Nursing Center 636 Boca Ciega Center 636 Bon Secours Maria Manor Nursing Care Cen 637 Carrington Place of St Pete 637 Clear Water Care and Rehabilitation Cent 637

Consulate Health Care of Safety Harbor 637 Consulate Health Care of St Petersburg 637 Countryside Healthcare Center 637 Cross Terrace Rehabilitation Center 637 Egret Cove 637 Glen Oaks Health and Rehabilitation Cent 637 Golfview Healthcare Center 637 Gracewood Rehabilitation 637 Gulfport Rehabilitation Center 637 Harbourwood Health & Rehab Center 637 Highland Pines Rehab Center 637 Lakeside Oaks Care Center 637 Largo Rehab and Spa 637 Laurellwood Nursing Center 637 Lexington Health & Rehab Ctrs 637 Manor Care of Palm Harbor #386 637 Morton Plant Rehab Center 637 North Rehabilitation Center 637 Oak Manor Healthcare & Rehab Center 637 Palm Garden of Clearwater 637 Palm Garden of Largo 638 Palm Garden of Pinellas- NHC 638 Peninsula Care & Rehab Center 638 Pinellas Park Care & Rehab 638 Rehabilitation Center of St Petersburg 638 Sabal Palms Health Care Center 638 Shore Acres Care Center 638 St Petersburg Nursing and Rehab 638 St Petersburg Nursing and Rehabilitation 638 Stratford Court of Palm Harbor 638 Sylvan Health Center 638 Tarpon Bayou Center 638 The Abbey Rehabilitation and Nursing 638 The Health and Rehabilitation Centre At 638

www.wellcare.com/Florida | 840

West Bay Rehab & Nursing Center 638 Westchester Gardens Rehabilitation Care 638 Westminster Suncoast 638 Wrights Healthcare & Rehab Center 638 Speech & Language Pathology Clifton, Andrea SLP Craven, Emily SLP Douglas, Marissa SLP Kurtz, Molly SLP Reed, Danielle SLP Zeitler, Christine SLP

719 719 719 719 719 719

Speech Therapy Coleman, Laci SLP Cummings, Kristin SLP Diaz, Elanda SLP Henke, Robyn SLP Le, Sharon SLP Miller, Rachel SLP Porreca, Tina SLP Rutland, Kristen SLP Stokes, Sarianna SLP Trimble, Chelsy SLP Vargas, Tania SLP Vizzi, Lindsay SLP

719 719 719 719 719 720 720 720 720 720 720 720

Substance Abuse Operation Par Inc

592, 593

Urgent Care Center Afc Urgent Care 638 After Hours Pediatrics Practices Inc 638 Doctors Urgent Care 638 Doctors Walk-In Clinics 639 Evening Pediatrics Inc 639 Healthnow Urgent Care LLC 639 Signature Urgent Care 639 Vascular Surgery Nwobi, Obinna MD

453

Polk Behavioral Health Counseling Chila, J Patricia LMHC 594 Cohen-Posey, Kate LMHC 594

EXTENDED HOURS INDEX Polk - cont.

Sirak, Laura ARNP 724 Lazar, Adam DDS 470 Soni, Ambica MD 67 Le, Nhu DDS 470 Behavioral Health Counseling Victorine, Suzanne ARNP 724 Le, Nhu DMD 470 cont. 724 Lombana-Cano, Edward DDS 470 Dowding, Daryl LMHC 594 Wright, Melissa ARNP Mantel, David DDS 470, 471 Ghent, Cathy LMHC 594 General Dentistry Marin Jimenez, Laura DDS 471 Kent, David LCSW 594 Amaro, David DDS 460 Nasseri, Sanaz DMD 471, 472 Olivares, Alicia LMHC 594 Avila, Daira DMD 461 Nguyen, Duy DDS 472 Azadi, Anthony DDS 461 Behavioral Health Facility Nguyen, Dzung DDS 472 Barrett, Steven DDS 461 Resilience Counseling Center Inc Nguyen, Hoang DMD 472 462 594 Beitscher, Stan DDS Nunez, Erick DDS 472 Calderon, Nadia DDS 462 Ortiz-Pimentel, Edgar DMD 472 Cardiology Caputo, Michael DDS 462 Patel, Janisha DDS 472, 473 Tai, Zaheed DO 455 Chan, Stacey DMD 463 Patel, Kinjalben DMD 473 Chasko Jr., Joseph DDS 463 Chiropractic Patel, Ripal DDS 473 463 Lucido, David DC 456 Chou, Victor DMD Patel, Yesha DMD 473 463 Parker, Dane DC 456 Colon, Agdha DDS Penland, Edina DMD 473 464 Puentes, David DC 456 Correal, Juliana DMD Pham, Quyen DMD 473 464 Raemisch, Christopher DC 456 Coughlin, Lauren DMD Priemer, Ryan DMD 473 464 Reckord, Mabbett DC 456 Daccache, Danny DDS Reyes, Monika DMD 474 Dacunha, Andrew DMD 464 Rivera, Abneris DDS 474 Community Mental Health Center Davidson, Timothy DMD 465 Rizziello, Derrick DDS 474 Peace River Center For Personal DO, Tutrinh DMD 465 RomeroQuevedo, Margarita DDS Developm 595 Doherty, Nicole DDS 465 474 Earnhardt, Charles DDS 465 Convenient Care Clinic Rosario, Jesse DMD 474, 475 465 Minuteclinic LLC 640 Edwards, Jesse DMD Seoane, Andres DMD 476 Fawcett, Ian DDS 466 Serrano, Yahaira DDS 476 Dialysis Feng, Connie DMD 466 Sider, Brian DDS 476 Lake Wales Dialysis 640 Ferreira, Stephanie DDS 466 Smillie, Joseph DMD 476 RAI Sr 60 East Lake Wales 640 Fidy, Ramez DDS 466 Suri, Niki DDS 476 Freeman, Michael DDS 466, 467 Durable Medical Equipment Tran, Faye DDS 476 467 Medi Health Care Inc 641 Gabel, James DDS Tran, Ivy DMD 476, 477 Gallagher, Megan DMD 467 Van, Tim DMD 477 Endodontics Gannon, Robert DDS 467 Varela, Monica DDS 477 Baker, James DDS 458 Garcia, Maritza DDS 467 Vasquez, Kristine DMD 477 Cherian, Shiju DDS 458 Gollob, Harrison DDS 467 Voaonsri, Nopparat DMD 477 Millstein, Ashley DMD 458, 459 Golomb, Alyson DMD 468 Vu, Clara DMD 477 Mir, Hamza DDS 459 Gonzalez, Lisset DDS 468 Walker, Aaron DDS 478 Schwartz II, William DDS 459 Goodwin, Aaron DMD 468 Ward, Michael DDS 478 Sreekantaiah, Kiran DDS 459, 460 Greenberg, Andrew DDS 468 Yu, Lina DMD 478 Guarnieri, Sam DDS 469 Family Practice 469 General Practice Amin, Sapnalaxmi MD 66 Holzman, William DDS Howard, Belisa DMD 469 Aime Celian, Beatrice MD 478 Knight, Amelia ARNP 723 469 Cruz Diaz, Ana MD 67 Louisville, Tommy MD 66, 460 Hua, Yang DDS Kamat, Amit DDS 469 Fersobe, Saadia MD 68 Metts, Huey ARNP 723 469 Garcia, Nestor MD 68 Nelson- James, Cara DO 67 Kasem, Shovon DDS Katsur, Justin DDS 470 Ham Ying, John MD 68 Nelson-James, Cara DO 67 470 Lafontant, Anne MD 68 Shoba, Sama MD 67 Koren, Daniel DMD

www.wellcare.com/Florida | 841

EXTENDED HOURS INDEX Polk - cont. General Practice - cont. Maduagwu, Okoroafor MD Nelson James, Cara DO Pierre, Jean MD Rodriguez Marin, Yomayra MD Vasquez, Kimber MD Virella Guzman, Vivian MD General Surgery Gaugler, Andrew DO

68 68 69 69 69 69 479

Home Health Care Care and Life Home Health Services 641 Maxim Healthcare Services Inc 641 Hospice Good Shepherd Hospice Inc 641, 642 Vitas Healthcare Corporation of Florida 642 Hospital Bartow Regional Medical Center 557 Lake Wales Medical Center 557 Lakeland Reg Medical Center 557 Poinciana Medical Center 557 Winter Haven Hospital 557 Internal Medicine Acuna, Jose MD Bhatia, Gitashree MD Fernandez, Rodolfo MD Issar, Rekha MD Latt, Khin MD Min, Zaw MD Singh, Japinder MD

Obstetrics/Gynecology Bainbridge, Megan CNM 727 Best, Erin MD 488 Clarke, Cheryl MD 489 Duke II, Billy MD 489 Dyer, Diana ARNP 728 Fanarjian, Nicole MD 489 Felski, Emil DO 489 Frazier, Cathy ARNP 728 Haddox, Linda MD 489 Jones, Kurt MD 490 Jones, Malcolm MD 490 Lopez-Rosa, Magda ARNP 728 Mashandure, Mercy ARNP 728 McGinty, Susanne ARNP 728 McKinnie, Cynthia ARNP 729 Ortiz, Edwin MD 491 Prabhakaran, Sujatha MD 491 Qadri, Syed MD 491, 492 Reames, Amanda ARNP 729 Redlin, Jacqueline ARNP 729 Rodriguez-Benitez, Jose MD 492 Rosa, Hector MD 492 Shreve, Tanya PA 729 Smith, Susan MD 493 Staal, Jacqueline ARNP 730 Sterlacci, Susan MD 493 Turnquest, Merse MD 493 Valentin, Socorro ARNP 730 Ward, Leslie ARNP 730 Waterman II, Philip MD 494

69 69 69 Optician 70 Eye Doctors Optical Outlets PA 71 498 71 72 Optometry Bassion, Kellie OD 498 Licensed Clinical Social Worker Betton, Kimberly OD 498 Chinlund, Heidi LCSW 595 Blade, Pamela OD 498 Braudway, Sonya OD 498 Licensed Mental Health Counselor 499 Lopez, Marianne LMHC 726 Buffano, Roxanne OD Cabatana, Tisha OD 499 Nurse Midwife Dixon, Dustin OD 499, 500 Hatcher, Tammy ARNP 726 Hamilton, Christopher OD 500 Lorenz, Kelly CNM 726 Ismail, Esaam OD 500 Russell, Laura ARNP 727 Lewenson, Robert OD 500 Lopez, Viviana OD 501

www.wellcare.com/Florida | 842

Miller, Barbara OD Naqvi, Zarrin OD Neal, Terry OD Ngar, Lucie OD Olson, Arlese OD Parrish, Gregory OD Patel, Binal OD Phillips, James OD Phillips, Stephen OD Puzzo, Melissa OD Renaud, Lauren OD Roberts, David OD Roberts, Elizabeth OD Ruckman, Carli OD Sadek, Ginger OD Salomon, Brad OD Salomon, Katie OD Salomon, Teresa OD Thai, Pauline OD

501 501 501, 502 502 502 502, 503 503 503 503, 504 504 504 504, 505 505 505 505 505, 506 506 506, 507 507

Pediatric Cardiology Arrillaga, Frances MD Gonzalez, Javier MD John, Jonathan MD Martinez, Richard MD McKenna, Daniel MD

508 509 510 510 511

Pediatric Gastroenterology Tenn, Alicia ARNP

731

Pediatrics Anchundia, Maria MD 72, 73 Brar, Sardul MD 73 Brown, Rachel ARNP 731 Cannon, Cara MD 73 Cano Montoya, Angelica MD 73, 514 Chachad, Sairah MD 73 Cory, Matthew MD 73 Cosic, Sanja MD 74 D'Aunoy, Mary MD 74 Depadua, Maria MD 74, 75 Gonzalez, Francelis MD 75 Harrison, Krystin MD 75 Hernandez Montalvo, Myriam MD 514 Leviten, Daniel MD 76 Mueller-Barker, Denise ARNP 732 Polk, Sara MD 77

EXTENDED HOURS INDEX Polk - cont. Pediatrics - cont. Pruthi, Jagdeep MD 77 Ramos-Collazo, Yesenia MD 77 Ray, Dorothy MD 77 Ray, Rachel MD 77 Rolette, Ayanna MD 77 Rupert, Brooke ARNP 732 Snow, Rodney ARNP 732 Thomas, Janelle ARNP 732 Tucker, Michele DO 77 Vazquez Maldonado, Lilliam MD 78 Wagoner, Mary ARNP 732 Wallace, Cynthia ARNP 733 Whitworth, Heather MD 78 Pedodontics Harrell, Laurie DDS Perez, Marina DDS Van, Vincent DDS Yeung, Vincent DDS

515 515 515 515

Periodontics Cherry, Elizabeth DDS Perelmuter, Steven DMD Sabzehei, Bahareh DDS

515 515 516

Physical Therapy Hanson, Tina PT Kane, Susan PT Singleton, Ulysses PT Vogel, Kenneth PT Westervelt, Lindley PT

733 733 733 733 733

Preventive Medicine Senatorov, Vladimir MD

516, 517

Prosthodontics Galindo-Ramirez, Ricardo DDS

517

Psychiatry Patel, Shodhan MD Restrepo, Alvaro MD

596 597

Psychology Robinson-Kyles, Jeanene PHD

597

Psychosomatic Medicine Sadowsky, MD, William MD 597, 598

Radiation Therapy Miller, Cheryl SLP

733

Rehabilitation Facility Beth Ingram and Associates Inc 642 Central Florida Speech Hearing Center I 642 Physical Therapy Specialists of Pine Cas 642 Retail American Care of Tampa Inc Lakeland 776 American Care of Tampa Winter Haven 776 American Care Tampa Haines City 776 Bartow Pharmacy Med Supply 776 Benzer Pharmacy 776 Careplus Pharmacy 776 Central Pharmacy 776 Cleveland Heights Pharmacy 776 CVS 776, 777 Dundee Community Pharmacy 777 Fast and Friendly Pharmacy 777 First Choice Pharmacy 777 First Choice Pharmacy, Zocalo Plaza 777 First Choice Specialty Pharmacy 777 Good Health Pharmacy 778 K M Drugs 778 Kay Pharmacy 003 778 Lake Wales Pharmacy 778 Lakeland Family Pharmacy 778 Medina-Meds Pharmacy 778 Medoz Pharmacy of Polk Inc 778 Mulberry Long Term Care Pharmacy 778 Mulberry Pharmacy Inc 778 Noble Care Pharmacy 778 One-Stop Pharmacy 101 778 Peoples Pharmacy 778 Pharmacy One Pro Specialty Care Ph 778 Providence Pharmacy 778 Quickn Save Pharmacy 778 Ritemed Pharmacy 778

www.wellcare.com/Florida | 843

RX Care Pharmacy 778 SAMS CLUB 778, 779 Sunrise Pharmacy 779 Sunshine Pharmacy 779 Supreme RX 779 The Apothecary Shop 779 Villa Medical Health Solutions 779 Villa Pharmacy 779 Walmart Pharmacy 779 Watsons Pharmacy 779 Webbs Square Pharmacy 779 Winn-Dixie Pharmacy 780 Winter Haven Pharmacy 780 Skilled Nursing Facility Astoria Health and Rehabilitaiton Center 642 Auburndale Oaks Care and Rehabilitation 642 Bartow Center 642 Brandywyne Health Care Center 642 Consulate Health Care At Lake Parker 642 Consulate Health Care of Lakeland 642 Consulate Health Care of Winter Haven 643 Florida Presbyterian Homes Inc 643 Grace Healthcare of Lake Wales 643 Haines City Health Care Center 643 Lake Wales Medical Centers Inc 643 Lakeland Hills Center 643 Lakeland Nursing And Rehabilitation 643 Life Care Center of Winter Haven 643 Oakbridge Healthcare Center 643 Palm Terrace of Lakeland 643 The Crossroads 643 The Groves Center 643 Wedgewood Healthcare Center 643 Speech & Language Pathology Lopez, Sharon SLP 733

EXTENDED HOURS INDEX Polk - cont. Speech & Language Pathology cont. Marrero, Zayra SLP 733 Speech Therapy Comkowyez, Sharon SLP Kirkland, Mary SLP Rhines Ogara, Shelly SLP

734 734 734

Substance Abuse Peace River Center For Personal Developm 598 Urgent Care Center Doctor Today Urgent Care LLC 643 First Care Winter Haven LLC 643 First Help Urgent Care Clinic 643, 644 Nite Owl Pediatrics Urgent Care MD 644 Premier Walkin Clinic 644 Vascular Surgery De Jesus Gomez, Gustavo MD 520 Sarasota Allergy & Immunology Ly, Jean Marie MD

521

Ambulatory Surgery Center Aesculapian Surgery Center, LLC 645 Behavioral Health Counseling Alvarez, Carmen LMHC Audeh, Alisha LMHC Burkard, Megan LMHC Dunn, Dolores LMHC Emens, Christine LMHC Kaufman, Deborah LCSW Levine, Robert LCSW Marshall, Michelle LMHC Musselwhite-Weaver, Patricia LMHC Nikla, Richard LMHC Olivere, Mark LMHC Osgood, Bonnie LMHC Reidsema, Lisa LMHC Snyder, Todd LMHC St Aubin, Mary LMHC

600 600 600 600 600 600 600 600 600 600 600 600 600 601 601

Steiner, Judith LMHC 601 Branscombe, Tyler DMD 523 Thatcher-Janowski, Amy LCSW 601 Brito, Daryl DMD 523 Bushati, Ivo DMD 523 Certified Nurse Midwife Caputo, Michael DDS 523 Cantwell, Carol CNM 736 Carbonell, Kevin DMD 524 Child Neurology Dockus, Matthew DMD 524 Portman, Steven MD 521 Eckels, Shane DDS 524 Genninger, Jasen DMD 524 Chiropractic Greenberg, Andrew DDS 524 Grappin, Carl DC 521 Hall, Joshua DMD 524 Grappin, Linda DC 522 Kanach, Paul DMD 524 Hawthorne, Robert DC 522 Katsur, Justin DDS 524 Price, Jeffre DC 522 Martinez, Magela DMD 525 Rhodes, Dennis DC 522 Mazariegos, Stephanie DMD 525 Rice, Wayne DC 522 Nalley, Brittany DMD 525 Diagnostic Imaging Ngo, Denise DDS 525 Choice Diagnostic Imaging 645 Patel, Kinjalben DMD 525 Partners Imaging Center of Naples Phan, Christine DMD 525 645 Rivera, Jade DMD 525 Partners Imaging of Venice 645 Rizner, Amanda DMD 525 Partners Imaging of Venice LLC 645 Skordas, Fotios DDS 526 Teresi, Kirsten DMD 526 Dialysis Trivedi, Mehulkumar DMD 526 RAI Care Centers of Sarasota LLC Wade, Brianne DMD 526 645 RTC Venice 646 Geriatric Medicine Reeder, Robert MD 526 Durable Medical Equipment Hoveround Corporation 646 Home Health Care All Stat Home Health Inc 646 Endodontics Fusion Healthcare 646 Gargasz, Bret DDS 522 One Key Home Care Florida LLC Family Practice DBA Firstlight 646 Bayindiryan, Teodora MD 79 Hospice Brand, Andrea MD 79 Tidewell Hospice Inc 646 Collingwood, Susan ARNP 736 Collins, Emily ARNP 736 Hospital Ferris, Karen ARNP 736 Doctors Hospital Sarasota 558 Fleener, Carola MD 79 Englewood Community Hospital Gero, Michele MD 79 (MP) 558 Reeder, Robert MD 79 Healthsouth Hospitals 558 Siegal, Jeffrey MD 522 Sarasota Memorial Hospital 558 Venice Regional Medical Center General Dentistry 558 Adderly, Erica DDS 523 Bacchelli, Lara DMD 523 Internal Medicine Barrett, Steven DDS 523 Arnold, Chelsea ARNP 737 Boswell, Gibson DMD 523 Burke, Christina PA 737 Bradley, Ashley DMD 523 Dankanich, Ivan ARNP 737

www.wellcare.com/Florida | 844

EXTENDED HOURS INDEX Sarasota - cont. Internal Medicine - cont. Fergeson, Jennifer DO Heymann, William MD Maliot, Jerry MD Nguyen, Thieu MD Soscia, John MD Zoher, Mina MD

530 80 80 80 81 81

Rosa, Hector MD Santos, Ramon MD Shreve, Tanya PA Singer, Joseph MD Slackman, Robert MD Staal, Jacqueline ARNP Stephens, Shawn MD Trupiano, Christine MD Ward, Leslie ARNP Waterman II, Philip MD

534 534 739 534 534 739 534 534 739 535

Licensed Mental Health Counselor Gussin, Lisa LMHC 737 Miller, Linda LMHC 738 Occupational Therapy 739 Sterling, Jocelyn LMHC 738 Kiellach, Jennifer OT 740 Walker, Larry LMHC 738 Milton, Melissa OT Optician Mammography Choice Diagnostic Imaging 646 Eye Doctors Optical Outlets PA 537 MRI Open Sarasota Outpatient MRI 646 Optometry Beck, Susan OD 537 Nurse Midwife Billings, Rick OD 537 Hollifield, Cheryl ARNP 738 Carr, William OD 537 Luu, Diane OD 538 Nurse Practitioner 538 Sanchez, Lajuan ARNP 738 Morchesky, Darren OD Schatz, Scott OD 538 Obstetrics/Gynecology Shin, Susan OD 538 Addae, Yusif MD 532 Soto, Frederick OD 538 Baill, I Cori MD 532 Stupp, Elliott OD 539 Bainbridge, Megan CNM 738 Doyle-Vallery, Deanna MD 532 Pediatric Psychiatry 602 Dyer, Diana ARNP 738 Halder, Ranjay MD Lopez, Rafael MD 602 Easterling, Gary MD 532 Fanarjian, Nicole MD 532 Pediatrics Felski, Emil DO 532 Bernard, Lisa ARNP 740 Frazier, Cathy ARNP 738 Bryant, Valerie ARNP 740 Garner, Kyle MD 533 Everett, Kari MD 543 Hall, Kathryn ARNP 738 Fleener, Barbara MD 81 Jamison, Richard MD 533 Fleener, Carola MD 81 Jones, Malcolm MD 533 Gonzales, Eusebio MD 543 Lopez-Rosa, Magda ARNP 738 Gonzalez-Abello, Lisa MD 81 Mashandure, Mercy ARNP 739 Gulati, Rachna MD 82 McGinty, Susanne ARNP 739 Horvat, Nevenka MD 82 McKinnie, Cynthia ARNP 739 Le, Yen MD 543 Micklavzina, Connie MD 533 Lyons, David MD 82, 543 Ortiz, Edwin MD 534 Perez, Richard MD 82 Prabhakaran, Sujatha MD 534 Rizkallah, Munir MD 82 Reames, Amanda ARNP 739 Shiffner, Beth PA 740, 741 Redlin, Jacqueline ARNP 739

www.wellcare.com/Florida | 845

Pedodontics Lee, Sara DMD

543

Periodontics Bardsley, Norman DDS

544

Physical Therapy Cecil, Adam PT Lissone, Said PT Randall, Kelly PT SMH Sports Medicine Center Watson, Maxine PT

741 741 741 647 741

Podiatry Bernstein, Myron DPM

544

Psychiatry Lopez, Rafael MD Thomas, Matthew MD

603 604

Psychology Baird, Nancy PsyD Baker, William PsyD Boxley, Robert PHD Hendon, Marvin PHD Trancik, Anika PHD

604 604 604 604 604

Retail Americas Pharmacy 781 CVS 781, 782 Davidson Drug 782 Davidson Drugs Inc 782 Englewood Pharmacy 782 Family Pharmacy 782 Gulf Gate Pharmacy 782 Healthcite Pharmacy 782 Hedges Healthmart Pharmacy 782 Lemon Bay Drugs East 782 Lemon Bay Drugs North 782 Medical Arts Pharmacy 782 Medplus Pharmacy 782 Meds Made Easy 782 North Port Pharmacy 782 Olson Liggett Drug 782 Pharmerica 782 SAMS CLUB 783 Sarasota Apothecary 783 Sarasota County Health Dept 783 Sarasota Discount Pharmacy 783

EXTENDED HOURS INDEX Sarasota - cont. Retail - cont. Sarasota Pharmacy Sv Co Bee Ridge Pharmacy 783 St Simon Pharmacy 783 Sun Discount Pharmacy 783 Sun Pharmacy of Venice 783 Town Pharmacy 783 Venice Apothecary 783 Village Pharmacy 783 Walmart Pharmacy 783, 784 We Care Pharmacy 784 We-Care Pharmacy 784 Winn-Dixie Pharmacy 784

Speech & Language Pathology Clifton, Andrea SLP 741 Hart, Katherine SLP 742 Smith, Mary SLP 742 Speech Therapy Carter, Anna SLP

742

Substance Abuse First Step of Sarasota Inc

605

Urology Bilik Jr, Alfred MD Gapin, Tracy MD Tingle, William MD Williams, Thomas MD

547 548 549 549

Skilled Nursing Facility Bay Village of Sarasota 647 Beneva Lakes Healthcare and Rehabilitati 647 Consulate Health Care of Sarasota 647 Harbor Chase of Venice 647 Hawthorne Health and Rehab of Sarasota 647 Heartland Health Care Sarasota 647 Heritage Health Care Center 647 Kensington Manor 647 Magnolia Health and Rehabilitation Center 647 Manor Care Health Services Venice 647 Manorcare Health Services Sarasota Bu 53 647 Palmer Ranch Rehab& Healthcare 647 Pinebrook Center 647 Quality Health of North Port 647 Sarasota Health Rehab 648 Sarasota Memorial Nursing and Rehab Center 648 Sunnyside Properties of Sarasota Inc 648 Sunset Lake Health& Rehab 648 Tarpon Point Nursing and Rehabilitation 648 The Springs At Lake Pointe Woods 648

www.wellcare.com/Florida | 846

PROVIDER INDEX Numerics 1st Care Medical 1st Choice Pharmacy 4th Street Pharmacy 5 Star Pharmacy 54th Ave Pharmacy

Adderly, Erica DDS 621 125, 126, 278, 368, 523 763, 767 Adewunmi, Mopelola DDS 767 368, 369 746 Adibi, Farnaz DMD 126, 278 767 Adkinson, Jason ARNP 675, 731 Adla Reddy, Mahathi MD 331 A 215, 414 A Life At Home 624 Adler, Shepard OD Adnan, Khan MD 18 A Plus Family Urgent Care, LLC 621 Ab Specialty Pharmacy Inc 763 Adoption Related SVS - Pinellas, 587 Abady, Robert DPM 446 Inc 746 Abanishe, Dahomey PHD 577 Advance Pharmacy Service Advance Pharmacy-2 760 Abaunza-Fiallos, Yanina MD 18 636 Abbott Jr, Norman MD 351 Advanced Care Center Advanced Diagnostic Group 612 Abdel-Aziz, Mohamed MD 193 Abdelmalek, Hend MD 35 Advanced Medical Pharmacy Inc 746 Abdelrahman, Layal MD 392, 396 Abel, Naomi MD 259 Advanced Orthopedics and 628 Abid, Syed MD 327, 388 Prosthetics Inc Abiose, Olufunke MD 334 Advanced Technological Radiology 640 Aboul-Hosn, Nawal LMHC 561 Abraham, Andria ARNP 665, 691 Aesculapian Surgery Center, LLC 645 Abramovitz, Sarah SLP 693 638 Abreu, Edward DMD 125 Afc Urgent Care Affordable Medical LLC 615 Accentia Health and Rehab Center of Tamp 620 After Hours Pediatrics Practices Inc 621, 629, 638 Access Home Health Care Inc DBA 47, 48 Preferre 634 Afzal, Ahsan MD Agazzi, Heather PHD 589 Accurate Health Services Corp 616 186 Acharya, Muralidhar MD 331 Agazzi, Siviero MD Agency For Community Treatment Acharya, Naveen MD 276 562, 584, 594 Acheson, Kimberly LCSW 566, 588 Services Agocha, Augustine MD 101 Acker Lense, Beverly MD 50 447 Ackerman, Ivan MD 263 Agrawal, Rajesh MD Agrawal, Saurabh MD 122, 171 Ackley, Karen MD 12, 18 484 Aclaris Home Health LLC 616 Aguayo, Jose MD Aguilu, Karla PsyD 577 Acme Pharmacy 746 589 Acosta Jr, Romeo MD 401 Agustines, Rachel MD AHF Pharmacy Safety Harbor 767 Acosta, Cary LCSW 581 582, 596 Acquaro, Ronald DMD 278 Ahmad, Kazi MD Ahmed, Safi MD 454 Activstyle Inc 615 93 Acuna, Jose MD 69 Ahmed, Syed MD Ahn, Byung-Joon MD 210, 294, 535 Adami, Angela LCSW 582 365 Adams SLP 733 Ahn, John DO Ahson, Imran DMD 233 Adams, Sherry ARNP 589 Addae, Yusif MD 532 Aime Celian, Beatrice MD 86, 91, 478 Aime, John MD 18

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Airlife Medical LLC 641 Ajayi, Akinyemi MD 249, 513 Akel, Amir DMD 126 Akel, Rami MD 309 Akella, Jagan MD 276 Akers, Laura ARNP 696 Akintan, Bade MD 519 Aksu, Ahmet MD 193, 194, 487 Al-Andary, Hazem MD 48 Alarcon, Rene MD 12 Albanna, Issam MD 18 Albares, Jamie ARNP 722 Albergo, Robert MD 361 Albright, Cheryl OT 739 Albrink, Michael MD 160 Alemar, Jose MD 388 Alere Womens and Childrens Health 634 Alesnik, Joseph MD 307 Alexander Pharmacy 767 Alexander, Jack MD 31 Alexander, Sandra ARNP 688 Alfano, David DDS 253 Alfaro, Carmen MD 19 Alfonso, Dennis MD 160 Alhambra Health & Rehab Center 636 Al-Hassani, Yaser MD 166 Ali Dinar, Tarig MD 513 Ali, Asad MD 31 Ali, Mohamed MD 448 Ali, Muhammad MD 560, 567, 568, 569, 589, 595, 596 Ali, Rias MD 309 Alkafaji, Aziz MD 326 Alkass, Mark MD 488 Alkire, Mark MD 271, 272 Alkurdi, Basem MD 392 All Childrens Hospital OP Pharmac 746 All Childrens Outpatient Pharmacy 767 All Stat Home Health Inc 646 Allarakhia, Liaquat MD 294 Allen, Kathie DDS 279 Allen, Kathleen MD 326, 384 Allen, Sarah LCSW 575

PROVIDER INDEX A - cont. Alliance Oxygen and Medical Equipment 634, 646 Allison, Joanna MD 19 Allure Home Health Corp 616 Ally Medical Services LLC 615 Almahasneh, Firas MD 101 Almerico, Jessica ARNP 734 Almond, Brett MD 452 Al-Nakshabendi, Imad MD 122 Alonso, Zenaida DDS 369 Alpha-Omega Pharmacy 767 Alpine Health Rehabilitation Center 636 Al-Suleiman, Osama MD 454 Altaras, Rona MD 479 Altemose, Rand MD 178 Alter, Jason DMD 369 Alter, Lorielle DMD 305 Altman, James DC 85 Altoos, Taghrid MD 449 Alvarez, Alfred MD 39 Alvarez, Carmen LMHC 600 Alvarez, Dennis OD 215 Alvarez, Edel MD 11, 67 Alvarez, Juan DDS 126 Alvarez, Pedro MD 487, 488 Alviani, Clay DMD 279 Amann, John MD 486 Amaro, David DDS 460 Amato, Frank ARNP 707 Ambler, Kathleen CNM 697 Ambulatory Surgery Center 611 Ameh, Joseph MD 517 Amen Pharmacy 767 American Care of Tampa Inc Lakeland 776 American Care of Tampa IncNtampa 746 American Care of Tampa Inc W 746 American Care of Tampa Winter Haven 776 American Care Tampa Haines City 776 American Dialysis Center Inc 633 American Homepatient Inc 615 Americas Pharmacy 781

Ames, Robin OT 672 Amin, Devendra MD 448 Amin, Jay MD 351 Amin, Mahesh MD 351 Amin, Mukund MD 12 Amin, Sanjiv DO 365, 366 Amin, Sapnalaxmi MD 2, 4, 66 Amis, Jacqueline MD 194 Amrooei, Danoosh DMD 126 Amurgis, Christie SLP 680 Ancaya, Francisco PA 734 Anchundia, Maria MD 2, 72, 73 Anclote Pharmacy 767 Andah, Edmund MD 488 Andal, Laurie DO 290 Andersen, Bailey SLP 680 Anderson, Angela OD 87, 95, 498 Anderson, Bruce OD 210, 215 Anderson, Clinton OD 216, 337 Anderson, Mary ARNP 666, 727 Anderson, Nicholas OD 414 Anderson, Wayne MD 43 Andrade, Edgard MD 113 Andre, Philippe PA 722 Andrews, Ena MD 358 Andrews, Robert MD 288 Andrews, Thomas MD 242, 304, 434, 511 Andriola, Michael MD 397 Aneja, Lalit MD 527 Aneja, Parul MD 169, 172 Angel, Jeffrey MD 175 Angelillis, Kimberly OT 692 Angell, William MD 270, 451 Ankalikar, Satish DDS 126 Annoni-Suau, Luis MD 309, 310, 350, 351 Anthony, Charles MD 210, 294, 295, 535 Antigua-Suarez, Nathaly PA 657, 658 Antonucci, Iris Had 627 Antony, Archana DDS 85, 90, 461 Anvari, Farshad MD 270 Anzalone, Kelli ARNP 675 Apollo Advanced Home Health Corp 616 Apollo Beach Pharmacy 746

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Apollo Health and Rehabilitation Center 636 Aponte, Dawn Had 627 Appler, Bonnie PA 654 Apria Healthcare LLC 627, 641 Apuri, Susmitha MD 327 Aquino, Sheila ARNP 689, 698 Arango, David MD 96, 507 Arango, Jan MD 19, 51 Arasu, Thiru MD 244, 511 Arcadia Dialysis Center 607 Arcenas, Rey MD 89 Archibald, David MD 119 Arditi, Sibel DMD 279 Arevalo-Araujo, Roberto MD 327 Argeles, Horacio MD 263 Argiropoulos-Dhima, Margaret OD 337 Arias Howard, Guillermo MD 97 Arias, Carlos MD 30 Arkhipenko, Tatiana MD 48 Arkin, Steven MD 194 Armas, Ignacio MD 188 Armenia Ambulatory Surgery Center Inc 611 Armstrong, Ashley PA 659, 705 Armstrong, Brett MD 160 Armstrong, Christine MD 19 Armstrong, Frank DO 361 Armstrong, John DO 43 Armstrong, John MD 160 Armstrong, Kathleen PHD 568, 569 Armstrong, Paul DO 273 Arnedo, Johanna DDS 127, 369 Arniella, Alvaro MD 83 Arnold, Anita DO 101 Arnold, Chelsea ARNP 737 Arnold, Heidi MD 188 Arnold, Michelle AUD 660 Aronson, Barry OD 414 Arora, Ajay MD 397 Arora, Payal DDS 127 Arredondo, Andra LCSW 584 Arrigo, Christopher PT 677 Arrillaga, Frances MD 237, 238, 303, 428, 508, 509, 540 Arroyo Jr, Jose MD 19, 252 Arroyo, Fernando MD 39, 51

PROVIDER INDEX A - cont. Arroyo, Lizbeth ARNP 655 Arroyo, Luis MD 101 Arshadi, Eftekhar DMD 523 Arthur, Jayson Had 609 Artreches Camacho, Tahirin PsyD 567 Arumugam, Roger MD 5 Arvelo-Velez, Beatriz MD 51 Asante Korang, Alfred MD 428 Asap Pharmacy 767 Asare, Kinglsey DO 390 Ashmeade, Terri MD 180 Asis, Maria Belina MD 5 Askren, Holli CNM 684 Assad, William MD 266 Assisting Hands Gulf Coast 616, 624 Astoria Health and Rehabilitaiton Center 642 Asuncion, Melissa MD 122, 172 Atalla, Sameh MD 91 Atiq, Shehla MD 530, 547 Atkinson, William DDS 127, 369 Atluri, Tej MD 12 Attie, Abelardo DMD 127, 369 Auburndale Oaks Care and Rehabilitation 642 Audeh, Alisha LMHC 600 Auguste, David DPM 261 Aum Pharmacy 763 Aungst, Cary MD 39, 51, 442 Austin Respiratory Equipment Inc 634 Austin, Bradley OD 216 Austin, Deborah DDS 127 Austin, Mitchell MD 522 Avant Garde Urgent Care LLC 621 Avashia, Jaydev MD 483 Averoff, Lisa LMHC 562 Avery, Samantha DO 351, 392 Avian Home Health Corp 616 Avila, Daira DMD 461 Avon Park Royal Holdings Lld DBA Royal C 609 Avon Pharmacy 745 Awad, Asma DDS 127 Awad, Reda MD 39

Awwad, Abraham DO 396 Axcess Pharmacy 763 Axel, Jonathan MD 263, 264 Ayala, Indira SLP 733 Ayala, Irmel MD 246, 436, 437, 512, 541 Ayer-Cole, Jawan MD 167 Ayestaran Cassani, Frank MD 439 Ayoubi, Maher MD 101 Ayub, Jorge MD 327 Azadi, Anthony DDS 461 Azank, Karina MD 35 Azzi, Nadine MD 48 B Baab, Holly MD 43 Baacke, Keri MD 175, 176, 330, 482, 530 Babayan, Zaruhi MD 102 Babbs, Garrett PA 698 Babilonia, Gerardo PT 649 Babu, Keshava MD 238 Bacchelli, Lara DMD 127, 128, 279, 319, 369, 370, 523 Back, Kendra ARNP 649 Bada Arniella, Alvaro MD 83 Bader Prosthetics Orthotics 618 Badillo, Linda MD 331 Baez Henry, Carlianette DMD 128, 370 Baez, Tomas DDS 128, 370 Baghdadi-Gegati, Marcel DDS 320 Baig, Mohammad MD 120 Bailey, Charles MD 161, 273 Bailey, Glenda CNM 726 Baill, I Cori MD 532 Bain, Darryl MD 318 Bainbridge, Megan CNM 667, 710, 727, 738 Baird, Nancy PsyD 604 Bajor, Jane LMHC 584 Bajsanski, Lori PT 677 Bajwa, Neil MD 366 Bakarania, Magan MD 102 Bakay, Scott PsyD 577 Baker, James DDS 458 Baker, Joanna LMHC 600 Baker, Kimona CNM 728

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Baker, Marisa MD 194 Baker, Teresa MD 569 Baker, Wayne DDS 320, 370 Baker, William PsyD 604 Bala, Jennifer MD 290 Balakrishnan, Maya MD 180 Balcacer-Estevez, Nery MD 391 Baldwin, Melisha MD 194, 488 Balis, Gene MD 186 Ball, Jennifer DO 388 Ballal, Natraj MD 238 Ballard, Michelle PT 733 Ballo, Amanda ARNP 667, 728 Ballow, Mark MD 349, 521 Balmick, Reshma Had 634 Balunos Mitchell, Mary Rose ARNP 675 Banks, Elizabeth MD 51 Baptiste, Raoul ARNP 707 Barakat, Ayman MD 394 Barany, Pamela CNM 667, 728 Barasch, Marc DO 43 Barber, Laura MD 545 Barberet, Leigh ARNP 652, 722 Barbour, Ronald MD 169 Barcia, Antonio DDS 461 Bardach, Reut MD 334 Bardsley, Norman DDS 259, 445, 544 Barinas-Duval, Froilan DDS 320 Barlow, Kathleen DDS 128 Barlow, Kevin AUD 722 Barnes, Raymond MD 494 Barnes, Wanda LMHC 584 Barnes-Murphy, Cheryl ARNP 654 Baron, James MD 188, 189 Barr Prosthetics & Orthotics 447 Barreiro, Francis OD 414 Barrett, Brendan DPM 344 Barrett, Steven DDS 128, 279, 370, 461, 523 Barrido, Kevin OD 216, 337 Barriga, Julia MD 20 Barrios, Juan MD 479 Barry, Scott DC 114 Bartell, Lisa ARNP 654 Bartelt, Erica MD 20 Barth, Jeanne SLP 680

PROVIDER INDEX B - cont. Bartow Center 642 Bartow Dialysis 640 Bartow Pharmacy Med Supply 776 Bartow Regional Medical Center 557 Barzyk, Jeffrey DMD 461 Bass, Kristina OT 730 Bassaly, Renee DO 194 Bassetti, Dennis MD 98 Bassil, Claude MD 182 Bassil, Nadijda MD 7 Bassion, Kellie OD 498 Batzer, Jon OD 537 Baumgartner, James MD 248 Bay Area Behavioral Services Inc 564 Bay Breeze Dialysis 633 Bay Dermat Cosmetic Surgery 767 Bay Discount Pharmacy 746 Bay Life Pharmacy 767 Bay Life Pharmacy II 767 Bay Life Pharmacy III 767 Bay Pointe Nursing Pavilion 636 Bay Tree Care and Rehabilitation Center 636 Bay Village of Sarasota 647 Baycare Alliant Hospital 556 Baycare Homecare 767 Baycare Life Management 564, 565 Baycare Outpatient Imaging 612, 632 Baycare Outpatient Imaging Center 626, 632 Baycare Pharmacy 746, 767 Baydoun Pharmacy 767 Bayfront Health Dade City 555 Bayfront Medical Center 556 Bayfront Neonatology Services 395 Bayfront Same Day Surgery Center 631 Bayindiryan, Teodora MD 79 Bayonet Point Surgery & Endoscopy Center 626 Bayron, Carlos MD 310, 351 Bayron, Jennifer OT 692 Baysa, Darlene ARNP 661

Bayshore Pharmacy 760 Bayside Rehab & Nursing 636 Bayview Pharmacy 768 Bayview Radiology 612 Bayview Surgery Center 645 Baywood Nursing Center 636 Bazargan, Sadaf MD 183 Bazley, Robert MD 488 Beach, Christopher DDS 370 Beagle, Linda ARNP 658 Beal, Jeffrey MD 83 Bear Creek Nursing Center 628 Beard, Margita MD 305 Bearss Pharmacy 746 Beaton, William DPM 446 Beauchamp, Magda MD 516 Beck, Sandra OT 692 Beck, Scott MD 248, 439 Beck, Susan OD 537 Becker, David MD 366 Becker, Edward MD 234 Beckwitt, Julie-Ann OD 414 Bedi, Bharminder MD 589 Beer, Jamie SLP 694 Beers, Eda DDS 370, 371 Beetler, June DO 52 Befeler, Carley MD 43 Begum Hasan, Jahanara MD 434 Beiler, Mark OD 338 Beitscher, Stan DDS 462 Belal, Farouk MD 454 Belaunzaran, Pedro DDS 128 Belilovskiy, Elina ARNP 650, 743 Belisle, Julian MD 270, 347 Bell, Roger DC 315 Belle, Beverly MD 401 Belleair Surgi-Center-HCA Columbia 631 Belogolovkin, Victoria MD 176, 195 Belongie, Iriana MD 116, 118, 316, 317, 361, 363 Belony, Assoye PA 686 Belsole, Robert MD 165 Beltranwalshe, Maria DPM 261, 344 Beltre, Miguel MD 5 Beltroy Cornejo, Eduardo MD 244 Benbadis, Selim MD 183 Bender, Jan MD 52

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Beneva Lakes Healthcare and Rehabilitati 647 Benfanti, Paul MD 248, 342, 440, 542 Bennett, Victoria ARNP 708 Benson, Beth MD 399, 401 Benson, Matthew PA 716 Bentivenga, Lisa LCSW 566 Benzer Pharmacy 746, 760, 763, 768, 776 Berdeal, Rogelio OD 216, 217 Bergamo, Dale MD 247 Berger, Adam MD 94, 336, 494 Berger, Todd MD 210, 295, 408, 535 Berges, Eddy MD 183 Bergier, Gregoire MD 388 Berio Alvarez, Marta MD 52 Berk, Lawrence MD 267 Berk, Madeline DMD 320, 371 Berland, Gregory MD 7 Berlowitz, Michael MD 102 Berman, David DO 247, 304, 438, 542 Berman, Peter MD 102 Bernal, Ellen ARNP 678 Bernal, Hernando MD 264 Bernard, Lisa ARNP 740 Bernatsky, Sylvia OD 217 Berner, Melissa ARNP 674 Bernstein, Myron DPM 544 Bernus, Anna MD 238, 342, 428, 429, 509, 540 Berrios, Jose MD 363 Berry, Brian MD 289 Berry, David MD 384 Berry, Mattie ARNP 655 Bessada, Ashraf DMD 320 Best Care Providers Inc 616, 635 Best Deal RX Pharmacy 746 Best, Erin MD 86, 93, 488 Betancourt, Fernando MD 195, 488 Betensky, Marisol MD 388 Beth Ingram and Associates Inc 619, 642 Better At Home LLC 616 Betton, Kimberly OD 498 Betzu, Robert MD 102 Bezerra, Francisco DDS 343

PROVIDER INDEX B - cont. Bhadja, Kantilal MD 12 Bhaleeya, Swetangi MD 211 Bhamber, Davinder MD 31, 80 Bhandare, Deepti MD 89, 92 Bharucha, Corrie MD 52, 53 Bhashyam, Siva MD 454, 482 Bhaskar, Varun MD 448 Bhat, Anjali PA 673 Bhatia, Gitashree MD 2, 5, 69 Bhatia, Vikas MD 351 Bhatt, Bipin MD 98 Bhattacharyya, Rishi MD 528 Bhutiani, Inder MD 518 Biandudi, Odessa DDS 129, 279, 320, 371 Bielitz, Robert LMHC 580 Bilella, Mark MD 12, 20 Bilik Jr, Alfred MD 84, 87, 307, 547, 548 Billings, Rick OD 537 Bills Prescription Center 746 Bioscrip Infusion Services 746 Bioscrip Infusion Services LLC 615, 617 Birnbaum, Suzanne OD 414 Birthways Family Birth Center 645 Bishay, Sawsan MD 346 Bishop, Bonni PsyD 577 Bishop, Harold LCSW 584 Biss, Kimberly MD 399 Bitar, Hassan MD 183 Bittles, Mark MD 450 Bjorkman, Tara LMHC 580 Black, Daniel OD 87, 95 Black, Harrison DMD 253, 254 Black, Janet MD 53 Black, Robert MD 351 Blackburn Point Ambulatory Car 647 Blacker, Julie OT 673 Blackman, Edward MD 32 Blackmon, Jennifer ARNP 649 Blade, Pamela OD 498 Blake Imaging LLC 624 Blake Medical Center 554 Blake Pharmacy 763 Blake, Richard DDS 444

Blanchard, Richard MD 363 Blanchard, William MD 509 Blanco, Adolfo MD 67 Blanco, Allisha DC 315 Blanco, George MD 351, 352 Blanco, Rafael MD 167 Blankenship, Susan DMD 444 Blankinship, Louellen SLP 693 Blix, Andrew ARNP 737 Blom, Thomas OD 297, 537 Bloom, David MD 449 Blue, Sharon ARNP 658 Blumencranz, Peter MD 384 BMA Avon Park 609 BMA of Bradenton 623 BMA of Carrollwood 614 BMA of Clearwater 633 BMA of Ybor City 614 Boca Ciega Center 636 Bock, Christie ARNP 675 Boersma, David DC 90 Bohan, Kristen OT 739 Bohnert, Shannon DPM 446 Bolanos, Rodrigo MD 454 Boley Centers Inc 587 Bollegraf, Morris DO 30, 277 Bollepalli, Sureka MD 243 Bon Secours Maria Manor Nursing Care Cen 637 Bonaparte, Katina MD 43 Bondar, George DO 361, 362 Bonnet, Desiree ARNP 678 Bontemps, Ernst MD 366 Boonyathitisuk, Pisami SLP 680, 694, 719 Booth, Christine MD 39, 53 Booth, Kimberly SLP 680 Boothby, Richard MD 481 Borislow, David MD 366 Bornstein, Ilan MD 481 Borra, Sujatha MD 183 Boswell, Gibson DMD 129, 279, 371, 523 Botros-Mikhail, Hany MD 569 Bou-Gauthier, Salvador MD 20 Boulay, Sheryllyn PA 678 Bowers, Janaya SLP 719 Bowers, William MD 384

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Bowersock, Angela PA Bowes Imaging Center LLC

720

623, 645 Bowles, David DDS 305, 543 Bowlin, Walter DDS 233 Bowman, Steven MD 12 Boxley, Robert PHD 604 Boyce, William MD 303 Boyer, Kevin MD 291 Boyett, Kimberly DDS 462 Boyette Walk In Clinic 621 Boyette, Suzette ARNP 728 Boyette-Peterson, Bonnie ARNP 684, 737 Boyiadzis, Harris MD 310 Bozeman, Andrea ARNP 663 Brachowicz, Maria DDS 129, 130 Braden River Rehabilitation Center LLC 624 Bradenton Card Mngt Services 624 Bradenton Dialysis 623 Bradenton Health Care 625 Bradenton Hometown Pharmacy 760 Bradenton Prosthetics Orthotic 624 Bradenton Surgery Center Inc 623 Bradfield, Joseph MD 457 Bradley, Ashley DMD 130, 279, 371, 523 Bradley, Timothy MD 249 Bradner, Michael MD 270 Brady, Patrick MD 122 Braley, Katherine MD 509 Branch, Mia MD 489 Brand, Andrea MD 79, 278 Brandon Ambulatory Surgery Center 611 Brandon Artificial Kidney Center 614 Brandon Community Health Center 747 Brandon East Dialysis 614 Brandon Health Rehabilitatio 620 Brandon Open MRI 617 Brandon Outpatient Surgery Center 611 Brandon Pharmacy 747

PROVIDER INDEX B - cont. Brandon Regional Hospital 553 Brandon Surgery Center 611 Brandywyne Health Care Center 642 Branin, Leslie OD 414 Brannan, Anthony MD 115 Branscombe, Tyler DMD 130, 280, 320, 371, 523 Brantley, Diane LCSW 559 Brar, Gurinder MD 35 Brar, Sardul MD 2, 5, 73 Brasington, Steve MD 602 Brattain, Andrew DMD 130 Bratton, Edward DPM 345 Braudway, Sonya OD 498, 499 Braun, Edward MD 122, 168, 365, 390 Braver, Yvonne MD 13 Bravo, Flavia ARNP 659 Brea, Carlos MD 48 Brecher, Matthew DC 114 Breedlove, Megan SLP 680, 694 Breen, James PA 688 Breitenbach, Renee ARNP 722, 723 Bremm, Jessica ARNP 706 Bremmer, Pamela ARNP 665 Brendel, Dana PA 675 Brennan, Todd DPM 261 Breunig, Adam MD 494 Brewer, Staci Beth SLP 733 Brightstar of Pinellas County 635 Brinn, Melissa MD 442 Brinn, Nathan MD 13, 20 Briscoe, Sarah PA 705 Brito, Daryl DMD 130, 280, 371, 523 Britos-Bray, Martin MD 345 Brochu, Robert MD 30 Brockway, Chelsea DDS 303, 427 Bronleewe, Scott MD 271, 347 Brooks, Aaron ARNP 589 Brooks, Joel LCSW 562 Broom Smith, Nikole ARNP 710, 711 Brothers, Mary ARNP 716 Brown, Amy ARNP 698 Brown, Amy MD 195 Brown, Delrose CNM 691 Brown, Rachel ARNP 731

Brown, Richard MD 288, 527 Brown, Russell MD 92 Brown, Troy DDS 462 Brown, William MD 53 Browning IV, Robert MD 287 Brownlee, Harrison MD 43 Brucculeri, Michael MD 396 Bruder, Karen MD 195 Brumley, Jessica ARNP 667 Bryan II, Foster MD 451 Bryan, Vincent DC 359 Bryant, June ARNP 675, 731 Bryant, Melissa ARNP 726 Bryant, Valerie ARNP 740 Bryant-Barnett, Paula ARNP 668, 728 Buagas, Archiel ARNP 569 Buchholz, Emily PA 676 Buck, Richard MD 288, 527 Buckley, Breea PA 706 Buckley, Janet ARNP 676 Budharaju, Venkata MD 363 Budzinski, Volha DDS 320, 371 Buffano, Roxanne OD 95, 217, 499 Bufkin, Bradley MD 271 Bugni, William MD 102, 103 Buhari, Mudathiru MD 169, 391 Bui, Loananh DDS 254, 305, 444 Bulla, Angela LCSW 584 Bullard, Guinevere MD 86 Bulls Country Pharmacy 747 Bunton, Miriam LCSW 584 Burcenski, Holleen ARNP 576 Burgin, William MD 184 Burkard, Megan LMHC 600 Burke, Christina PA 661, 707, 737 Burke, Deborah MD 184 Burke, Elizabeth ARNP 711 Burke, James DC 359 Burks, Nicole OT 713 Burlison, Charles MD 401 Burnette, Michael MD 269 Burns, Craig DO 43 Burton, Debbie ARNP 594 Burton, Tracy MD 20 Buscemi, Michael DO 234 Busch Pharmacy LLC 747 Busciglio, Dana DMD 254

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Busciglio, Lindell MD 169 Bush, Jennifer ARNP 660 Bushati, Ivo DMD 131, 280, 371, 523 Butler, Robert MD 234, 235, 507 Butler, Stephen MD 161 Butto, Fouad MD 252, 442, 514, 542 Buzzett, Jennifer OD 217 By, Charya MD 456 Byju, Kizhakevilayil MD 523 Byrd, Michelle SLP 680, 694, 719 Byrne, Steven DC 359 Byun, Sung MD 388, 394 Byun, Sunghwan DPM 305 C Caballero, Jaime MD 310 Caban, Francis MD 116 Cabatana, Tisha OD 499 Cabral, Laiheng ARNP 678 Cabrera, Camilo MD 31 Caez, Brian DC 114 Cain, Mary MD 195, 334, 489 Cain, Richard MD 235 Caintic, Alberto MD 182 Caire, Michael MD 122 Calcagno, Manuel DDS 320 Calderon, Guillermo MD 401 Calderon, Nadia DDS 462 Calderon, Nancy ARNP 658 Calero, Aurelia MD 273 Calero, Karel MD 264, 270 Calleja, Joseph MD 602 Caltenco, Elias MD 291, 292 Camargo, Tara OD 414 Camelot Community Care Inc 564, 575, 587 Cameron, Rhonda PHD 583 Camilo, Raisa MD 5, 6 Camp, Lori OD 297 Campanelli, Michael DO 486 Campbell, Christopher OD 415 Campbell, Elizabeth PHD 578 Campbell, Hannah ARNP 652 Campbell, Kristy ARNP 676 Campos, Alfonso MD 248, 513 Cancel, Jeanette MD 392 Cancio, Margarita MD 169 Candis, Lavasaous LMHC 562

PROVIDER INDEX C - cont. Carrington Place of St Pete 637 Canedo, Mario MD 175 Carrington, Moise MD 169 Canizares, Carina DMD 280 Carrion, Rafael MD 272 Cannon, Aileen MD 13, 20 Carrollwood Care Center 620 Cannon, Cara MD 73 Carrollwood Dialysis 614 Cannon, Fay MD 582 Carrollwood Pharmacy 747 Cano Montoya, Angelica MD Carter, Anna SLP 742 73, 514 Carter, Jade DDS 372 Cano, Carlos MD 53 Carter, Jenny PA 673 Cantwell, Carol CNM 736 Carter, John MD 269 Capote-Dishaw, Jessica MD 32 Carter, Kristyn ARNP 675 Caputi, Lori OD 415 Carulli, Denise ARNP 690 Caputo, Michael DDS Casa Mora Rehabilitation Extended 131, 280, 372, 462, 523 Care 625 Carbonell, Kevin DMD Casadonte, Joseph MD 358 131, 280, 281, 372, 524 Casady, Lise ARNP 663 Cardenas, Carlos DDS Casanas, Beata DO 169, 172 85, 90, 462, 463 Casanova, Anthia LMHC 562 Cardiovascular Mobile Ultrasound Cascio, Cynthia PT 741 Inc 618 Case, Barry OD 415 Cardona, Francisco MD 352 Caselnova, Michael MD 35 Cardona, Jerges MD 264 Caselnova, Petra MD 195 Care and Life Home Health Casler, Viva ARNP 690 Services 641 Cassels, Lewellyn ARNP 649 Care One of Florida LLC 629 Cassidy, Dennis MD 350 Care Plus Pharmacy 768 Castelli, Jennifer OT 652, 730 Caremark Specialty Pharmacy 747 Castillo, Orlando MD 182 Caremark Therapeutic Svcs 617 Castro, Alfonso MD 448 Careplus Pharmacy 747, 776 Castro, Maria ARNP 724 Carey, Carolyn MD 248, 439, 513 Catalanotto, Chelsea ARNP 709 Carifi, Vincent MD 479 Cauble, Elliot MD 122 Carillon Surgery Center LLC 631 Cauffield and Associates Inc 600 Carini, Andrew LCSW 584 Causey, Michael OD 338 Carlee, Christina ARNP 705 Cazes, Elliot MD 195 Carlin, Faith MD 401 Ccm Pharmacy, LLC 747 Carlisle Imaging Center 632 Cecil, Adam PT 741 Carlson, Ruben OD 217 Cef Vision Inc 214 Carlson, Timothy MD 43 Cendana, Elisa MD 32 Carlton Manor Inc 587 Centerstone of Florida Inc Carmichael, Melissa ARNP 663 575, 576, 601, 602 Carney, Jacquelyn PA Central Florida Health Care 674, 692, 715, 740 Pharmacy 745, 776 Carpenter, Elizabeth MD 264 Central Florida Health Care Carpenter, Sandra ARNP 656 Pharmacy Lakeland 776 Carpenter, Thomas DO 7 Central Florida Imaging Center Inc Carr, Diana MD 92, 96 609 Carr, Silvana MD 252 Central Florida Speech Hearing Carr, William OD 297, 298, 537 Center I 642

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Central Florida Surgicenter 640 Central Park Healthcare and Rehabilitati 620 Central Pharmacy 760, 776 Central Tampa Dialysis 614 Cetin, Kenan PA 649 Cha, John MD 161 Chachad, Sairah MD 73 Chadda, Nader MD 310 Chae, Sanders MD 100 Chae, Soojong MD 123 Chai, Sook OD 298 Chakola, Paul MD 345 Chamarthy, Latha MD 99, 309, 349 Chamberlain, Andrea MD 590 Chamberlain, Brian PA 720 Chamberlain, Kerry DO 388, 389 Chamorro Roberts, Zayda MD 189 Champion, Natasha MD 196 Chan, John MD 235 Chan, Stacey DMD 463 Chandarana, Himanshu MD 448 Chandler, Nicole MD 161, 250, 287, 304, 385, 441, 526, 542 Chandy, Joshua DO 569, 570 Chang Chen Lin, Yih MD 172, 269 Chang, Fong MD 310 Chang, John MD 123 Chapa, Liberato MD 451 Chapagain, Shweta DDS 320, 372 Chari, Ganesh MD 332 Charles, Jay II DDS 321, 372 Charles-Logan, Constance MD 32 Chase, Kely DMD 131, 372 Chase, Stacy DO 43 Chasko Jr., Joseph DDS 463 Chatoor, Hafeez MD 178 Chaudhri, Tahir MD 97 Chauhan, Ketul MD 454, 482 Chauhan, Veeraish MD 290 Chavez, Claudia OD 415 Chawk, Beverly ARNP 689, 698 Chaykin, Louis MD 522 Chazhikattu, Ambrose John MD 13 CHC of Bayonet Point 629 CHC of Brandon 620 Cheatwood, Janice DC 114 Chee Awai, Ronald MD 98

PROVIDER INDEX C - cont. Chekan, Theodore DDS 131, 132, 373 Chen NBHD Medical Clearwater 768 Chen NBHD Medical St Petersburg 768 Chen Neighborhood Medical E Tampa 747 Chen, Allan MD 103 Chenault, Shelley CNM 697, 709 Cheng, Wayne MD 352 Cherian, Shiju DDS 458 Cherkinsky, Jordan DDS 281 Cherpelis, Basil MD 116 Cherry, Elizabeth DDS 515 Cherry, Jerry DDS 281 Chi, Andy DPM 84, 306 Chichkova, Rossita MD 184 Chila, J Patricia LMHC 594 Childers, Eleanor LCSW 584 Childers, Seldon DDS 132 Childrens Health Center Pharmacy 781 Childrens Home Society of Florida 565, 574, 594, 598 Childrens Therapy Solutions Inc 624 Childres, Jillian PHD 572, 592 Chin Lue, Roland MD 123 Chin, Leo DMD 233 Chinlund, Heidi LCSW 595 Chintakayala, Durga MD 7, 35 Chiritescu, Cristian MD 33 Chiro Alliance Corporation 359 Chisholm, Keith MD 326 Chiu, Kathrine MD 352 Cho-Chung-Hing, Lorraine MD 531 Choe, Leo DO 48 Choice Diagnostic Imaging 645, 646 Choice Pharmacy 747 Chokshi, Saurabh MD 103 Choksi, Tarak MD 13, 38, 165, 327 Chou, Victor DMD 463 Choudhry, Umesh MD 366 Chowdhury, Quamrul MD 570 Christian III, Claiborne LMHC 562 Christova, Albena LMHC 584

Chu, Luis MD 288, 527 Chua, Caroline MD 484 Chudzinski, Allen MD 115 Chung, Elizabeth MD 113 Chuong, Christopher DDS 343, 444 Chuong, Robert DMD 341 Cibran, Mariano MD 20, 53 Ciccarello, Jim OD 415 Cichra, Deborah SLP 694 Ciesla, David MD 161 Cimilluca, Cara PA 674, 693, 715 Cimino, Cynthia PHD 567 Cimino, David MD 349, 442 Cinquegrano, Amanda ARNP 656 Circle of Friends Services Inc 565 Cisneros, Aura DMD 132 City Care Pharmacy 747 City Pharmacy 747 Clanton, Rosemary ARNP 658 Clare, John LMHC 584 Clark, Colby MD 161 Clark, Louann ARNP 693 Clark, Louisa LMHC 584 Clark, Randall MD 98 Clark, Tatiana ARNP 684 Clarke, Cheryl MD 489 Clarke, John MD 385 Clark-Whitlock, Ann ARNP 698, 699 Claudio Torres, Angela LMHC 562 Clear Water Care and Rehabilitation Cent 637 Clearwater Limb & Brace 635 Clearwater Prosthetics & Orthotics 635 Clement, Veronica PHD 589 Cleveland Heights Pharmacy 776 Clifton, Andrea SLP 719, 741 Clinicare Medical Resources Inc 615 Clough, Scott OD 217, 338, 415 Clum, Stephen MD 264, 270 Clyburn, Thomas PHD 578, 604 C-Med Ambulatory Surgery Center 631 Coastal Behavioral Healthcare Inc 601, 604 Cobb Dewitt, Mary SLP 680 Cobbe, Michael DDS 343, 444

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Cocchieri, Richard DDS 85, 90, 463 Cochran, John OD 217, 415, 416 Cockrell, Erin DO 246 Codolosa, Jose MD 352 Cofer, Kristen PA 740 Cogburn, Julia MD 167 Cohen, Benjamin PHD 592 Cohen-Oram, Alexis MD 570 Cohen-Posey, Kate LMHC 594 Colalillo, Maryanne MD 196 Colaluce, Marc DPM 446 Colbassani, Harold MD 398 Coleman, Laci SLP 719 Collector, Murray DC 359 Collingwood, Susan ARNP 736 Collins, Emily ARNP 736 Collins, Lawrence PA 681 Collins, Paul MD 385 Collins, Sara ARNP 689, 698 Collins, Sharon SLP 733, 734 Collison, Lori AUD 683, 736 Colon Rivera, Malieri MD 334 Colon, Agdha DDS 463 Colon, Yaritza MD 54 Columbia Eye & Specialty Surgery Center 611 Columbia South Bay Hospital 553 Comfort IV Therapy 781 Comkowyez, Sharon SLP 734 Community Convalescent Center 620 Community Health Ctrs of Pinellas 768 Community Specialty Pharmacy 768 Compassionate Care Hospice of Central Florida 609, 641 Comprehensive Medical Care 347 Concepcion, Maria MD 66 Conde, Nicole DO 54 Condino, Adria DO 244, 435, 511 Confident, Leonard MD 43 Conlon, Kelly Had 609 Conlon, Patrick Had 609 Conlon, Sharon Had 609 Conner, Kevin DC 315 Connery, Sheila MD 196 Connolly, Brendon MD 84, 303, 539

PROVIDER INDEX C - cont. Connors, Donna MD 334 Connors, James MD 362 Constantine, Nicholas DC 276 Consulate Health Care At Lake Parker 642 Consulate Health Care of Lakeland 642 Consulate Health Care of New Port Richey 629 Consulate Health Care of Safety Harbor 637 Consulate Health Care of Sarasota 647 Consulate Health Care of St Petersburg 637 Consulate Health Care of Winter Haven 643 Contreras, Philip DDS 463 Cook, Brittany MD 408 Cook, Patricia DDS 83 Cook, William MD 85, 86 Cooks, Aaron MD 288 Cooney, Patricia LCSW 584, 585 Coons, Audra LCSW 566 Cooper Mercado, Rachel MD 93 Cooper, Angela DDS 85, 91, 464 Cope, Winston MD 408, 409 Copeland Prosthetics & Orthotics 618 Copley, Christian OD 499 Copple, Debra SLP 734 Cora Health Services Inc 609, 619, 620, 628, 636 Cora Health Systems 609, 642 Cora Rehabilitation Clinics Seminole 636 Coram Healthcare Corp of Florida 747 Corbyons, Katherine MD 251 Corcella, Deborah ARNP 699 Cordova, Juan MD 103 Core Rehabilitation Inc 642 Cornish, Victoria ARNP 722 Coronado, Zaida PT 677 Coronato, Eric DO 548 Coronica, Helen ARNP 658 Corradini, Frank LCSW 580

Correa, Raul MD 30 Correal, Juliana DMD 464 Corrick, Kyle PT 677 Cortes Ramirez, Luz LCSW 582 Cortes, Lourdes DMD 254 Cortinas-Small, Maria PT 677 Corwin, Lois C ARNP 590 Cory, Matthew MD 73 Corzo, Hector MD 590 Cosic, Sanja MD 2, 6, 74 Cosmo, Leonard MD 264 Costa, Lori ARNP 699 Cothran, Nora OD 416 Cotman, Henry MD 449 Cottam, John MD 116, 277, 456 Cotton, John MD 507 Couch, Harold MD 385 Coughlin, Jacquelyn LCSW 566 Coughlin, John MD 161, 250, 479, 514 Coughlin, Lauren DMD 464 Couluris, Marisa DO 249, 250, 252 Countryside Birthing Place Inc 631 Countryside Healthcare Center 637 Countryside Surgery Center 631 Cowan, Nena ARNP 683 Cox, Carol MD 196 Cox, Charles MD 161 Cox, Jennifer MD 264 Cox, Stephen DC 114 Craft, Mark MD 13 Crager, Kenneth MD 307 Crandall, Charles DC 359 Crandall, James DDS 321 Cranial Technologies Inc 619 Crank Jr, Richard DO 507 Cravatta, Vanessa ARNP 675, 731 Craven, Emily SLP 719, 741 Craven, Michael DC 315 Crawford, Marguerite MD 238, 303, 342, 429, 509 Creed, Kevin MD 445 Crenshaw, Melissa MD 436 Crescentini, Robert MD 167 Crespo, Shannon SLP 687 Cressman, Wade MD 242, 304, 342, 434, 511 Crestmark Pharmacy Services LLC 747

www.wellcare.com/Florida | 855

CRMC At Bayonet Point 555 Cronen, Geoffrey MD 235 Cropper, Robert DPM 306, 544 Cross Terrace Rehabilitation Center 637 Croteau, Sean PA 714 Crovo, Shana ARNP 727 Cruse, C Wayne MD 260 Cruz Diaz, Ana MD 67 Cruz, Jairo DPM 261 Cruz, Jose MD 7 Cruz, Tatiana ARNP 657 Csere, Anne DO 184 Cuadra, Deborah MD 401 Cuenca, Rosa MD 244 Cuevas, Hiram MD 13 Cummings, Kristin SLP 719 Cura, Jose MD 103 Curant Health Florida 768 Curd, Francis DDS 281 Curiale, Steven MD 385, 451 Curlew Pharmacy 768 Currier, Glenn MD 570 Curtis, Gerard MD 308 Curtis, Lindsay ARNP 690 Curtis, Margo MD 211 Curtis, Mary ARNP 696 Custred, Jeffrey OD 217 Cutrera, Norele MD 507 Cuva, Philip OD 217 CVS 744, 745, 747, 748, 749, 750, 760, 763, 764, 768, 769, 770, 776, 777, 781, 782 D Da Souza, Wilma MD 35 Dabage Forzoli, Nemer MD 31 Dabrow, Sharon MD 20 Daccache, Danny DDS 464 Dacco 565 Dacunha, Andrew DMD 464 Dadisman, Katherine DO 399 Dagher, George MD 352 Dagher, Georges MD 310 Daka, Dedrix OD 298 D'Alesio, Michael OD 416 D'Alessandro, Matthew DO 98, 273, 519 Dalton, Natalie ARNP 726

PROVIDER INDEX D - cont. Daly Jr, Joseph MD 366 Daly, Diana SLP 680 Damayo, Mizyl MD 602, 603 Damian, Gracia MD 487 Danang Pharmacy 770 Dandamudi, Uday MD 327 Dang, Hoc PA 657 D'Angelo, Michael MD 519 Daniel, Jeffrey DO 570 Daniels, Nikki LCSW 566 Dankanich, Ivan ARNP 737 Dann, Kelly LCSW 585 Danner, Erin SLP 694 Danser, Laura LMFT 567 Danzey, Patrick DC 90 Dao, Thieu DDS 321, 373 Dap Pharmacy Management and Consult 770 Dare, Erika ARNP 656 Das, Shilpa DDS 132, 133, 321 Dasouza, Wilma MD 35 Dastgir, Farooque MD 172 Datta, Indrani MD 13 Daughtry, Janet CNM 697, 709 D'Aunoy, Mary MD 2, 6, 74 Davenport Ambulatory Surgery Center LLC 640 Davenport Dialysis Center 640 Davenport, Glenda LCSW 585 Davenport, Misti ARNP 720 Davids Pharmacy 750 Davidson Drug 782 Davidson Drugs Inc 782 Davidson, Robert MD 326, 385 Davidson, Timothy DMD 465 Davidson, Wayne LMHC 562, 585 Davis Islands Pharmacy 750 Davis, Bonnie ARNP 707 Davis, Christopher MD 276 Davis, Donald MD 161 Davis, Jeffrey MD 211, 295, 535 Davis, Jennifer PA 675, 716 Davis, Luke Had 615 Davis, Mark MD 196 Davis, Michael MD 7 Davis, Patrice ARNP 668 Dawod Rajiiha, Samir MD 1

Dawoodjee, Yousuf MD 545 Dawson, Heather ARNP 688, 696 Day, Paul OD 217, 338, 416 Dayicioglu, Deniz MD 260 Dcunha, Prakas MD 331, 396 De Armas, Odalys LMHC 562 De Brigard, Tomas MD 20 De Frain, Michael MD 451, 452 De Jesus Flynn, Myrna ARNP 566 De Jesus Gomez, Gustavo MD 273, 274, 453, 520 De Jesus Rosario, Nilsa MD 568, 570 De LA Garza, Miguel MD 341 De LA Torre, Miguel OD 416, 417 De Vera, Melva MD 67 Dean, Byron DO 66 Decambra, Nicole DMD 133, 321 Decastro, Maria MD 184 Decker, David MD 184 Decker, Jamie MD 429 Declue, Terry MD 243, 541 Decubellis, Chase DC 315 Degala, Ami MD 99, 309, 349 Degala, Gourisankar MD 366 Degala, Sree MD 186 Deicke, Adair ARNP 603 Deignan, Brian MD 249 Del Grosso, Robert DC 315 Del Sol, Rene LMHC 561 Del Toro Rivera, Eliud MD 11, 67, 68 Delaney, Janet ARNP 683 Delellis, Salvatore DPM 446 Delgado, Alain MD 485 Delgado, Francisco DO 103 Delgado, John MD 123 Delikat, Terrence DO 2 Deltoro, Kristin ARNP 715, 740 Delucia, Tracey MD 249 Demaio, James MD 288 Demarco, Leo OD 338, 417 Dembinksi, Karolina DO 252 Demery, Frank MD 14, 21 Demissie, Seifu MD 440 Dempsey, Donna ARNP 590 Denardis, Michael DO 489 Denault, Albert DPM 306 Den-Haese, Greg MD 189

www.wellcare.com/Florida | 856

Denholm, David MD 545 Dent, Leah PA 714 Denzer, Lisa ARNP 658 Depadua, Maria MD 74, 75 Depauda, Maria MD 6 Derasari, Kalyani MD 21, 99 Deray, Dipesh MD 1 Desai, Ajay DO 252 Desai, Chetan MD 366 Desai, Devyani MD 570 Desai, Neel MD 409 Desai, Pratibha MD 31, 327, 389 Desai, Rupal MD 39 Desai, Sangita MD 590 Desai, Sanjiv MD 7 Desaneto, Artur MD 103 Desantis, Marshall MD 347 Descalso, Reynaldo MD 92 Desermia, Kristin AUD 683, 688 Deshpande, Vilas MD 385 Desinor, Darlene DDS 133 Desoto County Health Dept 1 Desoto Memorial Hospital 550 Desper Jr, David MD 401 Desrosiers, Florence MD 21 Dessani, Nehal MD 396 Detweiler, Edwin OD 218, 298, 538 Deukmedjian, Armen MD 186 Devanesan, Sheila MD 399 Devarakonda, Subrahmanyam MD 104 Devries, Benjamin DO 43 Devries, Jennifer ARNP 662 Dewberry, Frederick MD 396 Dewhurst, Robert MD 104 Dhana, Leila MD 245, 435, 512, 541 Dhillon, Amarjeet MD 582 Di Martino, Peter MD 310, 311, 328 Diaczyk, Andrew OD 417 Diakonis, Vasilios MD 211, 409 Dialysis Newco Inc 614 Diasti, Sam MD 14 Diaz, Elanda SLP 719 Diaz, Jany DMD 133, 373 Diaz, Michael MD 389 Diaz, Nannette DPM 261 Dicicco, Richard MD 161, 326, 479 Didonato, Louis DC 359

PROVIDER INDEX D - cont. Diego, Alejandro MD 443 Diener, Howard MD 545 Dietrick, John MD 162 Dietz, Rodney DDS 133, 134 Digiovanni, Ernest DO 328 Dilallo, Mary SLP 742 Dilella, Vincent DO 44 Dillon, Donna ARNP 559, 577 Diner, Beth MD 399 Diner, Eric MD 452 Dinh, Lan DMD 134 Dipasquale, Paul DO 317, 344 Dire, Anthony DMD 134, 373 Directions For Living 587 Disalvo, Heidi DO 196 Ditaranto, Heather OT 730 Ditrapani Stephenson, Tonya MD 532 Dittmer, Amy ARNP 665 Divico, Alicia LMHC 562 Divita, David MD 30 Diwadkar, Sachin MD 104 Diwadkar, Vijay MD 7 Dixon, Danita ARNP 707 Dixon, Dustin OD 95, 218, 499, 500 Dixon, Gloria PA 720 Djulbegovic, Benjamin MD 167 DO, Tutrinh DMD 465 Dockus, Matthew DMD 134, 135, 281, 321, 373, 524 Docobo, Angel MD 162 Doctor Today Urgent Care LLC 643 Doctors Choice Pharmacy 764 Doctors Express 621 Doctors Hospital Sarasota 558 Doctors Same Day Surgery Center -HCA 645 Doctors Urgent Care 629, 638 Doctors Walk-In Clinics 621, 622, 629, 639, 648 Dodd, David MD 518 Doepker, Leslie ARNP 737 Doherty, Nicole DDS 465 Dolber, Pamela DPM 97 Dolce, Vincent DMD 135, 374 Dolgin, Daniel PHD 578 Dollex Pharmacy 750

Dollison, Indya ARNP 731 Dolskaya, Elena MD 292 Dominguez, Jose MD 99 Dominguez, Vymarys OD 218 Donate, Guillermo DPM 345 Dondero, Aldo MD 39 Donelan, Peter MD 117 Donkor, Cynthia MD 21 Dookhan, Marlene MD 401 Doris, Kevin PT 677 Dorsett, Kevin MD 495 Dorsey, Hazel ARNP 660 Dorton, David DO 117, 362 Dos Passos II, John DMD 135 Doshi, Amit DDS 135 Doud, Debra MD 89 Dougan, Grace MD 243 Dougherty, Aimee ARNP 676, 716 Dougherty, Erin DMD 374 Dougherty, Phyllis ARNP 590 Douglas, Jamie PA 654 Douglas, Marissa SLP 719 Douglas, Rodney OT 673 Doumit, Elias MD 182 Dowding, Angela ARNP 665 Dowding, Daryl LMHC 594 Dowidar, Sahar MD 543 Downes, Sandra MD 99 Doyle-Vallery, Deanna MD 532 Draeger, John MD 589, 590 Drake, Carol ARNP 725 Drew, Kelly SLP 687 Drucker, Mitchell MD 211 Drug Store Healthmart 764 Dsi Lutz LLC 614 Dsi South Tampa LLC 614 Duarte, Ignacio MD 271 Dubey, Rita MD 39 Dubovsky, Ladislaus LMHC 580 Ducker, Stephen MD 47 Duff, Carla ARNP 714 Duggirala, Sita MD 21 Duharte Vidaurre, Luis MD 92 Duke II, Billy MD 489 Dulcio, Magdala LMHC 563 Dumois III, Juan MD 438, 542 Dundee Community Pharmacy 777 Dunn, Dolores LMHC 600

www.wellcare.com/Florida | 857

Dunn, Michael MD 169, 289, 391, 529 Duquette, Tara PA 698 Durable Medical Equipment 606 Durham, Rodney MD 479 Durojaiye, Babatola MD 14 Durr, Jacques MD 182 Durve, Aparna DMD 135, 374 Dutt, Ramana MD 327, 330 Dyer, Diana ARNP 668, 711, 728, 738 Dzembo, Daria ARNP 707 E E Street Endoscopy LLC 631 Eagle Lake Pharmacy 777 Eagle Optical Co 214 Eakle, Janice MD 530 Earnhardt, Charles DDS 465 East Manatee Pharmacy 760 Easterling, Gary MD 532 Eastman, Jessica ARNP 686 Easy Living Inc. 635 Ebadi, Ameneh DO 509 Ebner, Stephen DDS 465 Ebrahim, Hassan MD 486 Ebsworth, Gloried DPM 261 Echevarria, David MD 162 Eckardt, Shea MD 448 Eckels, Shane DDS 135, 281, 374, 524 Eckstein, Daniel MD 44 Eddy Gennocro, Erin ARNP 686 Edelman, Robert MD 211, 295, 535 Edmondson, Ellen CNM 655, 665 Edwards II, Stephen LMHC 580 Edwards Pharmacy 770 Edwards, Charles MD 172 Edwards, Denise MD 21 Edwards, Elizabeth DPM 446 Edwards, Eric MD 196, 489 Edwards, Jenny DMD 254, 444 Edwards, Jesse DMD 465 Efemini, Ese MD 334 Egan, Patricia ARNP 736 Egas, Juan MD 237 Egret Cove 637 Eichenbaum, Annette DO 445 Ekers, Mary ARNP 682 Ekici, Sedat MD 90

PROVIDER INDEX E - cont. El Sayed, Eiman MD 75 Elchahal, Sami MD 104 El-Deiry, Mark MD 119 Eldin, Adel MD 14 Elefteriou, Elena PA 696 Elfers Pharmacy Healthmart 764 Elhammady, Mohamed MD 186 Eliazer, Raj MD 184 El-Jabali, Fayssal DO 94, 211 Ellen, Jonathan MD 443 Ellenton Discount Pharmacy 761 Ellermeyerstapleton, Mary Kathryn ARNP 725 Elliott, Brian MD 391, 529 Elliott, Danielle ARNP 654 Elliott, Julie ARNP 722 Ellis, Lynne MD 54 El-Sherbini, Sara DDS 135, 321, 374 Elsworth, Thomas Had 634 Emara, Magdi MD 21 Embassy Pharmacy 764 Emens, Christine LMHC 600 Emmanuel, Patricia Jacques MD 247 Empath Health Pharmacy 771 Empire Pharmacy 764 Encore Respiratory 609, 615 Eng, William MD 118, 119 Engelman, Sharon DDS 374 Englewood Community Hospital (MP) 558 Englewood Pharmacy 782 Epstein, Patricia ARNP 659 Epstein, Steven MD 385 Epting, Stephanie DO 259, 344 Erickson, Shannon LCSW 580, 585 Ericsson, Dawn MD 196, 197, 489 Escalante, Pamela PA 659 Esele, Fitzwilliam ARNP 707, 708 Esguerra, David DO 362 Esoga, Kelechi MD 11 Espana, Edgar MD 211 Esparza, Francisco MD 291 Esperanza Home Health Services Inc 616 Esperanza, Michelle OD 298 Espinal, Licette DDS 135 Espinal, Miguel PHD 578

Espino, Derek DDS 136 Espinoza, Daniel MD 7 Estess, Erica ARNP 697 Estrada, Paul ARNP 725 Estrella Gonzalez, Carlos MD 75 Evans, David MD 455 Evans, Michael DDS 305 Evening Pediatrics Inc 622, 639 Everett, Kari MD 543 Ewing and Thomas Inc 628 Exact Dose Pharmacy Inc 750 Exactus Pharmacy Solutions Inc 750, 759 Excel Care Center 620 Excel Medical Imaging 626 Exceptional Health Care Inc 616 Express Care of Tampa Bay 622 Express Orthotics and Prosthetics Inc 615, 619 Express Specialty Pharmacy 750 Extra Care Pharmacy Inc 750 Eye Doctors Optical Outlets PA 214, 215, 297, 337, 413, 498, 537 Eye Institute Optical LLC 413 Ezeude, Ngozi DPM 446 F Fabelo II, Edward MD 396 Faghih, Fakhredin MD 104 Fairway Pharmacy 761 Fajolu, Olukemi MD 507 Falemban, Mounika DDS 254 Fallen, Tina ARNP 665, 666 Fallon, Kourtney ARNP 676 Families First of Florida LLC 565, 594 Family Care Pharmacy 750 Family First Homecare LLC 616, 646 Family Pharmacy 782 Family Preservation Service 565 Familycare Discount Pharmacy 761 Fanarjian, Nicole MD 197, 292, 402, 489, 532 Fant, Michael MD 181, 252 Faraq, Estafan LCSW 559, 575 Fares, Iman MD 395 Farhangi, Vida MD 80 Farino, Gregory MD 539

www.wellcare.com/Florida | 858

Faris, Talal MD Farkas, Frank DC Farmer, Stacey PA Farooq, Ahmed MD Farooq, Shiraz MD Farooqui, Zubair MD Farrar, Ted MD Farrell, Patricia ARNP Farrell, Thomas DDS Farzaneh, Masoud DDS Fast and Friendly Pharmacy

317 359 731 529 116 14 44 696 321 466

750, 777 Fatmi, Ashfaq MD 81 Fauber, Dean MD 21 Faulkner, Kim MD 44 Fawcett, Ian DDS 466 Fawks, David ARNP 736 Fazio, Eric OD 95, 218 Fdoh In Pinellas County 402 Federico, Jeanne SLP 679 Fee, Krysta CNM 726 Feiler, Angela LMHC 585 Feinstein, Harris MD 568, 570 Feldbaum, Victor MD 402 Feldman, Alan MD 571 Feliciano, Emy OD 298 Feliz De LA Cruz, Victor MD 104, 311 Felski, Emil DO 197, 402, 489, 532 Felts, Christie ARNP 696 Fendt, Meeru PA 736 Feng, Connie DMD 466 Fergeson, Jennifer DO 530 Ferlita, John MD 334 Fernandez, Alfredo MD 162 Fernandez, Joel MD 104 Fernandez, Juan MD 11 Fernandez, Raymond MD 113 Fernandez, Rodolfo MD 69 Fernandez, Sonia OD 218, 219 Fernandez-Boratti, Maruja MD 189, 190 Ferreira, Carmen MD 113 Ferreira, Felicia LMHC 662 Ferreira, Jose MD 113 Ferreira, Stephanie DDS 466 Ferrell, Bobbie ARNP 722 Ferretti, Francesco MD 90

PROVIDER INDEX F - cont. Ferreyra, Stephanie OT 673, 692 Ferris, Anthony OD 219, 338, 417 Ferris, Karen ARNP 736 Ferris, Vijay MD 326 Ferrone, Damian Had 615, 627 Ferrone, Dimitri Had 615, 616, 627 Ferry, Jenelle MD 181 Fersobe, Saadia MD 68 Fichtelman-Bosley, Lucinda CNM 697, 709 Fidy, Ramez DDS 466 Field, Melvin MD 486 Fields, Jason MD 562 Figaro, Mark DDS 321 Figueroa Rivera, Nitza MD 197 Figueroa, Astrid DO 264 Fikry, Driss PA 705 Fils, Jean MD 571 Fine, Frank LMHC 585 Fines Dailey, Verlee MD 176, 330, 393, 482, 530 Fink, Matthew MD 178, 179 Finn, John MD 352, 353 First Care Walk In Clinic LLC 622 First Care Winter Haven LLC 643 First Choice Pharmacy 777 First Choice Pharmacy, Zocalo Plaza 777 First Choice Specialty Pharmacy 777 First Help Urgent Care Clinic 610, 643, 644 First Step of Sarasota Inc 605 Fischer, III, Frank MD 94, 495 Fischer, Jr, Frank MD 495 Fishberger, Steven MD 509 Fishco, Robert MD 30 Fisher, Ronald MD 80 Fitch, Dwight MD 306 Fitzgerald, Frederick MD 533 Fitzgerald, Jennifer OT 692 Fitzpatrick, Laura SLP 694 Fitzsimmons, Daniel PsyD 578 Flanagan, Deborah OD 417 Flanagan, Thomas OD 298, 417 Flannery, Michael Thomas MD 172 Fleegler, Bruce MD 545

Fleener, Barbara MD 81 Fleener, Carola MD 79, 81 Fleischer, Jeannette ARNP 676 Fleming, Connie ARNP 676 Fletcher Health and Rehabilitation Center 620 Fletcher Medical Center Pharmacy 750 Flores Torres, Jaime MD 181 Flores, Anita SLP 687 Flores, Noemi MD 184 Florida Apnea Diagnostics LLC 629 Florida Brace & Limb Inc 635 Florida Dept of Health In Hillsborough C 7, 197 Florida Hospital At Connerton Long Term 555 Florida Hospital Carrollwood 553 Florida Hospital Centra Care University 629, 630 Florida Hospital Heartland 552 Florida Hospital Lake Placid 552 Florida Hospital North Pinellas 556 Florida Hospital Tampa 553 Florida Hospital Wauchula 551 Florida Hospital Wesley Chapel 555 Florida Hospital Zephyrhills 555 Florida Med Clinic Pharmacy of Wiregrass 764 Florida Medical Clinic 764 Florida Pharmacy 764 Florida Presbyterian Homes Inc 643 Florschutz, Anthony MD 235 Flynn, Lynn ARNP 693 FMC Belleair Dialysis Center 633 FMC Belleair Home Therapies 633 FMC North Sarasota Dialysis Center 623 FMC Pharmacy Services 771 FMC Pinellas Park 634 FMC Sarasota Coastal Dialysis Center 645 FMC Southwest Florida Dialysis Center 623 Fogleman, Ruthann LMHC 580, 585 Folkner, James ARNP 649 Folsom, Martha ARNP 699

www.wellcare.com/Florida | 859

For Eyes Optical Co of Coconut Grove Inc 215 Forcella, John DO 393 Forde, Jessica OD 95, 219 Forman, Seth MD 117 Fornos, Jorge DDS 136, 374 Forszpaniak, Margaret MD 596 Fosnot, Susan DO 399 Foster, Cherie MD 181 Foster, John MD 211, 295, 535 Foster, Linda Had 607 Foster, Thomas OD 298 Fotopoulos, Theodore MD 316 Foundational Health Pharmacy 750 Fountain, Lorna MD 44 Fouraker, Bradley MD 211 Fowler, Charlotte DMD 282 Fox, Julie DDS 136 Fradley, Michael MD 101, 105 Franceschi, Marisa DDS 85, 91, 466, 524 Frankel, Manuel DDS 321 Franklin, Michael MD 397 Franzese, Frank MD 267, 449 Frattalone, Sam DC 359 Frazier, Brett MD 8 Frazier, Cathy ARNP 668, 684, 711, 728, 738 Frease, Linda OT 739 Freed, Heather ARNP 676, 716 Freedland, Curtis DO 318, 319 Freedomed Pharmacy 750 Freeman, Michael DDS 466, 467 Freeman, Thomas MD 186 Freire, Grace MD 429 Fresenius Medical Care Wauchula 608 Frias, Frederico MD 33 Fridley, Donald DO 479 Friedberg, Murray MD 295, 535 Friedman, Charles DO 427 Friedman, Robert MD 295, 535, 536 Friedman, Scott MD 211, 296, 495, 536 Friends Pharmacy 750 Fritch, Kristin ARNP 656 Frontera, Alfred MD 184

PROVIDER INDEX F - cont. Fry III, Alland MD 176, 393, 482, 483, 530 Fuentes, Armando MD 402 Fuentes, Taniya ARNP 705 Fugleberg, Keefe PT 741 Fuhrig, Lauren MD 402 Fullem, Brian DPM 446 Fuller, Ellis DDS 136, 374 Fuller, Mary LMHC 585 Funai, Edmund MD 176, 197 Funieru, Iulia MD 456 Furman, Adam OD 219, 338, 417 Furman, Alexandre MD 264, 345 Furman, Megan OD 417 Furman, Walter MD 539 Fuschini, Linda ARNP 665 Fusion Healthcare 609, 616, 624, 635, 646 Fusselman, John OD 219, 220 Futch, Emily PHD 592 G G and H Pharmacy 771 Gabel, James DDS 467 Gabordi II, Robert MD 162 Gabriel, Amy MD 403 Gabriel, Yves MD 453 Gadiyaram, Vijayakrishna MD 389 Gadouas, Cassandra LMHC 580 Gagnon, Robyn DMD 136, 137 Gagot-Rivera, Mirza MD 1, 4 Gaik, Shane ARNP 699, 700 Gajjela, Hemlata MD 39 Galasso, Jed PA 731 Galeano, Lilian SLP 687 Galindo-Ramirez, Ricardo DDS 517 Galiszewski, Brooke SLP 679, 693 Gallagher, Cassandra LCSW 602 Gallagher, James MD 399 Gallagher, Megan DMD 467 Gallant, Michael MD 446 Gallardo, Ignacio MD 105 Gallea, Elisabeth OT 673, 692 Gallego, Manuel MD 559 Galligan, Andrew MD 246 Gallina, Michael DPM 544 Gambro Healthcare 623

Gambro Healthcare-Town & Country Hospital 614 Gamell, Lisa MD 212 Gandhi, Adithya MD 105 Gandhi, Drashti MD 66 Gandhi, Malay MD 350, 351 Gandle, Larry MD 267, 346 Ganga, Roopa MD 391 Gangadharan, Venkataramanan MD 105 Gannon, Robert DDS 467 Gapin, Tracy MD 84, 87, 308, 548 Garay Claudio, Maria MD 21 Garcia Cardona, Maria MD 362 Garcia Jr, Jose MD 14, 69, 70 Garcia, Jorge MD 97 Garcia, Juan MD 105 Garcia, Maritza DDS 467 Garcia, Michael MD 235 Garcia, Nestor MD 11, 68 Garcia, Rodrigo MD 288, 527 Garcia, Rolando MD 21 Gargasz, Bret DDS 120, 121, 277, 364, 522 Garner, Kevin MD 353 Garner, Kyle MD 533 Garrido Jr, Eduardo PA 723 Garruto, Anthony MD 79 Garruto, Bryan MD 94, 212 Garsva, Allison DO 54 Gateway Radiology At McEr 632 Gateway Radiology Consultants 632 Gatons, Yelena DDS 374, 375 Gaud, Rosa MD 39, 54 Gaugler, Andrew DO 479 Gavi, Eli MD 448, 451 Gavino, Belinda MD 35 Gayahan, Glivery Mary MD 54, 55 Geddes, Carol MD 55 Geddes, Jennifer ARNP 700 Geimer, Kristie OT 685 Geldart, Donald MD 2, 4 Gellady, Andrew MD 40, 342 Genesis Healthcare DBA Origin Home Healt 616 Genho, Beth DDS 321 Gennara, Thomas PA 681, 720

www.wellcare.com/Florida | 860

Genninger, Jasen DMD 137, 282, 321, 375, 524 Genoa-QOL Healthcare 750, 761, 771, 777 Gentle Touch Home Care Inc 616 Genuardi, Sharon SLP 680 George, Christopher MD 167 Georges, Lena DPM 261 Georgiev, Maria MD 521 Gerling, Tiffany LMHC 563 Germaine Pharmacy Compounding Inc 750 Gero, Michele MD 79 Gerrish, Prianka MD 100 Gettes, Ruth MD 568 Geyvandova, Yana ARNP 690 Ghaly, Milia MD 14 Ghanekar, Dilip MD 319 Ghent, Cathy LMHC 594 Ghobrial, Victor MD 306 Ghose, Ranjan MD 531 Giannone, Louis DPM 544 Giannoni Delgado, Miguel MD 353 Giarelli, Natalie ARNP 659 Gibala, Virginia LMHC 575 Gibson, Angela LCSW 585 Gibson, Mary ARNP 736 Gier, Terry SLP 734 Gieron Korthals, Maria MD 113 Gieron-Korthals, Maria MD 113 Giglia, Jennifer MD 167 Gilbert Drugs 745 Gilby, Jennifer MD 400 Gill, Jonell OD 220 Gill, Parmjit MD 75 Gillespie, Olivia DO 44 Gillham, Nicole SLP 694 Gillin, Kelly SLP 694 Gilling, Lucia MD 317 Gilton, Amber DMD 375 Gimon, Alexander PHD 592 Gimpelevich, Natalie ARNP 654 Giovanetti, Austin PA 596 Giparas, Stephanie PA 676 Gipson, Amos MD 184 Giraldo Isaza, Maria MD 176, 330, 393, 483, 530 Giraldo, Hernan MD 264, 265

PROVIDER INDEX G - cont. Girling, Martin DPM 261 Gittess, Robert DDS 365 Gladwin, Lydia AUD 688 Glamour, Tejinder MD 366 Glassberg, Steven OD 220, 299 Glasser, Jay OD 299 Glen Oaks Health and Rehabilitation Cent 637 Glenn, Candace MD 456 Glick, Alexander MD 527, 530 Glidewell, Gloria CNM 655 Global Mobile Diagnostics of Florida Inc 612 Glover, Matthew MD 105 Gniady, Michelle MD 162 Gobo, Dean MD 398 Godofsky, Eliot MD 289 Goedicke, Heidi MD 545 Goel, Naveen MD 182 Goff, Michelle PA 689 Goldberg, Dean DO 162 Goldberg, Karen MD 571 Goldberg, Lawrence MD 409 Golden, Robert DC 359 Goldenberg, Neil MD 437 Goldman, Anthony MD 105 Goldman, Stephen MD 311 Goldsmith, Scott MD 235 Goldsmith, Stuart MD 235 Goldstein, Alexander DDS 137, 375 Goldstein, Stacey OD 220, 299 Golfview Healthcare Center 637 Golino, Alessandro MD 307 Gollob, Harrison DDS 467 Golomb, Alyson DMD 468 Gomara, Denise DDS 85, 91, 468 Gomez Cordoba, Gerardo MD 11 Gomez, Ana PsyD 578 Gomez, Christina MD 334 Gomez, Daniel MD 197 Gomez, Danielle MD 21, 243, 434 Gomez, Ivette OT 730 Gomez-Luengas, Alexander MD 40 Gondi, Avantica MD 66 Gondor, Magdalen MD 440, 513 Gonter, Paul MD 531 Gonzales Portillo, Gabriel MD 186

Gonzales, Eusebio MD 543 Gonzalez Abello, Lisa MD 81 Gonzalez Soldevilla, Hilda SLP 734 Gonzalez, Alberto MD 274 Gonzalez, Evguenia DPM 544 Gonzalez, Francelis MD 75 Gonzalez, Heidi OD 220 Gonzalez, Javier MD 238, 239, 303, 429, 509, 540 Gonzalez, Joanna PA 657, 689 Gonzalez, Lisset DDS 468 Gonzalez, Maribel ARNP 738 Gonzalez, William DMD 254 Gonzalez, Yanela DMD 137, 375 Gonzalezabella, Beatriz MD 113 Gonzalez-Abello, Lisa MD 81 Gonzalvo, John DO 162 Gooch, Clifton MD 184 Good Health Pharmacy 750, 777, 778 Good Samaritan Pharmacy 771 Good Shepherd Hospice Inc 609, 641, 642 Gooden, Natasha MD 190, 333 Goodman, Jamie DC 360 Goodman, Jerry MD 533 Goodwin, Aaron DMD 468 Gordillo, Manuel MD 529 Gordon, Jessica ARNP 676 Gottipati, Padmalatha DDS 322 Gowda, Umesh MD 105, 106 Gowing, Roy DC 360 Gozdanovic, Suzanne MD 385 Grabow, Harry MD 409, 536 Grace Healthcare of Lake Wales 643 Grace RX Pharmacy 750 Grace, David MD 31 Grace, Willie DDS 322 Gracewood Rehabilitation 637 Graddy, Nathan DDS 322 Graff, Sara LCSW 585 Graham, Adria PA 675, 693, 715, 740 Graham, Ben OD 417 Graham, Thomas MD 457 Grana, Erick MD 237 Grana, Jamira SLP 680

www.wellcare.com/Florida | 861

Grana, Nanette MD 246, 437, 512, 541 Granger, Sally ARNP 665 Granger, Steven MD 190 Grant, Stewart MD 21, 22, 75 Grappin, Carl DC 521 Grappin, Linda DC 522 Grauer, Leopoldo MD 123 Gray, Lelia ARNP 732 Greater Tampa At Home Pd 614 Green, April ARNP 656 Green, Deanna MD 440 Green, George DDS 137, 375 Green, Lisa ARNP 676 Greenberg, Andrew DDS 138, 282, 322, 375, 468, 524 Greenberg, Harvey MD 267 Greenberg, Mark MD 187 Greenberg, Steven MD 190, 333 Green-Blair, Jean ARNP 649 Greenbriar Nursing & Rehab 625 Greene, Brittany PA 705 Greene, Graham MD 519 Greene, Kristie MD 197 Greenfield, Adam DO 35 Greenfield, Ashley PA 690 Greenfield, David MD 547 Greenfield, Steven MD 30, 278 Greengold, Julian MD 44 Greenidge, Kevin MD 409, 410 Greenwood, Kenneth MD 603 Greer, Lucia DDS 138 Gres, Stephen OD 220 Gress, Samantha SLP 694 Grier, Carrol DDS 322 Griffen, Michael DO 40 Griffin, Denise MD 184 Griffin, Vivian MD 346 Griffith, James MD 80 Griggs, Adam DO 517 Grimes, Amy PA 652, 732 Grimm, Mariann LMFT 588 Grimmel, Stanley DC 360 Griner, Kimberly CNM 697, 709 Grinnell, Michelle CNM 663 Groden, Lewis MD 212 Grogan, Dennis MD 235 Gross, Andrew DO 45

PROVIDER INDEX G - cont. Gross, Francine MD 81 Grover, Alpana MD 40 Grubbs, Gerald MD 547 Gruszka, Melinda OD 417, 418 Gstalder, Roger MD 212 Gu, Qin MD 332 Guardian Medical Inc 646 Guardian Pharmacy 771 Guarnieri, Sam DDS 469 Guastavino, Ella MD 81 Gubernick, Samuel DO 349 Guerette, Nathan ARNP 668 Guerra Arias, Laura ARNP 662 Guerra, David MD 94 Guerra, Lucy MD 14 Guerra, William DDS 138 Guerrero Arias, Nestor MD 38 Guerrier, Kris MD 518 Guggino, Giacomo MD 212 Guichard, Raphael MD 403 Guida, Meghan PT 677, 693 Gulati, Rachna MD 82 Gulf Breeze Dialysis Center 634 Gulf Coast Jewish Family and Community S 587 Gulf Coast Kidney Center 627 Gulf Coast Kidney Center-NPR 627 Gulf Coast Orthotics Prosthetics Center 646 Gulf Coast Surgery Center-HCA Columbia 623 Gulf Gate Pharmacy 782 Gulf View Medical and Urgent Care Inc 630 Gulfport Pharmacy 771 Gulfport Rehabilitation Center 637 Gulfside Hospice and Pasco Palliative Ca 628 Gupta, Amitabh MD 445 Gupta, Ashwani MD 396 Gupta, Eva MD 166, 179 Gupta, Monesha MD 443 Gupta, Sneh MD 328 Gupta, Sunil MD 311, 454 Gursky, Beverly ARNP 715, 740 Gussin, Lisa LMHC 737 Gutierrez Jaramillo, Mavel MD 247

Gutierrez, Michael MD Gutu, Elena DMD Guzman, Andrew MD Guzman, Ulises DDS Guzman-Villar, Brenda MD Gyles, Richard DDS

457 376 30 233 516 255

H Habana Health Care Center 620 Haddox, Linda MD 489 Haffner, George OD 220 Hagan, Teri MD 55 Hager, Kristina LMHC 563 Haggerty, Megan DMD 138, 139 Hahn, Gregory MD 440 Haider, Kamal MD 483 Haight, Daniel MD 481 Haight, Tish ARNP 741 Haines City Health Care Center 643 Haines City Hma Urgent Care LLC 644 Hairston, Richard MD 410 Hakki, A MD 347, 452 Halder, Ranjay MD 576, 602 Hale, Gregory MD 437 Hale, Jonathan DDS 322 Halim, Tariq MD 559, 577 Hall, Jonathan MD 398 Hall, Joshua DMD 139, 282, 322, 376, 524 Hall, Kathryn ARNP 738 Hall, Lois ARNP 661 Hall, Sandra LMHC 585 Hall, Todd MD 508 Halliday, Megan OT 685 Halpern, David MD 166 Halttunen, Arthur DDS 376 Ham Ying, John MD 68 Ham, Michael MD 396 Hamblen, Terry DMD 139 Hamill Jr, John MD 316 Hamilton, Christopher OD 500 Hamilton, Richard MD 94, 336, 495 Hamor, Marianne SLP 680 Han, John MD 169 Handza, Jason DO 336 Hangauer, Jason PHD 572, 597

www.wellcare.com/Florida | 862

Hanger Clinic 609, 619, 624, 628, 635, 636, 642, 647 Hanna, Maher MD 14, 38 Hanna, Mina DMD 376 Hannah-Jones, Kimberly DMD 140 Hannum, Scott DO 520 Hanson, Amanda PsyD 572 Hanson, Tina PT 733 Hanusa, James MD 31 Harandi, Amir MD 288, 527 Harbison, Kimberly ARNP 683 Harbor Behavioral Health Care 764 Harbor Chase of Venice 647 Harbourwood Health & Rehab Center 637 Harcup, Craig MD 545 Hardiman, James MD 14 Hardin, Joel MD 239, 342, 429, 430 Hardy-Hunter, Eleanine MD 197 Hariachar, Srinivas MD 331 Harmony Home Health LLC 616, 635 Harper, Jennifer MD 334 Harper, William PA 658 Harrell, Laurie DDS 515 Harrington, Michael MD 260 Harris, Meghan MD 329 Harris, Michael MD 123 Harrison, Eric MD 106 Harrison, Krystin MD 75 Hart, Dennis MD 445 Hart, Hugo MD 479 Hart, Katelyn ARNP 706 Hart, Katherine SLP 742 Hart, Marlene MD 582 Hart, Stuart MD 197 Hartlage, Kiersten MD 56 Hartman, Eric MD 516 Hartney, Kimberly MD 571 Harwood-Warndahl, Debra ARNP 662 Hasan, Syed MD 38 Hasell, Douglass MD 40 Hashem, Tiffany MD 45 Hasija, Nalini MD 167 Haslup, Forrest MD 162 Hassan, Mahmoud LMHC 563 Hatcher, Tammy ARNP 726

PROVIDER INDEX H - cont. Hauber, Frederick MD 336 Haubner, Laura MD 181 Hauser, Robert Alan MD 184 Havana LTC Pharmacy Inc 750 Havens, Alicia OD 338 Hawthorne Health And Rehab of Brandon 620 Hawthorne Health and Rehab of Sarasota 647 Hawthorne, Robert DC 522 Haydon, Devon MD 398 Hayes, Christopher DC 360 Hayes, Lisa DO 40 Haynes, Bettina ARNP 676 HC Pharmacy 778 Healing Educational Alternatives For Des 565 Health Pro Pharmacy 750 Healthcite Pharmacy 782 Healthlink Pharmacy 751 Healthmed Pharmacy 771 Healthnow Pharmacy 771 Healthnow Urgent Care LLC 639 Healthsouth Hospitals 556, 558 Healthsouth Surg Center of Braden 623 Healthsouth Surg Center of Saras 645 Healthwise Pharmacy Inc 751 Healthy Services of Tampa Inc 617 Heaps, Eric OD 220 Heart of Florida Reg Med Center 557 Heart, Rami DO 92, 172, 482 Heartland Health Care Sarasota 647 Heartland of Zephyrhills 629 Heartland Pharmacy 744, 745 Heartland Pharmacy Lake Placid 745 Heather Hill Nursing Home-Pcs 629 Hechtman, Jason MD 162 Hechtman, Jill MD 197, 198, 489, 490 Hector, Richard MD 212, 296, 536 Hedges Healthmart Pharmacy 782 Heiman, David MD 123 Hein, Andrew DO 2

Heinrichs, Richard MD 80 Helfand, Janet PHD 578 Helmy, George DDS 376 Hemsath, Randolph PsyD 592 Henderson Sr, Gregory MD 212 Hendon, Marvin PHD 604 Hendren, Beatrice ARNP 700 Hendren, Debra ARNP 700 Hendry, Jill CNM 728 Henke, Robyn SLP 680, 694, 719 Henne, Kevin OD 500 Henne, Melinda MD 198 Hennes, Bryan ARNP 706 Henning, Trish LCSW 580, 585 Henry, Myrtle ARNP 737 Hensley, Scott DC 114 Herbert, Carrie MD 430 Heric, Blaine MD 452 Heritage Health Care Center 647 Heritage Park Care & Rehabilitation Cent 625 Heritage Park Health and Rehabilitation 629 Hermans, Howard MD 287 Hernandez Montalvo, Myriam MD 514 Hernandez, Ana MD 1 Hernandez, Cecilio MD 182 Hernandez, Celia DDS 140 Hernandez, David MD 272 Hernandez, Felix MD 353 Hernandez, Gredell DDS 140 Hernandez, Lazaro MD 198 Hernandez, Madeline OD 221, 338, 418 Hernandez, Martha PA 686 Hernandez, Sheridan MD 40 Herndon, David DO 35 Heron, Delisa MD 35, 36 Herrera, Cesar MD 12, 68 Herrero, Vivian MD 56 Herrin, Eric DPM 261 Herriott, Michael OD 339, 418 Herron, Jessica ARNP 582 Herrygers, Canaan MD 33 Herweg, Bengt MD 101, 106 Hess, Alfred MD 235

www.wellcare.com/Florida | 863

Hetherington, Mark OD 221, 339, 418, 419 Heuberger, David PT 677 Heymann, William MD 80 Heysek, Randy MD 267, 518 Hiben, Eugene MD 22 Hickok, Rebecca ARNP 696 Hicks, Mary MD 22, 56 Hidalgo, Carlos MD 56 Hidalgo, Janet OD 221, 222 Higgins, Michael DO 341 Highland Pines Rehab Center 637 Highlands Pharmacy 745 Highlands Regional Medical 552 Highshaw, Ralph MD 347, 348 Hill, Nathan MD 508 Hill, Taryn MD 443 Hill, Washington MD 533 Hillesheim, Angela ARNP 738 Hillsboro Specialty Pharmacy Blood Prss 751 Hillsborough River Pharmacy Inc 751 Hinson Knipple, Lindsay MD 190 Hirsch, Kevin MD 287 Hlalah, Osama MD 481 Ho, Janie MD 212, 410 Ho, Thanh OD 419 Ho, Thao DO 181 Ho, Vu Tran MD 389 Hoang, Jessie MD 443, 543 Hochberg, Lauri MD 198 Hoche, Nay MD 335 Hochman, Lawrence MD 346 Hodes, Ashley MD 162 Hodge Jr, Gameel Byron MD 519 Hodges, Richard MD 162 Hodill, Dylan PA 663 Hoefferle, Claudia PA 683 Hogue, Nicole ARNP 656 Holcomb, Lisa ARNP 725 Holiday Pharmacy Inc 751 Holland, Ann DPM 516 Holland, Cynthia LCSW 585 Hollen, Tyler MD 306, 546 Hollifield, Cheryl ARNP 738 Hollstrom II, Gregory DC 360 Hollstrom, Gregory DC 360

PROVIDER INDEX H - cont. Hollywood, Amanda LMHC 652 Holmstrom, Shelly MD 198, 199 Holstrom, Shelly MD 199 Holt, Douglas MD 14, 169 Holt, Jayne MD 33 Holzman, William DDS 469 Homayouni, Siavash DDS 322 Home Health Care 606 Honculada, Allan MD 508 Honeyblue, Shamika OD 222, 339, 419 Hoots, Glenn MD 268 Hoover, Dennis MD 251, 442, 514, 542 Hoover, Kurt PHD 572 Hoover, Sabina OD 500 Hopman, Rusudan MD 389 Hopson, Derek PHD 578 Horne, Leslie DC 315 Horner, Kelsey ARNP 715 Horng, Betty PHD 592 Horrell, Cindy Jo ARNP 726 Horton-Bender, Kimberly DC 360 Horvat, Nevenka MD 82 Hospice of The Florida Suncoast Inc 635 Hostler, T Richard MD 485 Hou, Peng MD 484 Hough, Bruce MD 166 Houin, Paul MD 250, 513 Houin, Satya MD 181 Hoveround Corporation 623, 646 Howard III, Fred MD 479 Howard, Arthur MD 533 Howard, Belisa DMD 469 Howard, Daniel DPM 544 Howe, Douglas DDS 322 Howell, Dina DDS 140 Howie, Flora MD 589 Hoy, Jeffrey MD 172 Hoyes Pharmacy 751 Hp Pharmacy 771 Hph Hospice 628 Hua, Yang DDS 469 Hubbard, Helene MD 576, 602 Hudkins, Emily PHD 572, 597 Hudson Drugs 751

Hudson Pharmacy 764 Hudson, Tamika ARNP 705 Huertas, Erica LMHC 661 Huggett, Edward OD 339, 419 Hughes, Jennifer PA 734 Hughes, Natasha MD 40, 56 Hughes, Teena MD 22 Huguet, Kevin MD 385 Huhta, James MD 239, 342, 430, 510, 540 Hulbert, Nelson DPM 84, 87 Hulett Johnson, Lesley PsyD 578 Hull, Kimberly SLP 680 Hulse III, Ronald MD 106, 172 Hummon, Ivy CNM 738 Humphrey, Chelsey SLP 687 Humphrey, Deborah DO 172 Hunter, Keri PA 708 Hunter, Lara PA 675, 715 Hurst, Rebecca MD 185 Hurwitz, Kenneth MD 545 Hussain, Sayyed MD 165 Hussein, Mohammad MD 167 Hussein, Qaali MD 287 Hussey, Karen ARNP 673 Hussey, Kelly PA 663 Huszar, Peter MD 358 Huynh, Bao-Chau MD 484

Indermaur, Megan MD 387, 403 Ingham, Richard OD 299, 419 Ingram, Jennifer LMHC 585 Ingulli, Lamar PsyD 573 Integrated Therapy Alliance 628 Integrity Health Services 617 Integrity Prosthetics and Orthotics LLC 642 Iqbal, Saima MD 182 Iqbal, Shahid MD 100 Irani, Jennifer MD 190, 333 Irani, Sarah MD 441 Irby, Rachel MD 169 Irizarry, Karina MD 245, 435, 512 Irwin, James MD 101 Isaac, Isaac MD 573 Isenberg, Mark DPM 446 Ismail, Esaam OD 299, 500 Ismail, Imran DO 482 Ismail, Sajid DO 92, 162, 479, 480 Ison, Alexander DC 456 Ison, Scottie DC 456 Issar, Jeetendra MD 70, 75 Issar, Rekha MD 70 Ivanov, Maria SLP 694 Ivsic, Tomislav MD 510 Iyer, Ananth MD 387, 394 Iyer, Pallavi MD 434 Iyer, Priyanka DDS 255 I Iyunni, Venkata MD 366 Icaza, Elisa ARNP 707 Izsak, Eliezer MD 460 Icely, Suzanne MD 400 Izzo, Edward MD 272 Idel Pharmacy 751 Iezzi, Alan MD 8 J Igel, G MD 403 J S RX Pharmacy 751 Ignacio, Joseph MD 245, 435, 512 Jacinto, Sergio MD 113 Ignatius, Renjitha MD 179 Jackman, Suzanne MD 434 IHS- At Riverfront 625 Jacks Pharmacy 764 Ilercil, Arzu MD 113 Jackson, Anthony DDS 141 Illig, Karl MD 274 Jackson, Darwin MD Imed Pharmacy 751 199, 403, 490, 533 Immadi, Lakshmi DDS Jackson-Curtis, Danuta MD 56 140, 141, 322, 376 Jacob, Binu MD 311 Impower Inc 581, 583, 594, 598 Jacob, Blessy MD 527, 528 Imudia, Anthony MD Jacob, John MD 79 199, 269, 335, 347 Jacob, Nirmala MD 70 Inaba, Caroline DDS 141, 376 Jacob, Pothen MD 366 Independent Living Inc 618, 619 Jacob, Viola MD 70

www.wellcare.com/Florida | 864

PROVIDER INDEX J - cont. Jacobs, Jeffery MD 242, 433 Jacobs, John MD 123 Jacoby, Leonard OD 299 Jacovino, Crystal DO 120 Jafarnia, Bahareh DDS 255, 256, 343 Jain, Surbhi MD 187, 332 Jakubiec, Jacqueline DMD 142 Jallo, George MD 399 James, Eric MD 235 Jamison, Richard MD 403, 533 Janicka, Ania DO 318, 363 Jara, Audrey MD 40 Jaramillo, Kate LMFT 582 Jares Pharmacy 745 Jasa, Luis MD 577 Jassal, Navdeep MD 260, 344 Jauch, Werner MD 311 Javate, Emanuel MD 403, 404 Javeed, Najam MD 311 Jawitz, Jack MD 277 Jayakody, Himali MD 359 Jean Baptiste, Stephanie DO 404 Jean Francois Benoit, Gladys MD 68 Jean Pierre, P Jacques MD 480 Jean, Gerda OT 649 Jeffery, Thomas ARNP 590 Jeffords, Jamie ARNP 663 Jeffries, Susan ARNP 700, 701 Jenkins, James DDS 524 Jenkins, Julia MD 365 Jenkins, Tawana DDS 142 Jennings, Jessica MD 22 Jennings, John DC 360 Jensen, Stephen DDS 322, 377 Jensen, Summer OT 713 Jerez, Diana MD 237 Jester, Adam MD 235, 236, 508 Jewish Family and Childrens Svcs 601 Jeyabarath, Ananthi MD 172 Jimenez Arocho, Emilio MD 68 Jimenez Sanders, Rebecca MD 185 Jimenez, Baltasar DDS 524 Jimenez, Raul MD 309, 311 Jindal, Mayuri MD 56 Jingtao, Chen ARNP 659 Jk Care Pharmacy 771

Jngilles, Josie MD 33 John Knox Med Center 620 John, Jonathan MD 239, 303, 430, 510, 540 John, Thomas MD 319 John, Tobin MD 36 Johns Hopkins All Childrens Hospital Inc 553, 554, 555, 556, 557, 558 Johnson II, Howard MD 199 Johnson, Alex MD 353 Johnson, Amy CNM 709, 711 Johnson, Brad MD 274 Johnson, Brandi DPM 262 Johnson, Douglas OD 419 Johnson, Jonathan DDS 142, 469 Johnson, Laura ARNP 662 Johnson, Lee Diahn SLP 742 Johnson, Megan DPM 447 Johnson, Michele ARNP 715 Johnson, Michele MD 490 Johnson, Skyler PA 690 Johnson-Milas, Audrey DO 57 Johnson-Towson, Michele MD 22 Jones Jr, David MD 394 Jones, Allyson MD 190, 191 Jones, Anne PsyD 578 Jones, Brandt DO 274 Jones, Courtney ARNP 732 Jones, Douglas OD 222, 299, 339, 419 Jones, Emily ARNP 711 Jones, Galen MD 191, 333 Jones, Jennifer ARNP 737 Jones, Joni DPM 97 Jones, Karl MD 590 Jones, Kurt MD 490 Jones, Malcolm MD 199, 404, 490, 533 Jones, Nathan DC 114 Jones, Phillip MD 89 Jones, Roderick DC 360 Jones, Tracy ARNP 663 Jonesjennings, Ivory PT 677 Jooma, Nurruddin MD 389 Joplin, Tennille SLP 680 Jordan, Cassandra LCSW 566, 582, 588

www.wellcare.com/Florida | 865

Jordan, Michael MD 40, 57 Jordan, Rosalind ARNP 701 Jorgensen, Ellen Verena MD 243 Joseph, Hazina ARNP 660 Joseph, Oji MD 454 Joshi, Neha OD 299 Joshi, Shailesh MD 5 Jothivijayarani, A MD 292, 533 Jothivijayarani, Arunachal MD 278, 292 Jothivijayarani, Arunachalam MD 278, 292 Jourdan, Myriam DMD 142, 143 Joy, Juan MD 485 Jrx Pharmacy 751 Js Pharmacy 764 Jubiz, Giovanni MD 404 Junagadhwalla, Mehnaz MD 531 Jung, Gina SLP 681 Juricic, Marilyn MD 79 Jurusz, Daniel MD 163 K K M Drugs 745, 778 Kabs Pharmacy 751 Kahlon, Devendra MD 460 Kahlon, Harpreet MD 75 Kahn, Randy MD 267 Kaif, Mohamed MD 123 Kaiser, Greg MD 245, 435, 436, 512, 541 Kakavand, Bahram MD 510 Kaleky, Benjamin Had 616 Kales, Lawrence DPM 345 Kalidas, Kavita MD 185 Kallins, Marc MD 305 Kalra, Lalit MD 391 Kalter, Craig MD 176, 177, 394, 483 Kamat, Amit DDS 469 Kamat, Shrinath MD 185 Kamath, Geetha MD 387, 394, 395 Kamath, Maya MD 199, 200 Kaminski, Jessica PT 687 Kamisetty, Sudarsan MD 22 Kamnik, Ronald MD 603 Kampsen, Edward MD 119 Kan, Elena DDS 121, 365 Kan, Peter Tze Man MD 187

PROVIDER INDEX K - cont. Kanach, Paul DMD 143, 282, 283, 322, 377, 524 Kanarek, Mark MD 22 Kane, Susan PT 733 Kanfer, Steven MD 568, 571 Kanicky, Jee OD 222, 299 Kanicky, Luc OD 222, 299 Kanner, Leah DMD 144 Kapadia, Mukesh DDS 144 Kaplan, Kerry MD 312 Kaplan, Stanley DPM 262 Karapasha, Christopher DDS 323 Karjoo, Sara MD 436, 541 Karkare, Rajendra MD 48 Karl, Tom MD 452 Karniski, Walt MD 252 Karr, Jeffrey DPM 516 Karthik, Aneetha DDS 144 Kasem, Shovon DDS 469 Kashlan, Ghiath MD 38 Kasiewicz, James MD 287 Kasper, Jeffrey MD 212, 296, 410, 536 Kassed, Marvin LMHC 580 Kassira, Noor MD 250, 251 Kasten, Camille ARNP 649 Kasten, Robert PA 684 Kaszuba, Francis MD 265 Kaszuba, Robert MD 48 Katsur, Justin DDS 144, 283, 323, 377, 470, 524 Kattan, Halide MD 70, 71 Katz, Michael DPM 545 Kaufman, Deborah LCSW 600 Kaufman, Seth DO 508 Kaufmann, Barry MD 163 Kay Pharmacy 751 Kay Pharmacy 003 778 Kay, Richard MD 36 Kay, Walter DO 45 Kayali, Fadi MD 288, 528 Kays, David MD 441 Kazmi, Ishrat MD 22, 76 KCI USA Inc 615 Kear, Mavra ARNP 597 Keefe, David MD 200 Keene, Jamie ARNP 711, 712

Kelleher, Erin MD 443 Kelleher, Margaret MD 362 Kelley, Sarah MD 57 Kellogg, David DDS 121 Kelly, Christopher PA 701 Kelly, Pamela ARNP 668 Kelsey, Ashley PA 673 Kendrick, Elizabeth CNM 655 Kenilworth Care and Rehabilitation Center 610 Kennel Besselieu, Allison ARNP 716 Kensington Manor 647 Kent, David LCSW 594 Kenton Haney, Julianne MD 533 Keo, Phanith DMD 283 Kepes, Kathryn MD 267 Kepto, Joyce CNM 697, 709 Kernaghan, Kelly SLP 694 Kero, Shawkat MD 124 Kerr, Jody MD 246, 437, 512, 541 Kerr, Thomas MD 274 Kerwin, Joan LMHC 585 Keshishian, Jessica MD 57 Kessler Posgai, Dorothy ARNP 708 Kethireddy, Ravi MD 353 Khadim, Ghazanfar MD 106, 172, 173, 312, 329, 454, 482 Khamare, Chetan MD 312 Khamisani, Saleem MD 398 Khan, Azima MD 82 Khan, Faisal MD 271 Khan, Kashan MD 66 Khan, Maria MD 76 Khan, Nadeem MD 170 Khan, Nasim MD 94 Khan, Tehreen MD 106 Khan, Wali MD 312 Khant, Ranchhod MD 107 Khara, Jaswinder MD 486 Kharbanda, Monica MD 57 Khator, Pooja MD 296, 536 Khin, U MD 38 Khodr, Bilal MD 76 Khoury, Joseph MD 236 Khulpateea, Beman MD 200 Khurana Radiology MD PA 609 Khurana, Sunaina MD 4 Kiani, Kamran DMD 144, 377

www.wellcare.com/Florida | 866

Kidd, Jamie ARNP 676 Kiellach, Jennifer OT 739 Kienzle, Jeffrey PA 741 Kilaru, Anusha MD 22, 23 Kilbride, Pamela MD 23, 57 Kiluk, Vinita MD 23 Kim, Dennis MD 349 Kim, Jennifer MD 57, 58 Kimbrell, Brian MD 287 King III, Joseph MD 335 King Pharmacy 751 King Pharmacy Compounding LLC 771 King, Kelly MD 14, 48 King, Michael MD 187, 291 King, Nadine ARNP 736 King, Vanessa MD 490 Kinkead, Laura DC 315 Kin-Ship Services Inc 575 Kirby, Shana MD 573 Kirchberg, Cynthia OT 685 Kiriluk, Randy MD 36 Kirkland, Mary SLP 734 Kirkpatrick Justice, Kimberly PsyD 597 Kirmani, Najib MD 583, 596 Kirsch, Leonard MD 410, 411 Kishun Jit, Nirmala MD 31 Kiss, Alexander MD 332 Kitterman, Christopher DO 58, 443 Klauber-Choephel, Enid MD 170 Klein, Howard MD 366 Klein, Ian DPM 447 Klein, Jay MD 58 Klein, Jesse DO 353 Kleine, Josef MD 76 Klibanoff, Alan MD 367 Klonaris, John MD 353 Klutke, Carl MD 548 Knapp, Don MD 411 Knight, Amelia ARNP 651, 723 Knight, Carrie PT 651 Knight, Randolph MD 341 Knipe, Richard MD 387, 395 Knobl, Thomas ARNP 690 Knobloch, Jacquelyn SLP 694 Knop, Karen LCSW 586 Knox, Brian MD 14, 23

PROVIDER INDEX K - cont. Kober, Terry PA 716 Koehler, Kevin MD 528 Koehler, Nicholas MD 237 Koehn, Ryan PA 689 Kohl, David MD 353, 354 Kohn, Heather DDS 144, 377 Kokemohr, Deann PT 718 Kokolis, Rodamanthos MD 354 Kolanko, Przemyslaw MD 8 Koliha, Melissa PA 681 Kolligian, Mark MD 251, 252, 343, 442, 514, 542 Kondabala, Rajani MD 33 Konka, Anita MD 119 Konynenbelt, Benjamin OD 420 Konynenbelt, Jessie OD 420 Kopynets, Viktor DDS 144, 377 Korabathina, Ravikiran MD 354 Korbaj, Rabee MD 49 Koren, Daniel DMD 470 Korivi, Praveen MD 8 Kornfeld, Stephen MD 350 Kortright, Luis MD 249 Koshy, Mary MD 307, 546 Koslacz Kolanko, Elzbieta MD 122 Kosoff, Peter MD 23 Kotolski, Amanda OT 713 Kouka, Nabeel DO 30 Kovach, Todd MD 354 Koval, John MD 268 Kozhimala, John MD 38, 319 Kozlov, Nicholas MD 367 Krackov, Warren MD 269, 450 Kramer, Leni MD 269 Krasnov, Rostislav DDS 145, 377 Krawetz, Leo DPM 262 Kraynak, Jodi PT 718 Kreifels, Kacie OD 420 Kreitzer, Stephen MD 265 Krinsky, Andrew MD 529 Krippendorf, Donald DC 360 Kriseman, Anthony MD 440, 513 Krishnadas, Praveen MD 6, 76 Krishnamurthy, Ashok MD 276 Krolick, Merrill DO 393 Kroll, Linda LCSW 575 Krueger, Leroy PA 683

Krumbholz, Gerald OD 222 Kuan, Sujey OD 420 Kuchmak, Olga MD 289, 290 Kudryk, John OD 339 Kuebel, Joseph MD 404 Kuebler, Elizabeth CNM 655 Kulkarni, Gajanan MD 328 Kumar, Alok MD 345 Kumar, Kapisthalam MD 328 Kumar, Mudra MD 23 Kumar, Siva MD 107 Kumar, Sujata MD 87, 97, 514, 515 Kumar-Pelayo, Meghna MD 398 Kundlas, Kulmeet MD 71 Kundra, Navnit MD 448 Kunhardt, Rene MD 312, 354 Kunins, Craig MD 589, 590 Kuntsmann, Vivian DDS 145, 377 Kurakula, Satya MD 8 Kuriakose, Kevin MD 250, 513 Kurtsikidze, Nino MD 49 Kurtyka, Donald ARNP 661 Kurtz, Molly SLP 719 Kussel, Ferdinand DPM 447 Kussel, Fred DPM 262 Kwazneski, Douglas MD 326 L LA Camera, Richard MD 367 LA Rosa, Robb OD 222, 223, 300 Labovitz, Arthur MD 107 Lackey II, Thomas DO 92 Lacorte, Michael MD 239, 240, 430, 510, 540 Lacson, J Agustin MD 92 Laddu, Prashanta MD 454, 455 Ladines, Cecilia MD 33 Laffer, Dennis MD 124 Lafontant, Anne MD 12, 68 Lajos, Laura PHD 578 Lake Placid Health and Rehabilitation C 610 Lake Seminole Pharmacy 771 Lake Vista Dialysis 640 Lake Wales Dialysis 640 Lake Wales Medical Center 557 Lake Wales Medical Centers Inc 643

www.wellcare.com/Florida | 867

Lake Wales Pharmacy 778 Lakeland Dialysis 640 Lakeland Family Pharmacy 778 Lakeland Florida Endodba Surgery Center of Lake 640 Lakeland Hills Center 643 Lakeland Nursing And Rehabilitation 643 Lakeland Red Med Center Publix Ph 778 Lakeland Reg Medical Center 557 Lakeland South Dialysis 640 Lakeside Oaks Care Center 637 Lakewood Ranch Medical Center 554 Lakewood Ranch Pharmacy 761 Lakshmi, Seetha MD 170 Lall, Rajesh MD 312, 455 Lam, David MD 316, 362 Lam, Yim MD 58, 59 Lama, Colleen SLP 681, 694 Lama, Maximo MD 517 Lamartin, Kimberly MD 14 Lamb, Cheryl LCSW 566 Lambert, Alexandra ARNP 686 Lambert, John LCSW 586 Lamke, Kimberly OT 673, 692 Lamoreaux, David MD 508 Lamoutte, Carlos MD 200 Lamperts Home Therapy Inc. 636 Land O Lakes Pharmacy 765 Landis-Nussbaum, Debbie CNM 708, 712 Landy, Jennifer MD 411 Lane, Jennifer ARNP 691 Lane, Kim OT 730 Langley, Charlotta MD 33 Langley, Stephen MD 242 Langone, Marie ARNP 737 Langston, Andrew DMD 233 Lapierre, Lindsay PA 706 Laplume, Jeffery OD 420 Lapolla, James MD 404 Lappano, Alfred OD 223, 339, 420 Lapresti, Lisa DMD 543 Laracuente, Minedy ARNP 727 Largo Medical Center 556

PROVIDER INDEX L - cont. Largo Medical Center Indian Rocks 556 Largo Medical Center-Sleep Center 638 Largo Rehab and Spa 637 Largo Surgery LLC DBA West Bay Surgery C 631 Larkin, Brandon DDS 444 Larkin, Julie MD 529 Larranaga, Jorge MD 484, 485 Larson, Danelle ARNP 649 Larussa, Suzette OT 673 Lasanta, Denisse DMD 256 Lascaibar, Albert OD 300 Lasebny, Deborah ARNP 577 Late Hours Urgent Care Center 622 Latt, Khin MD 71 Lau, Tsz MD 486 Laurellwood Nursing Center 637 Lautersztain, Julio MD 179 Lavalley, Robin CNM 712 Law, Trevor MD 354 Lawrence, David MD 240, 342, 431, 540 Lawrence, Elizabeth MD 45 Lawrence, James OD 223 Lawson, Tracie ARNP 673 Lawton Chiles Childfamily Health Center 761 Lazar, Adam DDS 470 Le, Hoang PT 678 Le, Nhu DDS 470 Le, Nhu DMD 470 Le, Sharon SLP 719 Le, Thanh MD 427, 445 Le, Thanh Xuan ARNP 663 Le, Yen MD 543 Leach, Christi MD 573 Leal, Jennifer ARNP 693, 716 Leanes, Mary LMHC 586 Leche, Carlos MD 107 Leclercq, Baudouin MD 173, 182 Ledford, Dennis MD 100 Lee, Lauri PT 718 Lee, Sara DMD 256, 444, 543 Leek, Joshua PA 720, 721 Lee-Loy, Ingrid DDS 145, 323

Leffers, David MD 236 Lefler, James MD 186, 269 Lefler, Linda MD 590 Leibmann, Susan MD 573 Leiding, Jennifer MD 428 Leigh, Jennifer SLP 681 Leinbach, Mary ARNP 675, 731 Leitner, Mark DPM 262 Lemert, Robert MD 490 Lemon Bay Drugs East 782 Lemon Bay Drugs North 782 Lemus, Carmen MD 590 Lenard, Melanie ARNP 688, 696 Lense, Pedro DDS 377, 378 Lento, Paul MD 544 Lentz, Scott MD 163 Lenz, Anne MD 243 Lenz, Kristen LMHC 586 Leon, Ana DDS 145, 146 Leon, Marlen MD 496 Leong, Kenneth MD 287, 305 Lepore, Krystina DDS 146 Lester, Lawrence PT 718 Leto, Heather ARNP 678 Leto, Melissa PA 656 Letson Jr, William MD 548 Leung, Melanie DDS 470 Levenson, Jeffrey MD 391 Leverone, Andrew DC 360 Levin, Stephen DPM 262, 345 Levine, Jason MD 354 Levine, Larry DO 45 Levine, Paul MD 200, 490 Levine, Robert LCSW 600 Leviten, Daniel MD 76 Levitt, Laura MD 23 Levitt, Michael MD 212 Levitt, Stephan MD 362 Levoy, Craig MD 45 Levy, Erik PsyD 578 Levy-Clarke, Grace MD 212, 411 Lewenson, Robert OD 223, 300, 339, 420, 500 Lewis Jr, Bertram MD 348 Lewis, Andre DDS 305, 444 Lewis, Deborah LMHC 586 Lewis, John OD 300 Lewis, Michael MD 292

www.wellcare.com/Florida | 868

Lewis, Paul MD 45 Lewis, Rayna LMHC 563 Lewis, Richard DPM 97 Lewiscroswell, Jaclyn PsyD 573 Lewis-Croswell, Jaclyn PsyD 573 Lewis-Serag, Maha MD 45 Lexington Health & Rehab Ctrs 637 Lexow, Stephen MD 532 Leynes, Rebecca PA 656 Li, Albert MD 385 Liaros, Demetrios DPM 447 Lidge, Alecia PA 602, 687 Lieb, Gregory OD 223 Life Care Center of New Port Richey 629 Life Care Center of Winter Haven 643 Life Saverx, LLC 751 Lifepath Hospice Inc 617 Lifeshare Management Group LLC 565, 594 Lifton, Robin MD 528 Lilly, Carol Marie MD 23, 24 Lily Care Pharmacy 765 Lim, Donnabelle MD 4 Lin, Huang-Ta MD 312 Lin, Kathryn MD 40 Lin, Lang MD 393 Lin, Maria DO 292 Lin, Tsu-Hui MD 243, 541 Linares-Flor, Jesus MD 577, 603 Lincare Inc 627 Lincourt Assisted Living, Inc 771 Lincourt Pharmacy 771 Lingamallu, Ratnamani MD 457 Linsey, Dennis OD 339 Linville, Tiffany MD 541 Liptak, Amy ARNP 734 Lipton, Alexis MD 404 Lipton, Barry DDS 146, 283, 378 Liquete, Egbert MD 83, 290 Lirio, Stephanie MD 603 Lissone, Said PT 741 Litschauer, Sharon ARNP 662 Little Road Pharmacy 765 Liu, Shih MD 187 Livingston, Floyd MD 513, 518 LLC of Sarasota 625

PROVIDER INDEX L - cont. Llinas Messeguer, Jose MD 201 Lluch, Roberto MD 571 Lo, Percy MD 446 Lockett, Ricky DO 445 Lockett, Stephanie MD 571 Lockhart, Jorge MD 272 Lockwood, Charles MD 201 Loebell, James DPM 262 Logan, Melissa MD 385 Logeswaran, Prashanti MD 404 Logos Pharmacy 751 Lokesh, Haravu MD 40 Loman, Lusiana MD 318 Lombana-Cano, Edward DDS 470 Long, Lori OD 223, 300, 538 Long, Molly MD 404, 405 Longley, Maliena MD 100 Lopez Del Valle, Ramon MD 182 Lopez Dominguez, Maria MD 59 Lopez Molina, Norma MD 59 Lopez Troy, Jennifer MD 191 Lopez, Grace DMD 146, 378 Lopez, Kenia DDS 146 Lopez, Luis MD 124 Lopez, Magda PsyD 573 Lopez, Marianne LMHC 726 Lopez, Rafael MD 559, 602, 603 Lopez, Raphael MD 71 Lopez, Sergio DDS 146 Lopez, Sharon SLP 733 Lopez, Viviana OD 95, 223, 501 Lopez-Mccormack, Celia MD 59 Lopez-Molina, Norma MD 59, 60 Lopez-Rosa, Magda ARNP 669, 684, 728, 738 Lorenz, Kelly CNM 726 Lotito, Jillian ARNP 584 Louis, Judette MD 177, 201 Louis, Salwan DDS 146 Louisville, Tommy MD 4, 66, 460 Loutfi, Rabih MD 545 Loux, Tara MD 251 Love, Kelly ARNP 723 Lovell, Alice PHD 578 Lozan, Krystan PA 669 Lubbers, Maegan MD 490 Lubiner, Eric DO 528

Luce, Amy DMD 378 Lucero, Heather ARNP 686 Lucido, David DC 456 Lucio, James MD 517 Luckey, Lisa DO 367 Lugo, Francis DDS 146 Lukas, Claudia PA 715 Luna, Juan MD 60 Lunden, Judy PsyD 592 Lungren, Hillary DO 45 Lunin, Scott MD 528 Luong, Don MD 390 Lupo, Joseph MD 568, 571 Lustig, Alan MD 396 Lutz Pharmacy 751 Luu, Diane OD 538 Luu, Jessica OD 223, 224 Ly, Jean Marie MD 521 Lynch, Catherine MD 165 Lynn, Suzanne MD 163 Lyons, David MD 82, 543 Lytle, Sharon CNM 738 Lyublanovits, Deborah LMHC 563 M Macdill Pharmacy 751 Mace, Joseph MD 390 Machado, Francisco MD 15 Maciel, Maureen MD 236 Maciver, Patrick MD 573 Mack, Teresa LMHC 586 Mackie, Benjamin MD 107 Mackie, Michael OD 300 Madden, Sasha ARNP 693 Madow, Brian MD 212 Maduagwu, Okoroafor MD 68 Magazine, Joanna DMD 378 Magee, Michael MD 508 Magers, Deborah SLP 681 Magnolia Health and Rehabilitation Center 647 Magnolia Pharmacy 765 Mahajan, Neeraj MD 36 Mahan, Teresa ARNP 662 Mahbub, Farah MD 490 Mahdavieh, Sadaf DMD 146 Maheshwari, Akhil MD 181 Mai, Cuc MD 173

www.wellcare.com/Florida | 869

Mai, Jane MD 170, 328 Mail Meds Clinical Pharmacy 771 Main Street Pharmacy 771 Mak, Sheila DO 24 Makati, Kevin MD 107 Makdisi, George MD 163, 271 Makram, Christina DDS 256, 444 Malde, Elyse OD 300 Maldonado, Janice MD 185 Maldonado, Luis MD 24 Maldonado-Colon, Bermily MD 485 Mali, Joshua MD 213, 296, 297, 536 Malik, Chander DDS 525 Malik, Shahid MD 107 Maliot, Jerry MD 80 Mallett, Lesley ARNP 716 Mallick, Sobiah MD 201, 490 Mallozzi, Christopher ARNP 658 Malone, Donna DO 45, 46 Maloney, Karen MD 362, 433, 434 Mamel, Jay MD 124 Manasota Dialysis 645 Manaswi, Abhijit MD 508 Manatee County Rural Health Services,Inc 624 Manatee Diagnostic Center 623 Manatee Discount Pharmacy 761 Manatee Family Pharmacy 761 Manatee Memorial Hospital 554 Manatee Surgical Center Inc 623 Mandaliya, Naishadh MD 265 Mangal, Ajay MD 457 Mangat, Mona MD 350 Manibo, Lourdes Alexandra DDS 283 Manik, Apurba MD 3 Maningo, Evelyn MD 15 Maniscalco, Benedict MD 107, 173 Mankodi, Kshemal MD 36 Mann, Angela ARNP 678 Mann, Clare OD 224, 225, 300 Mann, Nicholas DMD 146, 283, 378 Mann, Stacy ARNP 663 Manor Care Health Services Venice 647 Manor Care of Carrollwood #443 620

PROVIDER INDEX M - cont. Manor Care of Palm Harbor #386 637 Manorcare Health Services Sarasota Bu 53 647 Mantel, David DDS 470, 471 Manuel, Margaux MD 533 Manzur, Kasim DDS 146, 378 Marcano, Zaida DDS 543 Marcelin, Jackie ARNP 654, 676 Marcell, Mike DC 360 Marcet, Jorge MD 116 Marchant, Kimberly ARNP 682 Marchioni Beery, Renee DO 124 Marcuccio, Elisa MD 431 Mardones, Osvaldo MD 31 Margolin, Jerry MD 363 Marin Jimenez, Laura DDS 471 Marinock, David DC 90 Marion, Alicia ARNP 674, 676 Marlowe, Andrew MD 522 Marmagkiolis, Konstantinos MD 329 Marmolejos Baez, Euclides MD 5 Marques, Vasco MD 108, 313 Marrero, Ailis MD 36 Marrero, Isis MD 573 Marrero, Zayra SLP 733 Marrotte, Richard OD 300, 301 Marrs, Chad MD 522 Marsalisi, Frank MD 405 Marsh Dinham, Keddie MD 335 Marsh, Nancy OT 739 Marsh, Naomi DPM 262 Marshall, Brenda ARNP 669 Marshall, Kristine DDS 147, 378 Marshall, Marta LMHC 563 Marshall, Michelle LMHC 600 Marshall-Accardi, Brenda ARNP 669 Marte, Idelfia MD 390 Marteli, Rosalia LMHC 662 Marti Bagfasarov, Anjelika DDS 471 Martin, Agustin MD 24 Martin, Andres MD 590 Martin, Linda LMHC 575 Martin, Reta LCSW 567 Martin, Samuel MD 520

Martinasek, Dushan MD 181 Martinez, Gustavo DMD 147, 378 Martinez, Juan MD 170, 391 Martinez, Luciano MD 201 Martinez, Luis MD 251 Martinez, Magela DMD 147, 283, 378, 525 Martinez, Rafael MD 265, 345 Martinez, Richard MD 240, 304, 342, 431, 510, 540 Martinez, Sofia ARNP 676 Martinez, Susana DDS 283 Martino-Villanueva, Maria MD 487, 491 Mashandure, Mercy ARNP 669, 684, 712, 728, 739 Mason, Andrea LMHC 586 Mason, Carol ARNP 654 Mason, John OD 420 Mason, Karen SLP 720 Mason, Stephanie MD 160 Massaro, Joseph DO 93 Massarotti, Haane MD 116 Masson Jr, John MD 448, 451 Masterman, Wendy MD 41 Matallana, Herman DO 457 Matar, Fadi MD 108 Matcha, Mrinalini MD 396 Mathan, Sukumar MD 71 Mathew, Ajay DO 182, 331 Mathew, Dilip MD 108, 521 Mathew, Jeena ARNP 727 Mathew, Jeff MD 348 Mathis, Karen PA 651 Matrix Home Care LLC 646 Matrix Medical LLC 615, 646 Matthews, Irina DMD 147, 378 Mattingly, Michelle PHD 573 Matzkowitz, Arthur MD 346 Mauch, James MD 316 Mauricio, Margaret DDS 323, 378 Mauriello, Daniel MD 431 Maxcare Pharmacy 765 Maxim Healthcare Services Inc 617, 635, 641 Maxxycom RX Pharmacy 752 May, Jonathan DPM 447 Mayer, Cynthia DO 170

www.wellcare.com/Florida | 870

Mayer, James MD 269 Mayer, Robert MD 591 Mayorca, June LMHC 586 Mays, Michele ARNP 684 Mazariegos, Stephanie DMD 147, 283, 284, 323, 379, 525 Mazzaferro, Lisa ARNP 706 Mbakwem, Alexander MD 71 McAfee, Khirstin DO 202 McAre Pharmacy 772 McBride, Paul DC 360 McCabe, Cathleen MD 297, 536 McCaffrey, Thomas MD 119 McCauley, Jodi ARNP 705, 712 McClenathan, Daniel MD 245, 342, 436, 512, 541 McClendon, Michele DO 485 McConnell, Jeremy MD 307 McCormack, Jorge MD 240, 342, 431, 432, 511, 540 McCormack, Leah ARNP 693, 716 McCormack, Maire PT 718 McCormick, John MD 24 McCoy, Brenton DO 49 McCray, Taricatory ARNP 678 McCrimmon, Barrie ARNP 690 McCullough, Cynthia CNM 709 McCutcheon, Mark DC 360 McDonald, Bobbielee PA 731 McDonald, Robert MD 532 McDowell, Ernest DMD 233, 234, 303, 427 McEndree, Terri MD 487, 491 McGeehan, Cornelius DC 360 McGinty, Susanne ARNP 669, 685, 712, 728, 739 McGrew, Lasandra LCSW 563 McGuire, Margaret MD 386 McHugh, Sara ARNP 716 McIlwain Cruse, Laura MD 270 McIlwain, Harris MD 269, 270 McKeithan, Kyra AUD 688 McKelvie Zeller, Jessica ARNP 686 McKenna, Daniel MD 241, 304, 432, 511, 540 McKenzie, Amy LMHC 661 McKenzie, Karen DDS 86, 91, 471 McKinley, Scott DO 440

PROVIDER INDEX M - cont. McKinnie, Cynthia ARNP 669, 685, 712, 729, 739 McKnight, Jaclyn OD 420 McLaughlin, Darlene ARNP 591 McLaughlin, Matthew DMD 323 McMorris Soucy, Sally CNM 655 McNair, Clarence DDS 323 McNeill, Thomas MD 400, 405 McPartland, Leslie ARNP 669, 670 McPhie, Ashley MD 24 Meabe, Mark PA 678 Mease Countryside Hospital 556, 587 Mease Hospital Dunedin 556 Med Specialist Imaging 633 Medalle, Gregorio MD 86 Medi Health Care Inc 641 Medica Scripts 752 Medical Arts Pharmacy 782 Medical Center of Trinity 555, 581 Medical Personnels Services Inc 617 Medical Systems of Central Florida Inc 641 Medical Transportation Management 606 Medicine Place 752 Medicine Shoppe 752 Medicine Shoppe Pharmacy 765 Medicor Healthcare Inc 617, 628 Medicor Homecare Inc 615 Medidi, Subhakararao MD 8, 9 Medilink Pharmacy 765 Medina-Meds Pharmacy 778 Medoz Pharmacy of Polk Inc 778 Medplus Pharmacy 782 Medrock Pharmacy 772 Meds Made Easy 782 Meds To Home 752 Medsource Pharmacy 765 Meer, Henry OD 301, 339, 420, 421 Mehra, Rahul MD 567 Mehta, Ashwin MD 124 Mehta, Mary MD 511 Mehta, Saumeel MD 24 Mehta, Shital DO 15, 38 Mehuron, Sarah MD 9

Meiring, Maryellen ARNP 683 Mejias, Karen DDS 323 Melchert, Magda MD 167, 168 Melean, Alfonso DMD 148, 284, 323 Melendez, Nicole MD 270 Melichar, Jamie DO 46 Melilli, Steven DC 360 Mellor, Ryan MD 271, 347 Memon, Nabeel MD 392 Memorial Family Pharmacy 752 Memorial Hospital of Tampa 553 Mena Perez, Raysa MD 15, 71 Mendelblatt, Frank MD 213 Mendez, Carlos MD 33 Mendez, Pedro MD 166, 179, 180 Mendoza, Alfredo MD 124, 272 Mendoza, Jennifer PHD 579 Menezes, Allison MD 297, 537 Menezes, Marian MD 265 Menon, Meera MD 163 Mental Health Care Inc 565, 566 Mentis, Marni DO 446 Mercado, Roberto MD 529 Mercuri, Danielle LCSW 563 Mercury Medical 634 Meridian Pharmacy 752 Merlino, Brian OD 225, 340, 421 Merritt, Casandra LMHC 563 Merritt, Robert MD 90, 457 Messier Besser, Irene CNM 670, 729 Messina, Allison MD 247, 304, 438, 542 Mester, Stephen MD 108 Metts, Huey ARNP 651, 723 Metts, Jonathan MD 437 Meyer, Christopher MD 480 Meyer, Ernesto MD 60 Meyer, Laura MD 60, 349 Mgm Case Management Services Inc 595 Michael, Jenny MD 405 Michael, Melanie ARNP 737 Michaels Pharmacy 752, 772 Michaels, Samantha MD 168 Michel, Alejandro MD 108 Mickelson, Nicholas DMD 284 Micklavzina, Connie MD 533

www.wellcare.com/Florida | 871

Mickler, Christopher DO 399 Midence, Robert MD 5 Miercort, Craig MD 449 Migliore, Heidi ARNP 676, 716, 717 Mihm, Susan MD 82 Miilu, Erik OT 692 Mikhail, Emad MD 202 Mikulic, Lucas MD 448 Milam, Michael MD 529 Miller MS Ccc/SLP, Cheryl SLP 734 Miller, Barbara OD 301, 501 Miller, Cheryl SLP 733 Miller, Dwayne DDS 379 Miller, Jill ARNP 709, 710 Miller, Joseph OD 421 Miller, Julia SLP 720 Miller, Leslie MD 354 Miller, Linda LMHC 738 Miller, Matthew OD 225, 340 Miller, Michelle MD 432 Miller, Monica MD 260, 344 Miller, Rachel SLP 720 Miller, Richard DO 362 Miller, Robert MD 268, 449, 450 Miller, Sarah DO 405 Miller, Tracey MD 191, 333 Mills, Jeffrey AUD 688 Millstein, Ashley DMD 121, 122, 277, 318, 365, 458, 459 Milton, Melissa OT 740 Min, Zaw MD 71 Minias, Andrew DDS 148 Minnix, William MD 49 Minuteclinic LLC 611, 612, 626, 631, 632, 640 Mir, Haaris MD 305 Mir, Hamza DDS 459 Miranda, Edgar MD 395 Miranda, Elinor MD 60 Miranda-Genaro, Luis MD 12 Mirsky, Stephanie ARNP 674, 692, 714, 731, 740 Misch, David MD 94, 213, 336, 496 Mishkin, Michael DO 354 Mishra, Prabin MD 537 Misiaszek-Boser, Joann LCSW 582 Misiri, Juna MD 101, 108, 173 Misischia, William DDS 525

PROVIDER INDEX M - cont. Mitchell, Paul MD 41 Mitchell, Rita ARNP 683 Mizrachi, Alberto MD 395 Mobile Ultrasound Services of Florida 618 Modaff, Michelle DDS 148, 323, 324 Modh, Ashok MD 265 Moffitt Cancer Center PUBLIX 752 Mogul, Mark MD 247 Mohadjer, Yasaman MD 411 Mohib, Saiyed MD 455 Mohiuddin, Muhammad MD 460 Mohmand, Asad MD 170, 173, 328, 329 Mohr, Travis DC 114 Moinfar, Nader MD 336, 496 Moir, Stephanie LMHC 563 Mokin, Maxim MD 187 Mokotoff, David MD 354 Mole, Jose MD 15 Moler, Connie ARNP 666 Mompi, Emmanuel MD 124 Mondaca, Astrid MD 202 Monosiet, Frederic MD 601, 603 Montana Benincasa, Judy ARNP 664 Montane, Jorge MD 24 Montano, Jolene MD 202, 534 Monteleone, Joseph LMHC 563, 567 Montero, Jose MD 170, 173 Montes, Luis MD 33 Montgomery, Kelly MD 60 Montgomery, Nancy DMD 515 Monticciolo, Natalie DO 316 Montzka, Dan MD 336, 411 Moon, Suk MD 94, 213, 336, 496 Moondra, Vaibhav MD 355, 393 Moore, Alicia DDS 148, 324 Moore, Amanda SLP 694 Moore, Audrea LMHC 563 Moore, Cheryl 709 Moore, Colin MD 437 Moore, Dayna MD 24 Moore, Edith DDS 148 Moore, Joyce ARNP 701 Moore, Patricia ARNP 666, 691

Moore, Steven MD 60 Moore, Tracee PHD 579 Moore, Victoria LCSW 586 Mora Rasquin, Georges MD 1, 2 Mora, Viviana DMD 471 Moraczewski, Alexei MD 496, 497 Moraga, Juanita ARNP 670, 729 Morales Pabon, Cesar MD 108 Morales, Allamm MD 486 Morales, Miguel MD 596 Morales, Valerie ARNP 660 Moran, Byron MD 15, 270 Moran, Robin PA 656 Morano, Jamie MD 170, 171 Morchesky, Darren OD 538 Morel, Mary LCSW 586 Morell, Omar DMD 148, 379 Morelli, Karen DDS 148 Moreno, Anthony MD 236 Moreno, Patrice MD 355 Morgan Jr, Randall MD 539 Morgan, Hillary ARNP 661 Morgan, Jesse MD 508 Morgan, Kisha MD 545 Morgan, Randall MD 303, 539 Morgan, Robert DO 49 Morningstar, Tracy PA 721 Morris, Laura MD 532 Morris, Richard LMHC 586 Morrison III, John MD 36 Morrison, Anthony MD 120 Morrison, Caryn OD 225, 226 Morrison, Richard MD 271, 347 Morton Plant Hospital 556, 587 Morton Plant Mease Diagnostic Cardiology 626, 633 Morton Plant North Bay Hospital 555, 581 Morton Plant Rehab Center 637 Mosburg, Jeramy DO 448 Moscoso, Walter MD 87 Mosher, Laura MD 329 Moss, Brian DO 355 Moss, Lisa ARNP 709, 710 Moulton, Andrew MD 539 Mousli, Hasan MD 486, 643 MP Pharmacy 772

www.wellcare.com/Florida | 872

MRI Associates of Lakeland LLC 640 MRI Associates of St Pete 633 MS Supply and Home Health Co 615, 617 Mts Health Services LLC 566 Mudge, Tracie ARNP 654 Mueller Barker, Denise ARNP 651, 652 Mueller, Brigitta MD 437 Mueller, Pamela SLP 679, 694 Mueller-Barker, Denise ARNP 651, 653, 732 Mueller-Battaglia, Denise ARNP 651, 653 Mukalel, Jessen MD 237 Mukalel, Ninon MD 114 Mukayed, Usama MD 355, 392 Mukherjee, Dipak MD 355 Mula, Nicole DO 41 Mularoni, Philip MD 451 Mulberry Long Term Care Pharmacy 778 Mulberry Pharmacy Inc 778 Mulder, Joanna Np 664 Mulinda, Simon ARNP 732 Mumma, Michael MD 85, 521 Muniz-Verrando, Lorena MD 253 Munoz, Avilio MD 24 Munoz, Lorenzo MD 49 Murby, Nicole SLP 687 Murchie, Adam ARNP 692 Murchie, Brent MD 523 Murphy, Eugene MD 386, 453 Murphy, Heather ARNP 663, 664 Murphy, Kenneth OD 226, 340 Murphy, Melinda MD 24, 253 Murphy, William DO 46 Murr, Michel MD 163 Murray, David MD 117, 457 Murray, Ingrid PA 583 Muse, James OD 421 Mushonga, Nyarai MD 491 Musselwhite-Weaver, Patricia LMHC 600 Musumeci, Salvatore OD 421 Musunuru, S K Rao MD 313 Mutawalli, Khalid DDS 149

PROVIDER INDEX M - cont. Negrete, Latosha ARNP 701 Muthalakuzhy, George MD 49, 397 Neiswender, Holly PT 678 My Pharmacy of Big Bend 752 Nelson James, Cara DO 66, 68 My Pharmacy of Tampa 752 Nelson- James, Cara DO 67 Myers, Elizabeth MD 116 Nelson, Christopher MD 117 Nelson, Stephen DMD 234, 427 N Nelson, Stephen MD 60 Nadal, Florencio MD 25 656 Nadeem, Abdul MD 603 Nelson, Tony PA Nelson-James, Cara DO 67 Nadiminti, Yallappa MD 288 343 Nadkarni, Julie ARNP 677 Nensey, Zara DDS Nesternko, Marina MD Nagabandi, Padma DDS 324 602, 603, 604 Nagamia, Husain MD 271 Neuropsychiatric Institute LLC 565 Nagella, Sarasija MD 202 236, 249 Nair, Bindu MD 33 Neustadt, Jeffrey MD Nevins, David MD 80 Nair, Govindan MD 364 Nair, Sajeevakumar MD 303 New Port Richey Kidney Center 627 Nakanishi, Linda MD 213 Nakarmi, Bibek DDS 324, 379 New Port Richey Surgical Center 626 Nakka, Sushma MD 481 New Tampa Surgery Center 626 Nallamshetty, Samridhi MD New Waters Pharmacy 752 100, 309 448 Nalley, Brittany DMD 149, 284, 525 Newan, Michael MD Newby, David ARNP 591 Nallu, Sagarika MD 114 Newby, Suzanne PA 691 Naoom, Jennifer DDS Newcity, Amanda DDS 257, 258 256, 257, 305, 343, 444 685 Naqvi, Zarrin OD 95, 501 Newingham, Lorin OT Newman, Jaclyn MD 591 Naran, Sage MD 9 94, 213 Narayan, Aurindom MD 49 Newsom, Thomas MD Newton, William MD 191, 192, 333 Narducci, Dusty MD 122 432 Nareddy, Jogi MD 313 Ng, Benton MD Ngar, Lucie OD 226, 502 Narula, Rajan DO 367 Narvarte, Hugo MD 15 Ngo, Denise DDS 149, 284, 379, 525 Nguyen, Colin MD 114, 359 Narwal, Shivinder MD 149, 379 245, 246, 436, 541 Nguyen, David DMD Nguyen, Duy DDS 472 Naseer, Saira MD 68 472 Nash, Michelle ARNP 670 Nguyen, Dzung DDS Nguyen, Hoang DMD 472 Nasseri, Sanaz DMD 471, 472 427 Nastan, Mary PT 687, 741 Nguyen, James DMD Nguyen, Kenny MD 76 National DME LLC 615 149, 150 Navani, Anil MD 485 Nguyen, Phuc-Hau DMD Nguyen, Quyen OD 301 Navarre, Nicole ARNP 715 262 Navarro, Jesus MD 182 Nguyen, Thanh Binh DPM Nguyen, Thanh MD 163 Nazario, Margaret PA 697 80, 432 Nazario, Rhoderick MD 518 Nguyen, Thieu MD Nguyen, Tri MD 268, 307 Nazco Batista, Maria DDS 149 355 Neal, Terry OD 226, 501, 502 Nguyen, Van MD Niaz, Nabila MD 397 Needham, Gerald DO 397 Nickeson Jr, Robert MD 441

www.wellcare.com/Florida | 873

Nieuwenhoff, Fawn ARNP 673 Nieves Costas, Javier MD 124 Night Owl Pediatrics, PA 622 Nikla, Richard LMHC 580, 600 Nimbargi, Stephen MD 76 Nimoh Pharmacy Compounding LLC 765 Nirgudkar, Pranita MD 177, 330, 483 Nirmalan, Nadarajah MD 49 Nite Owl Pediatrics Urgent Care MD 644 Nitti, Teresa CNM 709 Nixon, Everly ARNP 709 Nixon, Jennifer MD 487, 491 Nnadi, Chinyere MD 15 Noble Care Pharmacy 778 Nobo, Christopher MD 460 Noel, Pamela MD 171 Nofsinger, Charles MD 236 Nolan, Christy DO 333, 400 Noorani, Nazneen MD 9 North Manatee Pharmacy 761 North Pinellas Surgery Center 631 North Port Family Health Center Pharmacy 782 North Port Pharmacy 782 North Rehabilitation Center 637 North Tampa Behav Health 583 North Tampa Pharmacy 752 Northdale Pharmacy 752 Northside Hospital 556 Northside Mental Health Center Inc 565 Norwood, Scott MD 326 Novis, Sarah MD 119 Novopharm of Tampa, LLC 752 Now Care Walk In Clinic Inc 622 Nowacki, Mark MD 49 Numotion 615 Numrungroad, Visal MD 331 Nunez, Boris MD 455 Nunez, Erick DDS 472 Nusbaum, Lana MD 80 Nutter, Jonathan MD 405 Nwobi, Obinna MD 453 Nyanda, Hoka MD 117 Nystrom, Joseph MD 36

PROVIDER INDEX O Oak Manor Healthcare & Rehab Center 637 Oakbridge Healthcare Center 643 Oaks Community Pharmacy 752 Oberlander, Mark MD 411 Obican, Sarah MD 177, 202 Obradovich, Shelia PA 656, 689 Obrien, James DO 9 O'Brien, James DO 9 Obrien, Kevin MD 173 O'Brien, Rhonda ARNP 701, 702 Obzut, Dana MD 247 Ocasio Silva, Maria MD 516 Ocasio, John OD 226, 340 Ochotorena Garrovillo, Mel MD 480 Odibo, Anthony MD 203 Odio, Francine LMHC 564 Offner, Lenka MD 529 Offner, Stuart MD 289 O'Flynn, Sonja ARNP 736 Ogunbameru, Aderonke DDS 150 Oguntebi, Bamiduro DDS 122 O'Hara, Mitchell DO 109 Ojeda, Ezer MD 491 Oldfield, Christopher AUD 654, 688, 696, 722 O'Leary, Christina CNM 655 Oliva, Adela MD 16 Oliva, Mario MD 604 Oliva, Robert MD 16 Olivares, Alicia LMHC 594 Olivencia Lozada, Melinda ARNP 729 Oliver Fulse, Joyce SLP 651 Olivera, Raul MD 187 Olivere, Mark LMHC 600 Olivero, Karen PA 702 Oliveros, Fabio MD 93 Olli, Edward DMD 305 Olson Liggett Drug 782 Olson, Arlese OD 301, 502 Olton, Robert PA 690 Omega Drugs 752 Omnicare of Tampa 752 Onderko, Gregory DO 591

One Key Home Care Florida LLC DBA Firstlight 646 One Source Medical Group LLC 634 Onea, Mirela MD 368 Oneil, Amanda ARNP 722 Oneil, Susan LMHC 586 One-Stop Pharmacy 101 778 Onestop RX Pharmacy 752 Ong, Alicia MD 25 Ong, Manuel MD 395 Oommen, Mathew MD 519 Oosterbaan Smith, Laura ARNP 702 Open MRI of Pinellas Inc 633 Operation Par Inc 587, 592, 593 Optimart Inc 215, 337, 413 Optimart St Petersburg 413 Option Care 634, 635, 772 Oracle Home Health Care 617 Orange Bay Pharmacy 752 Orchard Ridge Rehab & Nursing 629 Ordiway, Lester MD 271, 452 Orlando, Dana SLP 695 Orlando, Daniel MD 448 Orlick, Martin MD 411 Ormaza, Efren DMD 151 Orthotic and Prosthetic Centers Inc 636 Ortiz Guzman, Enrique MD 69 Ortiz, Edwin MD 203, 292, 405, 491, 534 Ortiz-Pimentel, Edgar DMD 472 Ortstadt, Jeffrey MD 291 Osgood, Bonnie LMHC 600 Oshodi, Temitope MD 203 Oshrine, Benjamin MD 437 Oshrine, Kathleen ARNP 674, 714, 740 Osman Mohamed, Hussein MD 386 Ostolaza Garcia, Otto MD 173, 182 Oswanski, Michael MD 287 Ottl, Linda ARNP 666, 671 Ouhri, Jasmina PA 737 Ousia Pharmacy Corp 753 Overcash, Janine ARNP 660

www.wellcare.com/Florida | 874

Owens, Henry PA Owens, Rose ARNP Oxner, ASA MD Oyekoya, Adebola MD

702 725 16 46

P Pabon, Carly ARNP 662 Pabon, Hernan MD 571, 583, 591 Pacifico, Daniel MD 521 Padronaggio, Joseph PHD 579 Pagan, Carlos MD 16 Paganini, Cynthia MD 49 Page, Steven MD 539 Pai, Rajendra MD 25, 60 Paidas, Charles MD 251 Paine, Lisa ARNP 671, 729 Painter, Lisa DDS 151 Palacio Ramirez, Carlos MD 318 Palacio, Liliana MD 34 Palazzolo, Arlene MD 71 Palazzolo, Mark DO 491 Palm Breeze Dialysis 645 Palm Garden of Clearwater 637 Palm Garden of Largo 638 Palm Garden of Pinellas- NHC 638 Palm Garden of Sun City Center 620 Palm Garden of Tampa 620 Palm Harbor MRI 633 Palm Plaza Pharmacy 753 Palm River Community Health Center 753 Palm Shores Behavioral Health Center 575 Palm Terrace of Lakeland 643 Palma Ceia Health Mart Pharmacy 753 Palmer Ranch Rehab& Healthcare 647 Palmer, James MD 203 Palmeri, Janine AUD 736 Palmetto Drug Mart 761 Palmisano, Daniel OD 226 Palms of Pasadena Hospital 556 Palms Pharmacy 753 Palmyra Pharmacy 753 Palomado, Raul MD 2

PROVIDER INDEX P - cont. Palomino Malecki, Lisa CNM 697, 710 Palomino, Celestino MD 290 Palosky, Eric DO 4 Palta, Anoop MD 76 Panchal, Priti OD 421 Panchigar, Nimesh MD 16 Panetta, Nicholas MD 260 Panganiban, Rudolfo MD 544 Panicker, Usha MD 41 Pansuriya, Dharmendra DMD 151, 379 Pansuriya, Vinubhai MD 449 Pantages, Efstratios MD 60 Panzarino, Valerie MD 248 Papadakis, Mary Frances LMHC 564 Paquin, Warren OD 301, 538 Parayath, Krishnan MD 391 Parbhoo, Arvind MD 364 Pardo, Maria DDS 284 Paredes, August MD 530 Paredes, Augusto MD 80 Parekh, Dipak MD 313 Parikh, Ankit MD 355 Parikh, Snehal MD 34 Parilla, Erin MD 181 Parisi, Valerie MD 203 Park South Imaging Center 623 Park, James DDS 151, 152, 379 Park, Y K Peter MD 168 Parker, Dane DC 456 Parker, David DDS 152 Parker, Glenda MD 16 Parker, Jill PA 706, 721 Parker, Justin MD 272, 273 Parker, Patricia LCSW 564 Parker, Vicki ARNP 736 Parks, Alicia ARNP 583, 591 Parrish, Denise AUD 683 Parrish, Gregory OD 95, 226, 421, 502, 503 Parsa, Mitra DDS 234, 427 Parsley, Chandra ARNP 649 Parsons, Brent OD 340 Parsons, Lisa DPM 262, 447 Parsons, Nicole OD 340

Partners Imaging Center of Bradenton 623, 624 Partners Imaging Center of Naples 645 Partners Imaging of Venice 645 Partners Imaging of Venice LLC 645 Paruolo, Joseph MD 529 Pascual, Eduardo MD 109 Passaro, Jr, Vincent OD 340 Patel, Aarti MD 109 Patel, Ajay MD 163 Patel, Anilkumar MD 25 Patel, Anish DC 315 Patel, Anjan MD 528 Patel, Ankit MD 16 Patel, Arpit DO 260, 344 Patel, Asha DMD 152 Patel, Ashok MD 591 Patel, Bharatkumar MD 124 Patel, Binal OD 95, 226, 503 Patel, Chandrakant MD 89 Patel, Chandravadan MD 16 Patel, Daksha MD 25 Patel, Darshan MD 313, 355 Patel, Deepa OD 422 Patel, Guarangi DDS 379 Patel, Hitesh MD 390 Patel, Janisha DDS 472, 473 Patel, Jaydeep MD 25 Patel, Jigneshkumar MD 319 Patel, Kinjalben DMD 152, 284, 379, 473, 525 Patel, Kirti PA 690 Patel, Krunal MD 16 Patel, Mahendrakumar MD 1 Patel, Mahesh MD 273 Patel, Mangesh MD 12 Patel, Manish MD 289, 531 Patel, Mihir MD 367 Patel, Nalin MD 119, 317 Patel, Nandesh MD 412 Patel, Niraj MD 192, 203, 333 Patel, Nirav MD 265 Patel, Nishit MD 117 Patel, Parag MD 329, 393 Patel, Payal MD 25, 364 Patel, Pragnesh MD 173, 571 Patel, Pritesh MD 17, 38

www.wellcare.com/Florida | 875

Patel, Pruthu MD Patel, Rajnikant MD Patel, Ravindra MD Patel, Ripal DDS Patel, Roshankumar MD

398 17 163 473

89, 109, 455 Patel, Satish MD 319 Patel, Seema MD 480 Patel, Sharad MD 163 Patel, Shilen MD 327, 330 Patel, Shodhan MD 572, 583, 596 Patel, Sonal MD 120, 173 Patel, Tracie PA 659 Patel, Trushar MD 273 Patel, Urmila MD 203, 204, 491 Patel, Vibhaben MD 38 Patel, Yagneshvari MD 171 Patel, Yesha DMD 473 Patel-Elio, Bhiru MD 46 Patidar, Bhavin MD 185 Patient RX Solutions Pharmacy 753 Patil, Abhitabh MD 367 Patil, Dipti MD 30 Patrice, Stephen MD 546 Patrick, Brian MD 67 Patrick, Christine ARNP 661 Patricoski, Thomas MD 522 Patrusky, Eric DO 82 Patz, Daniel PsyD 573, 579 Paul, Sean MD 596 Paula, Kelly DMD 324, 379 Pavan, Mary MD 253, 443 Pavan, Peter MD 213 Pavlock, Amanda ARNP 674, 714, 731 Paxson, Alicia PA 654 Payne, Tessa OD 226, 340 Peace River Center For Personal Developm 595, 598 Peak Pharmacy Inc 753 Pearce, Jr, Willard OD 503 Pearman, Carl MD 534 Pease, Michael DC 315 Pecoraro, Joseph MD 287 Pediatric Orthotic and Prosthetic Servic 619 Pediatric Surgery Center LLC Odessa 626

PROVIDER INDEX P - cont. Pediatric Surgery Centers LLC 611 Peebles, Michael MD 367 Pegasus RX Pharmacy 772 Pelaez, Robert MD 25 Pelayo, Miguel MD 288 Pelots Pharmacy 761 Peltzer, Bradley OD 87, 95 Pena Rosa, Karla PHD 579 Pena, Reshelle MD 204 Penabad, Jesus MD 318, 364 Pena-Ponson, Max MD 268, 346 Peninsula Care & Rehab Center 638 Penland, Edina DMD 473 Pennell, Sara SLP 695 Penugonda, Madhuri MD 250, 513 Peoples Pharmacy 778 Peraglie, Cesare MD 456 Peralta, Johnny DMD 284 Peralta, Jose DDS 324 Percent, Ivor MD 528 Perelmuter, Steven DMD 515 Perez Diaz, Elizabeth DMD 153 Perez Gonzalez Deapodaca, Jose MD 213 Perez, Hugo MD 335, 405 Perez, Kristina OT 685 Perez, Maria MD 3, 6 Perez, Maribelis MD 41 Perez, Marina DDS 515 Perez, Monica DDS 153 Perez, Rafael MD 405 Perez, Richard MD 82 Perez, Sergio MD 31 Perez-Arce, Jose MD 49 Perich, Larry DO 213, 336 Pernicone, Meira MD 163 Perry, Alyssa PA 697 Perry, Elizabeth Had 624 Perry, Matthew MD 88, 308, 548, 549 Perry, Robert PA 734 Persad, Farah PA 683 Personacare At St Petersburg 638 Personal Enrichment Through Mental Healt 588 Persons, Mylissa PA 649

Perzanowski Obregon, Christian MD 109 Pescasio, Michele MD 347 PET CT Center 633 Peters, Edward DDS 324 Peterson, John MD 395 Petit, Mitchell OD 96, 226 Petitfils, Lisa MD 61 Petrick, Christina SLP 681, 695, 720 Petrilli, John MD 36, 37 Petrino, Layne ARNP 726 Petrovic, Aleksandra MD 437, 438 Petry, Harold LMHC 661, 708 Petti, Erin ARNP 708 Pham, Kim OD 226, 227 Pham, Quyen DMD 473 Pham, Thanh DDS 324 Pham, Thi DDS 153, 380 Pham, Thuy MD 41 Pham, Tuan MD 251 Phan, Christine DMD 153, 284, 380, 525 Pharmaco Med Shop 772 Pharmacore RX 753 Pharmacy Innovations 772 Pharmacy One Pro Specialty Care Ph 778 Pharmacy Pros Corporation 753 Pharmalabs 772 Pharma-Ville RX Medical Supply 753 Pharmax Specialty Pharmacy 753 Pharmerica 753, 772, 782 Pharmexpress Pharmacy 753 Pharmscript 753 Philadelphia Professionals Inc 641 Philippe, Bernard MD 384 Phillips, J Wayne MD 350 Phillips, James OD 227, 503 Phillips, Jeffrey OD 422 Phillips, Lee MD 249, 440, 542 Phillips, Stephen OD 96, 227, 503, 504 Phillips, Susan OD 422 Physical Therapy Specialists of Pine Cas 642 Pick, Glenna ARNP 689, 698 Pierce, Tyne LMHC 586

www.wellcare.com/Florida | 876

Pierre, Jean MD Pile, Nadia MD Pillai, Anantha MD Pinebrook Center Pineiro, Alisha DO Pinellas Park Care & Rehab Pinellas West Shore Dialysis Pinero Correa, Rosario DDS

69 204 77 647 41 638 634

258, 444 Pinero-Pilona, Antonio MD 318, 364 Pinilla, Sandra MD 9 Pinkas, Daphne MD 508 Pinzon, Ernesto MD 93 Pirmohamed, Fermina MD 398 Pitarys II, Christos MD 313, 329 Pitt, Catherine MD 192 Pitts, Brianne ARNP 656 Pizaro Otero, Jose MD 398 Plank, David MD 516 Plant City Dialysis 614 Plant City Discount Pharmacy 753 Plant City Family Care 753 Plant, Rebecca MD 25 Plante, Parker OD 301, 422 Plasencia, Daniel MD 25 Plazarte, Monica DO 318, 364 Plosker, Shayne MD 269, 451, 547 Plous, Oren MD 213, 336, 412, 537 Pobi, Kwabena MD 98 Poblete, Sarah Jessica MD 17 Pogan, Cara OT 685 Poinciana Dialysis 640 Poinciana Medical Center 557 Polite, Leroy DMD 324 Polk, Sara MD 3, 77 Pollan, Alina MD 46 Polsky, Ethan MD 252, 343, 442, 514, 542 Polur, Marina MD 596 Ponce, Rolando DDS 153 Poncheri, Kelly DPM 516 Pope, Kathleen MD 178 Porcelli, Monica MD 41 Porras, Anabel PA 657 Porreca, Tina SLP 681, 695, 720 Porro, Guillermo DMD 153 Port, Martin DPM 263, 345 Porter, Alan MD 546

PROVIDER INDEX P - cont. Porter, Margaret LCSW 564 Porter, Thomas DDS 380 Portman, Steven MD 521 Portnow, Arthur MD 80 Post, James MD 355 Pothiawala, Yakub MD 10 Potorski, Robert MD 109 Poustchi-Amin, Farah DDS 343, 445 Powell, Donna DO 124 Powell, Traci ARNP 726 Power, Marianne CNM 727 Powrzanas, Trey ARNP 725 Prabhakar, Ankita DDS 153 Prabhakaran, Gayle SLP 681 Prabhakaran, John OT 673 Prabhakaran, Sujatha MD 204, 293, 405, 491, 534 Pradilla, Sergio OD 227, 228, 301, 422 Prado, Antonio MD 214 Prasad, Ishwari MD 124 Prato-Guia, Yelena DDS 154, 380 Prator, Bettina ARNP 660 Pratt, Frederick DDS 324 Precision RX 753 Precisionmed Pharmacy 753 Preferred Touch Home Care Inc 617 Premier Pharmacy LLC 753 Premier Surgery Center of Sarasota 645 Premier Walkin Clinic 644 Premium Health Services of Tampa Bay 622 Premkanth, Phimagham MD 77 Prendiville, Mary DDS 154 Preseau, Ranae ARNP 674 Preston, Marilyn MD 25, 26 Preston, Nancy ARNP 660 Prewett, Jennifer PA 682 Pribaz, Julian MD 260, 261 Price, Jeffre DC 522 Price, Melvin DPM 306 Price-Mccarthy, Staci DC 361 Prida, Xavier MD 109 Priemer, Ryan DMD 473 Prieto, Jose MD 168, 171, 406

Prime Pharmacy Services 783 Prime RX Pharmacy 772 Pringle, Aleisha ARNP 719 Pro Med Healthcare Services LLC 617 Promise Pharmacy 772 Pronto Pharmacy 754 Proper, Steven MD 117, 316 Providence Pharmacy 778 Prpich, John MD 250, 441, 513 Pruitt, Crayton MD 271 Pruitt, J MD 271 Pruitt, Rebecca MD 26 Pruthi, Jagdeep MD 77 PSA Healthcare 641 Puccio, Joseph MD 26, 99 Pudur, Sudhindra MD 397 Puentes, David DC 456 Puig, Katherine ARNP 727 Pulido, Laura ARNP 663 Puretz, Jeffrey MD 487, 491 Pursino, Heather SLP 695 Purvis, Susan ARNP 671, 729 Putnam, Lindsey ARNP 671 Puzzo, Melissa OD 96, 228, 504 Q Qadri, Subuhi DMD 154, 380 Qadri, Syed MD 86, 491, 492 Qazi, Arif MD 125 Qi, Quanle MD 331 Quadri, A H Zehra MD 17 Qualimed Respiratory and Mobility Inc 641 Quality Health of North Port 647 Quefatieh, Amir MD 345, 346 Quest Diagnostics 606 Quevedo, Fernando DDS 154, 380 Quevedo, Rachel DDS 154, 380 Quick N Save Pharmacy 754 Quick Pharmacy 772 Quick, Kimberly MD 355 Quickn Save Pharmacy 778 Quinn, Erik PA 660 Quinones, Eugenio MD 204 Quinones, Lourdes PT 678 Quinones, Rafael MD 480

www.wellcare.com/Florida | 877

Quinones-Edgecomb, Donna ARNP 662 Quintero, Yaquelin ARNP 657 Quinton, Cynthia LCSW 576 Qureshi, Mussarat MD 486 R Rabago Reyes, Cassandra MD 174 Rabenstein, Eric DO 181 Rabines Burga, Marco MD 577 Raccio, Diane ARNP 684 Radecki, Richard MD 260 Radeke, Amanda OD 422, 423 Radiance Radiology 635 Radiation Oncology Center 307 Radiology Associates of West Pasco 626 Radish, Douglas OD 83 Raemisch, Christopher DC 456 Raffoul, Georges DMD 380, 473 Raghuveera, Anavatti MD 6 Raguthu, Lalitha MD 42 Rahim, Abdur MD 313 Rahman, Farhana MD 10 Rahman, Omar PHD 592 RAI - 9th Street North - St Petersburg 634 RAI Care Centers of Sarasota LLC 645 RAI Sr 60 East Lake Wales 640 RAI Starkey Largo 634 Raiker, Anilkumar MD 395 Raimer, Karen MD 394, 406 RAI-US 19 N-Clearwater/Palm Harbor 634 Raj, Jayapriya MD 38 Rajaram, Perumalswamy MD 480 Rajendran, Pattabhraman MD 109 Raju, Stevy DMD 474 Ramamurthy, Guruswamy MD 291 Ramappa, Gogi MD 42 Ramappa, Renuka MD 335 Ramesar, Denyse OD 228 Ramey, Jeremy MD 432 Ramireddy, Kesavulureddy MD 313, 314 Ramirez, German MD 182 Ramirez, John MD 109

PROVIDER INDEX R - cont. Ramiro, Lucila MD 17 Ramos, Agustin MD 97 Ramos, Becky OD 301 Ramos, Geraldo MD 356 Ramos-Collazo, Yesenia MD 77 Rampersad, Avind MD 253 Rampertaap, Moonasar MD 266, 306 Ramsay, William OD 228, 340 Randal Minor Ocular Prosthetics, Inc 263 Randall, Kelly PT 741 Randolph, John MD 95, 214, 336, 497 Ranells, Judith MD 246 Raney, Dennis OD 229, 301 Raney, Ellen MD 249 Ranganathan, Radhika MD 26 Rankin Jr, George MD 46, 347, 451 Rankin, Trevan MD 46 Rankupalli, Babu MD 572 Ranon, Eric MD 72 Ranon, Shena ARNP 734 Rao, Kavita MD 49 Rao, Kiran MD 177, 204 Rao, Radhakrishna MD 114 Rao, Ramanath MD 109, 314 Rao, Sukhdeep MD 31 Rao, Takkallapelli MD 597 Rapkin, David MD 204, 205 Rapkin, Rachel MD 205 Raptoulis, Arthur MD 511 Rattehalli, Narayana MD 347 Rattes, Max MD 110, 174 Rau, Sathyanarayan MD 26 Raveling, Paul DC 361 Ravindra, Chitra MD 365 Ravindra, Nagella MD 386 Rawls, Jonathan PA 692 Raxwal, Vinod MD 314, 329 Ray, Dorothy MD 77 Ray, Geoffrey MD 346 Ray, Rachel MD 77 Ray, Tanya ARNP 691 Raymond, Shane LCSW 567 Rays Pharmacy 765 Razman, Dolores MD 61

Rcc Sebring 609 RCG Tampa North LLC 614 Read, Sonia MD 331 Reales, Vicky SLP 695 Reames, Amanda ARNP 671, 685, 712, 729, 739 Rebori, Brian DC 361 Reckord, Mabbett DC 456 Reddivari, Venkata MD 174, 183 Reddy, Ashok MD 72 Reddy, Dheeraj MD 79 Reddy, Lakshmi MD 545 Reddy, Mohan MD 356 Reddy, Purushottam MD 331 Reddy, Tiyyagura MD 319 Redlin, Jacqueline ARNP 671, 685, 712, 729, 739 Reed, Damon MD 247, 438 Reed, Danielle SLP 719 Reed, Samantha DDS 154, 325, 380 Reed, Shawn ARNP 702 Reeder, Robert MD 79, 526 Reese, Jasmine MD 443 Rego, Robert OD 538 Rehabilitation & Healthcare Center of Tampa 620 Rehabilitation Center of St Petersburg 638 Rehman, Farhan MD 37 Rehman, Jamil MD 273 Reichmann, David Had 609 Reid, Keslynn SLP 694 Reidsema, Lisa LMHC 600 Reifenstein, Chris PA 734 Reilly Hays, Elizabeth MD 26, 61 Reimer, Donald LCSW 559, 576 Reinbolt, Elizabeth OT 686 Reinhart, Joel DMD 154 Reintgen, Douglas MD 163, 386 Reis, Mary ARNP 702 Reiskind, Marc MD 445 Reiss, Jared PA 725 Reiter, Suzanne ARNP 702, 703 Rell, Brian DPM 306 Remaley III, Delbert DO 236 Remaley, Delbert DO 236 Remo Platt, Elizabeth ARNP 654, 655

www.wellcare.com/Florida | 878

Ren, Zeguang MD 187 Renaud, Lauren OD 504 Reneau, Carolyn CNM 664, 727 Renelus, Deborah MD 37, 46 Renewal Rehabilitation, Inc PT 677 Renshaw, Linda ARNP 703 Republic Pharmacy 754 Resilience Counseling Center Inc 594 Restrepo Jaramillo, Ricardo MD 266, 346 Restrepo, Alvaro MD 597 Reuter, Ilona ARNP 684 Reyes, Alexandria DO 400 Reyes, Carlos MD 400, 406 Reyes, Monika DMD 474 Reyes, Steven PA 708 Reynolds, Emily ARNP 591 Rhines Ogara, Shelly SLP 734 Rhodes, Dennis DC 522 Rhodes, Eric PA 708 Rhyne, Dennis MD 577 Riaz, Shahid MD 486 Riaz, Wasif MD 92 Ribot, Aliana DMD 155, 380 Ricalde, Pat DDS 233 Rice, Charles DC 115 Rice, David MD 84, 546 Rice, Wayne DC 522 Richards, David MD 214 Richardson Sullivan, Tonia ARNP 660 Richardson, Lisa LMHC 601 Richardson, Maree SLP 742 Richards-Rowley, Toni MD 26 Richter, Joel MD 125 Richter, Paul DPM 263 Rico, Juan MD 247, 253 Ricx Pharmacy 765 Riczu, Steven ARNP 703 Riddell, Scott MD 205 Riddle, Heather ARNP 693 Rideout, Drew MD 251, 441 Ridley, Marion MD 119 Riestra, Jorge MD 406 Rigberg, Matthew LMHC 661 Right Accord Private Duty Home Health Ca 646

PROVIDER INDEX R - cont. Right At Home Central Pinellas 635 Rihana, Nancy MD 171 Riley-Naylor, Erin OT 673, 692 Rinde-Hoffman, Debbie MD 110 Ringewald, Jeremy MD 241, 432, 433, 540 Rios Ortega, Dally PsyD 579 Rippy, Steven MD 34 Ritchie, Abigail PsyD 567 Ritchie, Tera ARNP 661 Rite RX Care 754 Ritemed Pharmacy 778 Ritter, Brooke DO 400 Rivera, Abneris DDS 474 Rivera, Abraham MD 237 Rivera, Enrique MD 276 Rivera, Ever MD 26, 27 Rivera, Jade DMD 155, 285, 380, 525 Rivera, Miriam MD 72 Rivera, Stephanie ARNP 651 Rivera-Ortiz, Wilfredo MD 83, 293 Rivero, Evaristo DPM 97 Riveros, Ashley OT 713 Riverview Pharmacy 754 Rizkallah, Munir MD 82 Rizner, Amanda DMD 155, 285, 380, 525 Rizziello, Derrick DDS 474 Rizzo, Gerald MD 397 Roa, Antonio MD 5 Roach, John DO 344 Robbins, Jeremy DDS 155 Robbins, Mark MD 180 Roberts, David OD 96, 229, 504, 505 Roberts, Elizabeth OD 96, 229, 505 Roberts, Tyler OD 538 Robertson, Sharon SLP 740 Robinson, Carolyn MD 441 Robinson, Kevin MD 90 Robinson, Marcus ARNP 594 Robinson-Kyles, Jeanene PHD 597 Roca, Jose MD 314 Rocha, Rafael MD 390 Rodriguez Marin, Yomayra MD 69 Rodriguez Mendoza, Carlos MD 32 Rodriguez Real, Jennifer SLP 695

Rodriguez Waitkus, Paul MD 119 Rodriguez, Alejandro MD 177 Rodriguez, Alex PA 698, 722 Rodriguez, Ana DDS 474 Rodriguez, Betzaida MD 531 Rodriguez, Carina MD 247, 248, 253 Rodriguez, Carlos MD 47, 441 Rodriguez, Fernando MD 183 Rodriguez, Henry MD 244 Rodriguez, Lisa MD 27 Rodriguez, Luis MD 248, 439, 513 Rodriguez, Madali ARNP 690 Rodriguez, Mauro MD 591 Rodriguez, Robert DC 115 Rodriguez, Rolando MD 110 Rodriguez, Wilina MD 164 Rodriguez-Benitez, Jose MD 492 Roever, Christopher DPM 447 Rogal, Philip MD 110 Rohatgi, Nalini MD 100 Rojas, Paola LMHC 564 Rolette, Ayanna MD 77 Rolland, Lilivette MD 27 Rollins, Ebony ARNP 704 Romagnolo, Stephen MD 117, 316, 317 Romano-Buckner, Jana ARNP 678, 679 Romero- Quevedo, Margarita DDS 474 Romero, Joseph DO 392 Romero, Stephanie MD 205, 492 Rommel, Duane MD 61 Rook, Michelle MD 246, 512 Rooney, James ARNP 704 Roopnarain, Samantra ARNP 663 Root, Allen William MD 435 Rosa, Hector MD 205, 293, 406, 492, 534 Rosanelli, Edward MD 214 Rosario, Angel MD 125 Rosario, Jesse DMD 474, 475 Rosario-Prieto, Michael MD 398 Roscher, Elizabeth ARNP 686 Rose Radiology Centers Inc 613, 623, 626, 627, 633, 645 Rose, Carey PA 684 Rosemary Birthing Home Inc 645

www.wellcare.com/Florida | 879

Rosemurgy, Alexander MD 164 Rosen, David DMD 258, 344, 445 Rosenberg, David MD 250, 441, 514 Rosenberg, Melissa PT 678 Rosenblatt, Arthur PHD 573 Rosenblum, Harry MD 113 Rosenfeld, Jay OD 423 Rosenthal, Andrew MD 356 Roskos, Melinda MD 356 Ross, Joseph MD 412, 537 Ross, Sharona MD 164 Ross, Susan MD 483, 484 Rossbach, Hans-Christoph MD 247 Rossi, Anthony DO 164 Rossi, Peter MD 314 Rossidis, Georgios MD 386 Rossidis, Heather PA 704 Ross-Johnson, Angela MD 10 Rostami, Maryam DMD 325 Roth, Deborah DO 573 Roth, Justin LCSW 564 Roth, Robert MD 326, 386 Rothstein, Marta ARNP 684 Rottgers, Stephen MD 446 Rotunda-Patino, Mariel DO 205 Rovin, Joshua MD 452 Rowan Discount Pharmacy 765 Rowan, Carey MD 337 Rowe, Keri DC 277 Rowland, Christine ARNP 732 Rox, Pamela CNM 709, 710 Roy, Bipul MD 110, 174 Royal Pharmacy 765 Royal RX Pharmacy 754 RTC Venice 646 Ruano, Giselle PsyD 574 Ruas, Ernesto MD 261 Rubin, David OD 538 Ruch, James PA 652 Rucker, Elsy MD 526 Rucker, Rajivi MD 1, 34 Ruckman, Carli OD 341, 505 Rudd, Melissa ARNP 572 Rudzewicz, Marianne LCSW 564 Ruelf, Michael DDS 258 Ruiz, Hugo DDS 155 Rumbel, Richard DDS 86, 91, 475 Rummel, Jenavieve PA 662

PROVIDER INDEX R - cont. Rumph, Melissa ARNP 732 Runyan, Fuying ARNP 664 Rupert, Brooke ARNP 732 Ruskin Health Center 754 Russell, Constance LCSW 575 Russell, Laura ARNP 651, 727 Russell, Robyn OD 87, 96 Russello, Flor ARNP 658 Rutherford, Thomas MD 205 Rutland, Kristen SLP 720 RX Care Pharmacy 765, 778 RX Care Pharmacy Kwik Mart 765 RX Discount Pharmacy 765 RX Express Pharmacy 754 RX Oasis 754 RX Solutions Inc 754 Rxperts Pharmacy Tampa Inc 754 Ryczek, Dennis OD 423 Ryder, Stephanie ARNP 674 S Saba, Fadi MD 50 Sabal Palms Health Care Center 638 Saberi, Ali MD 50 Sabia, Francesca MD 27 Sable, David MD 117, 118, 317 Saborido Battaglia, Francisco MD 293 Sabzehei, Bahareh DDS 516 Sachdev, Manu DMD 325 Sack, Jayson MD 187 Sacksteder, Ryan OD 423 Sadanandan, Saihari MD 110 Sadek, Ginger OD 505 Sadlowski, Yolanta PA 697 Sadowsky, MD, William MD 561, 597, 598 Saeed, Farrukh MD 125 Sagar, Vidya MD 397 Saglibene, Mark MD 719 Sahoo, Sanjiv MD 185 Saint Fleur, Guilda MD 92, 93 Saint Fleur, Paul MD 93 Saint Jean, Caleb OD 302, 341, 423, 424 Saiyad, Saleem MD 110

Salamanca, Edwin MD 492 Salazar, Manuel MD 356 Saleh, Mohamad MD 185 Salhab Pharmacy 754 Salib, Magda MD 61 Salim, Nauman MD 100 Sallman, Alan MD 485 Sallykay Pharmacy 754 Salomon, Brad OD 96, 229, 505, 506 Salomon, Katie OD 96, 229, 506 Salomon, Teresa OD 96, 229, 506, 507 Saloum, Yasser MD 125 Salter, Jennifer DO 406 Sambursky, Robert MD 297 Sampang, Reginald MD 42 Samper-Pena, Carolina MD 17, 166 Sampson, Marian MD 335 SAMS CLUB 754, 761, 765, 772, 778, 779, 783 Samter, Jordan MD 27 San Martin, Julio MD 492 San Tun, Sabine MD 79 Sanchez Ortiz, Margarita OT 730 Sanchez, Jamie MD 116 Sanchez, Juan MD 337 Sanchez, Lajuan ARNP 738 Sanchez, Mark MD 406 Sanchez, Ramon MD 12 Sanchez, Robert MD 356, 357 Sanchez, Wendy ARNP 707 Sanchez-Diu, Monica DMD 155 Sanchez-Ponce, Rafael MD 329, 330, 392, 393 Sanchez-Ramos, Juan MD 185 Sanchezvalle, Amarilis MD 178 Sander, Marc DDS 91 Sanderbeck, Tracey ARNP 591 Sanders, Roy MD 236 Sanders, Sherra SLP 679 Sandhu, Jagdeep MD 174 Sandhu, Neil MD 457 Sando, Jane MD 443 Sando, Mark MD 236, 508 Sangosanya, Tatiana ARNP 704, 705 Sanjeevi, Arthi MD 125 Sanka, Madhurima DO 309, 350

www.wellcare.com/Florida | 880

Sankar, Deo MD 89 Sankoorikal, Antony MD 451 Santa Maria, Ramon MD 27 Santana Hernandez, Omar MD 120 Santana, Carlos MD 574 Santana, Jorge DC 315 Santiago Perez, Jose MD 47 Santiago, Cesar MD 116 Santiago, Karmivis LMHC 586 Santiago, Laisa MD 441 Santiago, Lourdes MD 361 Santiago, Sylvia MD 10 Santiago, Yvonne MD 17 Santos, Luis DMD 91, 475 Santos, Ramon MD 534 Sappenfield, Elisabeth MD 205, 206 Saprounova-Hopf, Vera MD 17 Sarafian, Berc MD 449 Sarai, Abey MD 391 Saranga Perry, Vita MD 166 Sarasota Apothecary 783 Sarasota County Health Dept 783 Sarasota Discount Pharmacy 783 Sarasota Health Rehab 648 Sarasota Memorial Hospital 558 Sarasota Memorial Nursing and Rehab Center 648 Sarasota Memorial Nursing and Rehabilita 648 Sarasota Outpatient MRI 646 Sarasota Pharmacy Sv Co Bee Ridge Pharmacy 783 Sarasota Physicians Surgical Center LLC 645 Saraydar, Haychell DDS 380, 381 Sardo, Margo DO 47 Sargi, Zoukaa MD 119 Sarnaik, Shawn PA 674, 692 Saron, Whitnie ARNP 698 Sastry, Ashok MD 531 Sastry, Narendra MD 271 Sauder, Deborah MD 79 Sauter, Patricia ARNP 575 Save N Care Pharmacy 765 Save-Rite Pharmacy 754 Savill, Gary PHD 579 Savino, Tarah PA 693

PROVIDER INDEX S - cont. Sawar, Asad MD 110, 314 Sawczyn, Kelly MD 247, 438, 512, 541 Sawka, Jennifer MD 61 Sawyer, Keri ARNP 731 Sayad, Dany MD 110, 111 Scalercio, John DMD 325 Scamard, David OD 229, 341 Scannon, Michael MD 118, 317 Schachter, David MD 175 Schackman, Cynthia ARNP 649, 684 Schaffner, Daniel DDS 155, 285, 325 Schaible, Eric MD 537 Schamaun, Jonathan ARNP 664 Schatz, Scott OD 229, 230, 424, 538 Schau, Regina LCSW 559, 576 Schebel, Janette ARNP 677 Schell, Gina DO 50 Schemmer, Gary MD 497 Scherer, Warren MD 412 Scheu, William DC 316 Scheurer, Monica DMD 285 Schey, Nicholas MD 61, 62 Schiffner, Tiffany PHD 579 Schirripa, Jane ARNP 705 Schmidt, Patricia LMHC 586 Schmidt, Rick MD 386 Schneider, Erica DO 406, 407 Schoeffel-Hayes, Diane DC 361 Schoneck, Katie OD 424 Schreibman, Tanya MD 174, 392, 530 Schulman, Jeffrey MD 407 Schutt, Charles DDS 325 Schuyler, Gregg MD 357 Schwartz II, William DDS 459 Schwartz, Jeffrey MD 412 Schwartz, Rachelle DO 407 Schwartz-Fernandes, Francisco MD 166 Scialfa, August DDS 285 Sciortino, David MD 180 Scott, Christopher OD 230, 424 Scott, Gregory MD 398 Scott, Kevin MD 236 Scotts RX 772 Script Choice Pharmacy 754

Scripts Direct LLC 755 Scripts Pharmacy 772 Scruples Pharmacy 755 Scully, Karrin PT 687 Scutaru, Irina MD 50 Seaman Jr, Joseph MD 545 Sears, Karmon PsyD 579 Sebring Pharmacy 745 Seetahal, Shiva MD 480 Seffner Pharmacy 755 Sehgal, Manu MD 518 Sehres, Randell MD 10 Seifert, Thomas DDS 86, 91, 475 Seignon, Caroline ARNP 572 Selz, Amrita DMD 155, 156, 381 Semel Parkhurst, Barbara SLP 742 Senatorov, Vladimir MD 87, 97, 516, 517 Seneque, Renette ARNP 665 Senior Helpers 617 Seniorcare Comm Pharmacy 755 Sennabaum, Joseph MD 328 Seoane, Andres DMD 476 Seoane, Debra MD 480 Sequelcare of Florida LLC 581, 587 Serag, Sherif MD 47 Seralde Jr, Circilo MD 4 Seralde, Cirilo MD 4 Seralde, Victor MD 4 Serrano, Gustavo MD 17, 183 Serrano, Yahaira DDS 476 Servoss, Christopher ARNP 664 Settle, Edmund MD 572 Severino, Alba ARNP 724 Sevigny, Mark OD 87, 96 Sevigny, Ronald OD 87, 96 Sha, Sandra MD 518 Shafii Campbell, Alyssa SLP 681 Shafii, Fariba DDS 476 Shafii, Sohrab MD 206, 492 Shah, Abid MD 521 Shah, Amit MD 93 Shah, Apurva MD 50 Shah, Ashish MD 443 Shah, Avani MD 80 Shah, Bhumik MD 174 Shah, Geeta MD 214, 337 Shah, Hiral MD 450

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Shah, Jaimin MD 452 Shah, Jayesh MD 183 Shah, Manish MD 39, 42 Shah, Meena MD 589, 591 Shah, Nihal MD 591 Shah, Nilamben MD 50 Shah, Rakesh MD 266, 332 Shah, Ramesh MD 168 Shah, Sailesh DO 266 Shah, Shalin DO 180 Shah, Shalin MD 351 Shah, Shital OD 341 Shah, Shuchi MD 244 Shah, Siddharth MD 332 Shama, Stanley DPM 263 Shamas, Christina MD 407 Shames, Murray MD 274, 348 Shamim, Tabassum MD 27 Shamrock Pharmacy 745 Shane, Anita MD 214, 297 Shaner, Timothy PA 698 Shapiro, David MD 386 Sharma, Kamal DO 484 Sharma, Mahesh MD 242 Sharma, Nagaraja MD 314 Sharma, Rakesh MD 357 Sharp, Gloria PA 706 Shastri, Milind MD 50 Shaub, Brian DO 10, 11 Shaw, Kailie MD 574 Shawchuck, Kay MD 386 Shea, Daniel OD 424 Shea, Roger MD 522 Sheehan, Mary MD 572 Sheehy, Paul DPM 263 Shelden, Sarah DO 335 Sheneman, Debbie ARNP 572 Shenkman, Carl MD 398 Shepard, Ashleigh PA 675, 715 Sheppard, Robert MD 357 Sher, Mandel MD 428, 441 Shereff, Michael MD 237 Sheridan, Richard MD 181 Sherman, Andrew MD 271 Sherman, Shanna ARNP 715, 740 Sheshani, Shashidhar MD 576, 577, 602, 604 Shetty, Ranjith MD 309

PROVIDER INDEX S - cont. Shetye, Kedar MD 397 Shields Pharmacy 772 Shiffner, Beth PA 740, 741 Shimshak, Karen MD 497 Shimshak, Thomas MD 89, 93 Shin, Susan OD 302, 538 Shine, Leetoria ARNP 717 Shires-Waldron, Sarah MD 17 Shiver, Joseph DC 277 Shoba, Sama MD 67 Shontz, Michael DC 316 Shore Acres Care Center 638 Shreve, Tanya PA 671, 685, 712, 729, 739 Shriners Hospitals For Children Tpa 553 Shriver, Mary DO 185 Shrom, Stanley MD 519 Shulman, Carrie MD 399 Shulman, Dorothy MD 244, 253 Shulman, Sandra ARNP 677 Shulstad, Raymond ARNP 657, 689 Shuster, Paige SLP 720 Sia, Edwin Michael MD 77 Siambenes, David DO 249 Sica, Carissa DPM 447 Siddiqi, Reshma MD 42 Siddiqui, Irfan DO 89, 111, 455 Siddiqui, Munira MD 364 Sider, Brian DDS 476 Siedlecki, Michael MD 397 Siegal, Jeffrey MD 522 Siemiet, Erika DDS 325, 381 Sierra, Frank DMD 258 Sierra-Nieves, Elsie DMD 526 Sifain, Maggie MD 250, 514 Signature Urgent Care 639 Sijin, Odalis MD 206 Silbiger, Jonathan MD 497, 498 Silva, Luis MD 17 Silver- Hochberg, Lauri MD 207 Silver, Caryn MD 290, 531 Silverman, Larry MD 547 Silverman, Scott MD 297, 537 Silverstein, Jeffery MD 540 Silvestri, Fred MD 480, 481 Simeoni, Anna DDS 156

Simon, Keith DMD 285 Simoneau, Cheryl OD 538 Sims, Mary OT 714 Sims, Susan LMHC 564 Sinclair, Jeffrey OD 302 Sinclair, Karlene MD 481 Sincoff, Eric MD 332, 399 Sine, Jennifer ARNP 649 Singer, Joseph MD 81, 534 Singh, Alok MD 111 Singh, Harshinder MD 111 Singh, Japinder MD 17, 72 Singh, Manju MD 30 Singh, Satnam MD 32 Singleton, Ulysses PT 733 Sinha, Purendra MD 346 Sinnott, John MD 174 Sinoff, Stuart MD 398 Sirage, Mohamed DMD 259, 445 Sirak, Laura ARNP 651, 652, 724 Siron, Judith ARNP 730 Sisco, Kelly LCSW 587 Skaggs, William MD 527 Skarda, Janet MD 481 Skordas, Fotios DDS 526 Slackman, Robert MD 534 Sleem, Sonya SLP 681 Sleep Associates of Florida 629 Slement, Gaby DMD 156 Slickers, Albert LPC 582 Sloan, Chris MD 177, 207 Slonim, Charles MD 214 Small, Frankie LCSW 567 Small, Michael MD 125 Small, Sheri CNM 730 Small, Theodore MD 387 Smart RX Pharmacy 779 SMH Sports Medicine Center 647 Smillie, Joseph DMD 476 Smith Jr, Ronald MD 98, 307 Smith, Amanda MD 574 Smith, Daryl DDS 325 Smith, David DDS 83, 91 Smith, Donald MD 187 Smith, Elizabeth MD 27 Smith, James MD 111 Smith, Jeffrey PHD 592 Smith, Jessica MD 42, 62, 443

www.wellcare.com/Florida | 882

Smith, Karimah MD 207 Smith, Karla CNM 655 Smith, Kevin OD 230, 231, 341 Smith, Kimberly MD 270 Smith, Laura PHD 574 Smith, Mary OD 425 Smith, Mary SLP 742 Smith, Matthew MD 519 Smith, Michael Had 616, 646 Smith, Owen MD 72 Smith, Paul MD 164 Smith, Richard DO 592 Smith, Robert MD 335 Smith, Susan MD 492, 493 Smith, Vevian ARNP 661 Snoke, Don Blair DDS 285 Snow, Rodney ARNP 732 Snowball, Marcia MD 407 Snyder, Donald MD 80 Snyder, Kirk DMD 83, 91 Snyder, Sandra PA 657 Snyder, Todd LMHC 601 Sobowale, Olumide MD 481 Sochet, Kristin MD 47 Sodano, Dan MD 357 Soe, Kathleen DO 362 Soeker, Linda ARNP 686 Sokol, Gerald MD 346 Sokolich, Julio MD 164 Solaris Healthcare Bayonet Point 629 Solaris Healthcare Plant City 620 Solarus Enterprises LLC 615 Solc, Zucel MD 268, 450 Soliman, John DO 333 Solomon, Kenneth MD 181 Soma, Vikas MD 330, 482 Somboonwit, Charurut MD 18, 171, 174 Sommers, Keith MD 272 Soni, Ambica MD 67 Sonni, Rajeswari MD 3, 6 Sontchi, Richard MD 481 Sookdeo, Trishanna MD 67 Sorathia, Divyang MD 266 Soriano, Andres MD 528 Soscia, John MD 81 Soto, Adelene ARNP 656

PROVIDER INDEX S - cont. Soto, Frederick OD 538 Sotolongo, Ignacio MD 397 Soueidan, Natalie SLP 695 Sourbeer, Jeffrey MD 47 South Florida Baptist Hospital 553, 565 South Lake Pharmacy 765 South Tampa Health and Rehab Center 621 South, Stacey MD 293 Southcare Pharmacy Inc 773 Southeast Pharmacy 761 Southeastern Medical Supply Inc 641 Southern Pines Healthcare Center 629 Sovereign Healthcare of Tampa LLC DBA Ba 621 Sowka, Lawrence MD 519, 520 Soylu, Lana MD 27 Spadafora, Joseph DO 537 Spagnolo-Hye, Carol DO 42 Spalding, Chelsea OD 539 Spanos, Elena LCSW 564 Sparkman, Susanne AUD 688, 696 Sparrowhawk, Paloma LMHC 580 Spellacy, William MD 207 Spencer, Debbie MD 207, 208, 493 Spencer, Kathleen SLP 650 Spencer, Shelly SLP 734 Sperber, Harry MD 367 Spieker, Janet ARNP 714 Spinney, Elizabeth PA 731 Spoor, Lori DO 18 Sporn, Paul MD 208 Spoto Cannons, Antoinette MD 27 Spouh, Mohammad DDS 156, 325 Sprehe, Stacey PA 691 Sreekantaiah, Kiran DDS 459, 460 Sriaroon, Chakrapol MD 171, 266 Sriaroon, Panida MD 443 Srivastava, Amit MD 357 Srivastava, Sunit MD 289 Srivastava, Vinita MD 95, 214 St Anthonys Physicians Surgery 631 St Aubin, Mary LMHC 601 St Croix, Peggy ARNP 706

St Joseph Pharmacy 755 St Josephs Hospital 553, 565 St Josephs Pharmacy 766 St Laurent, Renee ARNP 604 St Luke Pharmacy 773 St Marks Pharmacy 773 St Mary Pharmacy 773 St Mary Pharmacy II 773 St Pete Cancer Treatment Center 450 St Petersburg Dialysis 634 St Petersburg Endoscopy Center 631 St Petersburg General Hospital 556 St Petersburg Limb & Brace 636 St Petersburg Nursing and Rehab 638 St Petersburg Nursing and Rehabilitation 638 St Petersburg Pharmacy 773 St Petersburg South Dialysis 634 St Simon Pharmacy 783 St Vil, Islaine LCSW 567 St. Hilaire, Nicholas DC 115 Staal, Jacqueline ARNP 672, 685, 712, 730, 739 Staffetti, Joseph MD 319 Stand Up MRI of Tampa 613 Stangherlin, Michael DC 115 Stanley, Cheryl ARNP 658, 659 Staples, Stephanie ARNP 708 Stapleton, Gary MD 241, 304, 342, 433, 511, 540 Stapleton, Stacie MD 247, 438, 512, 541 Starcare Pharmacy 766 Stauffer, Marc MD 111 Staywell Customer Service 606 Staywell Pharmacy 755 Steckler, Eric MD 368 Steel, John MD 268 Steeves, Andrea PA 721 Stefanic, Laurie ARNP 677 Steffel, Christine SLP 720 Stein, Paul DDS 526 Steinberg, Brandon MD 47 Steiner, Judith LMHC 601 Steinhoff, Jeff MD 357, 392

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Stelnicki, James DPM 345 Stemble, Kelly LMHC 580, 587 Stephens, Heidi MD 237 Stephens, Hera MD 185 Stephens, Pamela CNM 664, 672 Stephens, Shawn MD 293, 534 Stephens, Shieloh ARNP 679 Sterlacci, Susan MD 493 Sterling, Fran DO 62 Sterling, Jocelyn LMHC 738 Sterling, Peggy OD 231, 341 Stevens, Xuan PHD 579 Stewart, Brittany ARNP 659 Stewart, Christian AUD 696 Stewart, Stephanie DPM 545 Stilian, Douglas DMD 157 Stilson, Johnna LMHC 564 Stine, Jessica MD 208 Stipe, Denise SLP 679 Stirling, Kari MD 177, 178, 330, 394, 483, 530 Stjosephs Diag Cntr 613 Stock, Saundra MD 574 Stoici, Ioana DMD 381 Stokes, Melvin PHD 592 Stokes, Sarianna SLP 720 Stoneburner, Jon OD 302 Stonerock, Mary MD 111 Stopczynski, Kim ARNP 662 Stoyanov, Veselin MD 37 Stratford Court of Palm Harbor 638 Strathmann, Richard MD 208, 493 Straub, Diane MD 27, 99 Straub, Donald DO 164 Strauss, Lawrence PA 698 Strickland, Amy MD 368 Strickland, Kimberly ARNP 717 Strong, Shannon ARNP 672, 730 Stroud, Sandra OD 425 Strum, Neta MD 34 Stuart, Lorna MD 79 Stuart, Menachem MD 457 Stublen, Greta SLP 742 Stump, Kay ARNP 686, 687 Stupp, Elliott OD 302, 539 Stutts, Stacy ARNP 679 Stutzman, Sandra ARNP 661

PROVIDER INDEX S - cont. Suarez, Adriana MD 208, 493 Subramanian, Thondikulam MD 332 Sucandy, Iswanto MD 164 Success 4 Kids and Families 565 Suciu, Lavinia MD 289 Sudbury, Glenn OD 231, 302 Suh, Elsa MD 241, 242, 433, 541 Sullebarger, John MD 111, 174 Summerfield Pharmacy Inc 755 Summergate Pharmacy 766 Sumner, Warren PA 660 Sun City Center Dialysis 614 Sun Discount Pharmacy 783 Sun Pharmacy 773 Sun Pharmacy of Venice 783 Suncoast Center Inc 588 Suncoast Specialty Surgery Center 626 Suncoast Therapy LLC 647 Sundance Therapy Inc 609 Sundberg, Sharla MD 287 Sunlife Pharmacy 773 Sunnyside Properties of Sarasota Inc 648 Sunrise Pharmacy 755, 779 Sunset Lake Health& Rehab 648 Sunshine Pharmacy 779 Suntrust Pharmacy 766 Super Discount Pharmacy 755 Superior Medical Equipment Plus LLC 636 Supreme RX 779 Suradi, Alexis MD 185 Suradi, Yazan MD 186 Suresh, Adithya MD 274 Surgery Center At St Andrews 645 Suri, Niki DDS 476 Surrey Pl Convalescent Center of Bradenton 625 Susan Cheek Needler Breast Center 633 Sutter, Kara LCSW 567 Sutton, William DPM 545 Swan, Tricia MD 443 Swann, Forrest MD 412 Swanson, Rozales MD 271 Sweat, Steven DC 83, 277

Sweet Child O Mine LLC 611 Swor, Gray MD 547 Syed, Asma MD 344 Sylvain, Emily ARNP 741 Sylvan Health Center 638 Sylvester, John MD 307, 547 Symphony Diagnostic Services No1 LLC DBA 635 Szafran Swietlik, Anna MD 318, 364 Szafranski, Christy MD 27, 62, 63 T Ta, Alyssa MD 209 Tabassum, Rana MD 63, 444 Tabatabaian, Farnaz MD 18, 100 Tabesh, Amanollah MD 119 Tabesh, Mohammadreza MD 175 Tabor, Mark MD 119 Tager, Madisen SLP 695 Tai, Zaheed DO 455 Takagishi, Jennifer MD 27, 28 Take Care Health 612, 626, 632 Talakkottur, Charles MD 18 Talero, Guillermo MD 12 Talit, Uzi MD 112 Tallapragada, Sudha MD 529 Tally, Philip MD 291 Talton Williamson, Stephanie MD 37 Tamayo, Percival MD 5 Tamboli, Hoshedar MD 112 Tampa Bay Artificial Limbs In 263 Tampa Bay Diagnostic Imaging 627 Tampa Bay Orthopaedic Designs Inc 619 Tampa Bay Specialty Surgery Center 631 Tampa Bay Surgery Center 611 Tampa Community Hospital 553 Tampa Crossroads Inc 566 Tampa Drugs Diabetic Center 755 Tampa Family Health Centers -Florida Hospital 755 Tampa Family Pharmacy 755 Tampa General Hospital 553 Tampa General Hospital OP Pharmacy 755 Tampa Palms Pharmacy 755

www.wellcare.com/Florida | 884

Tampa Pathology Lab 617 Tampa Road Pharmacy 773 Tampa Urgent Care 622 Taneja, Amy MD 400 Tang, Huayang MD 328 Tang, Nathan MD 350, 428 Tangunan, Ray MD 4 Tanner, John DO 122 Tanyous, Walid MD 530 Taormina, Rochelle PHD 574 Tarabishy, Ahmad MD 337 Tarpon Bayou Center 638 Tarpon Discount Drugs 773 Tarpon Point Nursing and Rehabilitation 648 Taunk, Jawahar MD 368 Taunk, Pushpak MD 125 Tayao, Maria Concepcion MD 28 Tayao, Maria MD 28 Taylor, Lindsey DMD 157 Taylor, Marc MD 358 Taylor, Tara MD 407 Taylor, Thomas MD 118 Teefey, Patrick MD 209 Teekell-Taylor, Leah MD 452 Teixeira, Milton LMHC 564 Tejiram Martinez, Romeena DO 11 Telukuntla, Koteshwar MD 290 Temple Terrace Dialysis 614 Temple Terrace Pharmacy 755 Teng, James MD 119 Tenn, Alicia ARNP 674, 731 Teodorescu, Dumitru-Dan MD 83 Teresi, Kirsten DMD 157, 285, 381, 526 Terranova, Kelly PA 674 Tew, Jenna PA 706 Tfhc 15 Pharmacy 755 Tfhc 16 Pharmacy 755 Tfhc 17 Pharmacy 755 Tfhc 18 Pharmacy 755 Tfhc 21 Pharmacy 755 Tfhc 23 Pharmacy 755 Tfhc 28 Pharmacy 756 Tfhc 29 Pharmacy 756 Tfhc 30 - Fletcher Ave 756 Tfhc- Sligh 31 756 Tfhc22 Pharmacy 756

PROVIDER INDEX T - cont. Thai, Pauline OD 96, 231, 507 Thakkar, Vinod MD 90 Thal, Julie OT 673 Thangam, Sabanayagam MD 112 Thareja, Sumeet MD 118 Thatcher-Janowski, Amy LCSW 601 Thatimatla, Naga MD 326 The Abbey Rehabilitation and Nursing 638 The Apothecary Shop 779 The Back To Wellness Center LLC 628 The Chrysalis Center Inc 588 The Crossroads 643 The Drug Shoppe 756 The Florida Center For Early Childhood 601 The Groves Center 643 The Harbor BHCI 581 The Health and Rehabilitation Centre At 638 The Home Association 621 The Medicine Shoppe 756, 766, 773 The Nursing Center At University Village 621 The Oaks At Avon Park 610 The Prescription Shop 773 The Springs At Lake Pointe Woods 648 Theogene, Dorothy DDS 259, 344 Therhappy Therapy Services Inc 628 Thiel, Derrick DO 171, 175 Thinh, Nguyen MD 407 Thoenes, Melanie ARNP 718 Thomas Allen, Tequesta SLP 679 Thomas, Brandy CNM 685, 739 Thomas, Janelle ARNP 732 Thomas, Kelly DMD 381, 382 Thomas, Matthew MD 439, 604 Thomas, Rebecca MD 2 Thomas, Rosalyn LCSW 567 Thomer, Marguerite MD 452 Thompson, Cody PA 675, 693, 715 Thompson, Elisa MD 37 Thoresen, Lena OT 686

Thorpe, Lorraine DC 361 Thorpe, Rachel LCSW 601 Threadgill, Nichelle MD 63 Tidewell Hospice Inc 607, 624, 646 Tiesi, James MD 187, 291 Tijerino, Linda MD 400 Tillquist, Jackson ARNP 713 Times Pharmacy 756 Tingle, William MD 88, 308, 549 Tinny, Jacqueline CNM 688, 691 Tirupathi, Sreelatha MD 50 Tiwary, Alka DDS 325 Tobias, Penelope LCSW 567 Toka, Hakan MD 291 Tolouian, Ramin MD 291 Tom Lee Community Health Center 756 Ton, Kim-Oanh OD 231 Ton, Liem MD 4, 69 Toomey, Paul MD 287 Toonkel, Leonard MD 268 Toribio, Fiordaliza MD 18 Torres De Carlo, Rita MD 28 Torres Gluck, Jose MD 486 Torres, Alexander MD 98 Torres, Luz MD 28 Torres, Ramon MD 89, 90 Torres, Wanda MD 335 Torres-Bonilla, Gisela MD 362 Total Care Pharmacy of Bloomingdale 756 Total Care Pharmacy of Brandon 756 Total Therapy 620 Tower Imaging Inc 613, 618, 627, 628 Towey, Brigit LMHC 662 Town Pharmacy 783 Tralins, Kevin MD 450 Tramont, John MD 209 Tran Bergman, Kiki DPM 263 Tran, Baotram OD 231, 425 Tran, Faye DDS 476 Tran, Ivy DMD 476, 477 Tran, Quan MD 164 Tran, Thein MD 29, 64 Trancik, Anika PHD 604 Tran-Lockwood, Julie OD 302, 341, 425, 426

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Tranum, Megan LMHC 580 Trax, David DC 90 TRC Bayonet Point Dialysis 627 Treadway, Benjamin LMHC 662 Trevino, Miguel MD 50 Tri County Human Services Inc 560, 561, 595, 598, 599 Tri Med Medical Pharmacy 773 Trident Mobile Clinical Services 635 Trimble, Chelsy SLP 720 Trindade, Antonio MD 484 Trinity Pharmacy 773 Trinity Regional Rehab Center 629 Tripathi, Shreekant MD 516 Tripodi, Amedeo MD 81 Trivedi, Bhavya MD 97 Trivedi, Mehulkumar DMD 157, 285, 325, 382, 526 Trotman, Bruce MD 278 Trowbridge, Rose MD 242, 243, 304, 342, 434, 511 True Blue Therapy LLC 620 Truecare Pharmacy 761 Trupiano, Christine MD 534 Trussell, Kenneth DC 115 Trust Pharmacy 773 Tsai, David MD 305 Tucker, Michele DO 77, 78 Tuerkheimer, Barry OD 302 Tuite, Gerald MD 248, 439, 513 Tummel, Evan MD 164 Tun, Aung MD 112, 314 Turhan, Mine DDS 285, 286 Turke, Eric DDS 234 Turner, Angela DO 358, 393 Turner, Nancy ARNP 721 Turnow, Kory ARNP 708 Turnquest, Merse MD 86, 87, 94, 493 Turpin, Sharon CNM 713 Tutay, John DMD 91, 157 Twiggs, Rudolph DMD 157 Tyler Jr, Gilman MD 164 Tyler, Eric OD 231 Tyree, Mary PA 725

PROVIDER INDEX U Ubillos, Scott MD 171 Ultra Healthcare Services 635 Umamaheswaran, Indira MD 332, 398 Umeh, Ifeyinwa MD 78 Umstead, Thomas MD 335, 407 Univ Pain Management Center 756 University Diagnostic 613 University Pharmacy 761 Upadhya, Krishna MD 349 Upadhyaya, Dipakkumar MD 94 Urban Specialty Pharmacy 773 Urban, Jr, Robert MD 337 Urdaneta-Jaimes, Jose MD 518 Urgent Care USA LLC 622 Uribe, Juan MD 187 Urso, Gaetano DO 11 USF Dialysis Center 614 USF Endoscopy & Surgery Center 611 USF Health Pharmacy Plus 756 Uzbay, Lisa MD 209 Uzunova-Dimova, Kalina DDS 158, 382 V V T Pharmacy 756 Vagedes, Marie LCSW 582, 588 Vaikunth, Sachin MD 165 Valdes, Julio MD 29 Valdes, Ruben DO 11 Valdez, Harvey DMD 158 Valdivia Valdivia, Juan MD 188 Valdman, Vadim DDS 158, 382 Vale, Fernando MD 188 Valencia, Diana MD 42 Valencia-Serafini, Maria DO 29 Valentin, Marlene MD 274 Valentin, Socorro ARNP 672, 685, 713, 730 Valeriano-Marcet, Joanne MD 270 Vales, Ana-Marai DDS 544 Valez Gaetan, Jelexza MD 37 Valins, Robert DPM 263, 345 Vallejo, Elvia MD 407 Valrico Pharmacy 756 Valued Choice Pharmacy 756

Van Buren, George MD 34 Van Dam, Gregory PsyD 579 Van Der Wall, Ana MD 290 Van Gelder, Hugh MD 452 Van Kleeck, Phillip LMHC 561 Van Loveren, Harry MD 188 Van Pelt, Teresa LMHC 564 Van, Tim DMD 477 Van, Vincent DDS 515 Vana, Ted DO 11, 37 Vanbrackle, Cathryn PsyD 579 Vanderheuvel, Kimberly ARNP 697 Vangala, Vidyasagar MD 597 Vangara, Sreenivas MD 319 Vanguard Advanced Pharmacy Systems 761 Vanoverbeke, Allen DMD 286 Vanterpool, Clyde MD 92 Varda, Janice ARNP 660 Varela, Monica DDS 477 Vargas, Alfonso MD 181 Vargas, Catherine ARNP 735 Vargas, David MD 460 Vargas, Gisela MD 11 Vargas, Tania SLP 720 Varkala, Sreelatha MD 183 Varney, Ella MD 79 Vascular Ultrasound Services 618 Vasiloudes, Panos MD 118, 317 Vasquez, Jose MD 171 Vasquez, Kimber MD 2, 4, 69 Vasquez, Kristine DMD 477 Vasudeva, Indi MD 183 Vaughn-Kerns, Karen CNM 691 Vaz, Stephanie MD 407 Vazquez Maldonado, Lilliam MD 78 Vazquez, Carlos MD 83, 293, 294 Vazquez, Eduardo PA 679 Vazquez, Maribel OT 731 Vcare Pharmacy 773 Vecchio, Christine AUD 654, 683, 688, 722 Vega, Vilma MD 171, 175, 391, 392, 393, 529, 530 Velanovich, Vic MD 165 Velasco Segarra, Luis MD 11 Velcu, Laura MD 287

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Velett, Kristen OT 714 Velez Camacho, Hector MD 186 Velez, Ana ARNP 725 Velez, Giovanni MD 67 Velusamy, Muthusamy MD 112, 175 Venezia, Angela ARNP 732 Venice Apothecary 783 Venice Regional Medical Center 558 Venigalla, Madhavi MD 484 Venis, Monte DC 361 Ventura, Hugo MD 18 Venturino, Nicholas DC 115 Veracity Pharmacy 756 Verdeja Perez, Ana MD 209 Vergara, Claudia DDS 158 Verma, Shivani MD 514 Vernier, Eric MD 456 Veterans Pharmacy 756 Victores, Rebeca SLP 681 Victorine, Suzanne ARNP 724 Victor-Linkenhoker, Vanessa MD 34 Viegas, Melita MD 242 Viera, Gretel DDS 382 Vijapura, Ashit MD 572, 581, Vilches, Ricardo MD 485 Villa Medical Health Solutions 779 Villa Pharmacy 779 Villa, Maria MD 493, 494 Village Pharmacy 783 Villalba, Marcelo DPM 447 Villanueva, Pedro MD 1 Villar, Nelson ARNP 665 Villarreal, David MD 326 Villegas, Fabio MD 29 Vindhya, Naveena MD 42 Vinson, Mary Carolyn DO 272 Vintayen, Enrico MD 532 Virella Guzman, Vivian MD 69 Visalli, Alyssa LMHC 580 Visionworks Inc 215, 337, 413, 414 Visiting Nurse Association of Florida In 617, 628 Vistacare Pharmacy 756 Vistara Pharmacy 756 Visweshwar, Nathan MD 168

PROVIDER INDEX V - cont. Vitas Healthcare Corporation of Florida 642 Vizzi, Lindsay SLP 681, 695, 720 Vo, Jossette DMD 325 Vo, Mai OD 231, 232 Voaonsri, Nopparat DMD 477 Vodopija, Linda SLP 742 Vogel, Kenneth PT 733 Von Thron, James MD 192, 209, 333 Vought, Jill SLP 681, 695 Voutour, Deborah ARNP 741 Vp Pharmacy 757 Vu, Anthony OD 426 Vu, Bonnie OD 232 Vu, Clara DMD 477 Vu, Tan MD 47 Vu, Tuan MD 186 Vydyula, Ravikanth MD 346 Vymed Diagnostic Imaging Tampa LLC 614, 633 W Wachter, John OD 426 Wade, Brianne DMD 158, 159, 286, 382, 383, 526 Wages, David DC 115 Wagner, Stephen MD 209 Wagoner, Mary ARNP 732 Wagoner, Ryan MD 574 Wahl, Michael MD 347 Walding III, Stephen DMD 477 Walford, Nebbie MD 165, 251, 287, 304, 387, 441, 526, 542 Walgampaya, Dakshina MD 175 Walker, Aaron DDS 478 Walker, Amanda LCSW 567 Walker, Christopher MD 494 Walker, Larry LMHC 738 Walker, Robert Morgan MD 175 Walker, Stacey OD 232 Wall, Chanda OD 302 Wall, Ward MD 481 Wallace, Cynthia ARNP 733 Wallace, Davina SLP 681 Wallace, Robert MD 47 Wallner, Jean PA 655

Walmart Pharmacy 744, 745, 757, 758, 761, 762, 766, 773, 774, 779, 783, 784 Walsh Sr, Douglas DO 392, 529 Walsh, John MD 358 Walsh, Ronald DO 358 Walter, Andrew MD 209 Walters, Christopher PA 690 Wang, Judy MD 531 Ward, Clifford DDS 286 Ward, Eugene MD 125 Ward, Leslie ARNP 672, 685, 713, 730, 739 Ward, Michael DDS 478 Ward, Tasha DDS 91, 286, 383 Ware II, Donald DO 4 Ware, Rachel PA 660 Warne, Hannah PT 687 Warner, Daniel MD 530 Warner, Elizabeth MD 18 Warnick, Drew MD 249, 343, 440, 542 Warren, Ana ARNP 718 Warta, Steven PA 698 Washington, Gina MD 209 Wasylik, Kathleen MD 119, 120, 243, 277, 304, 363, 434, 458, 511 Waterman II, Philip MD 209, 294, 408, 494, 535 Waters, Madeline ARNP 707 Waters, Robin LCSW 567 Watkins, Antoinina MD 192 Watson Center 636 Watson, Ashlyn PT 678 Watson, Jeffrey MD 237 Watson, Jennifer DO 400 Watson, Maxine PT 741 Watson, Robert MD 165 Watsons Pharmacy 779 Wattenbarger, John MD 210 Wauchula Pharmacy 744 We Care Pharmacy 784 Wearden, Peter MD 242 Weathers, Laura MD 29 Weaver, Robert MD 180 Webbs Square Pharmacy 779 Weber, Theodore PsyD 579

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Webster, Jennifer PA 698 Wecare Pharmacy 774 We-Care Pharmacy 784 Wecare Pharmacy LLC 758 Weckesser, Barry MD 521 Wedgewood Healthcare Center 643 Wee Care Clinic Inc 630 Weerasooriya, Viraine MD 436 Wei, Michael MD 84, 546 Weinberger, Alyssa MD 64 Weingarten, Darlean CNM 697, 710 Weinstock, Stephen MD 412, 413 Weintraub, Alan MD 125 Weisbond, Steven OD 232, 302 Weiskopf, Mark DDS 383 Weiss, Allan MD 398 Weiss, Amy MD 29, 99 Weiss, Michael MD 335, 336, 368 Weiss, William MD 521 Weisser, Ettie DDS 159, 383 Weitzel, Andrew DO 549 Welch and McLoy Therapy Services PA 628 Weller, Conrad MD 592 Wellness Pharmacy Inc 758 Wells, Lindsey PA 724 Wells, Rachelle DDS 159 Wesley Chapel Dialysis, LLC 627 Wesnofske, Cassandra ARNP 718 West Bay Rehab & Nursing Center 638 West Coast Pharmacy LLC 758 West Cst Neonatology Inc 395, 396 West Florida PET Services LLC 614 West Florida Surgery Center Inc 623 West Hernando Diag And MRI Center 627 West Park Surgery Center, LLC 631 West Shore Pharmacy 758 West Tampa Dialysis 614 West, John MD 450 Westchase Surgery Center LTD 611 Westchester Gardens Rehabilitation Care 638 Westcoast Brace & Limb 619, 636

PROVIDER INDEX W - cont. Westcoast Radiology LTD 627, 633 Westerfield, Matthew DPM 447 Westervelt, James MD 387 Westervelt, Lindley PT 693, 733 Westminster Suncoast 638 Weston, Mark MD 112 Weston, Patrick MD 358 Wharton, Robert MD 368 Wheeler, Cynthia LCSW 588 Whipple, Judith CNM 655 Whispering Oaks 621 Whitaker, David MD 112, 113 White, Kathy LMHC 575 White, Laura SLP 680 Whitehead, Keith MD 192, 193 Whittingham, Zerica CNM 697, 710 Whittington, Candace DDS 159, 160 Whitworth, Heather MD 78 Whorf, Robert MD 290 Wical, Jessica ARNP 708 Wickert, Cecilia AUD 654 Wiegand, Lucas MD 273 Wilcoxon, Dennis OD 426 Wildcatt, Lisa MD 29 Wilkerson, Wallace MD 193, 334 Wilkinson, Donna ARNP 713 Willard, Cindylee CNM 713 Williams Pharmacy 758 Williams, Chandra MD 29 Williams, Christopher DC 115 Williams, Gregory DC 115, 316 Williams, J Kell MD 165 Williams, James MD 361 Williams, John OD 232, 341 Williams, Kelly LCSW 564 Williams, Kim SLP 742, 743 Williams, Mark PHD 579 Williams, Michelle Ann CNM 691 Williams, Natalie MD 47 Williams, Oswald MD 50 Williams, Stephen MD 29 Williams, Thomas MD 84, 88, 308, 549 Williams, Tosha DDS 160, 383 Williams, Vashaun MD 582, 583 Williamson, Blake LMHC 587 Williamson, Nicole PHD 574

Williams-Wallace, Nancy MD 413 Willis, Kathleen SLP 695 Willis, Richard PsyD 574 Willis, Steven DC 316 Willmitch, Martin DC 115 Wills, Todd MD 171 Wilsey Jr, Michael MD 246, 304, 342, 436, 512 Wilson Chan, Jessica DO 12 Wilson Henton, Shaana LMHC 564 Wilson, Amanda MD 169 Wilson, Christopher DO 358 Wilson, David MD 101, 113 Wilson, Heather ARNP 714 Wilson, Jason MD 326 Wilson, Jeffrey MD 275 Wilson, Mark OD 232 Wilson, Scott MD 275 Win, Moethu MD 314, 329 Windmoor Healthcare Inc 589 Windom, Hugh MD 521 Winesett, Michele MD 246, 436, 512 Winesett, Steven MD 114, 186, 315, 359, 456 Wing, Michael MD 98 Wingert, Frank LCSW 587 Winn-Dixie Pharmacy 745, 758, 759, 762, 766, 774, 775, 780, 784 Winston, Beverley ARNP 649, 652 Winter Haven Amb Surgical Center 640 Winter Haven Dialysis 640, 641 Winter Haven Hospital 557 Winter Haven Hospital Inc Center For Beh 595 Winter Haven Pharmacy 780 Winter Haven South Dialysis 641 Wishnew, Jessica MD 438 Witfill, Kristin MD 362 Wittine, Lara MD 266, 270 Wittmann, Lisa MD 82 Wittum, Roger MD 90 Wize Pharmacy 775 Wojas, Justyna MD 397, 592 Wojnowich, Katherine MD 47, 451 Wolford, Dale DO 83, 294

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Wolfson, James PA 741 Wong, Elaine DDS 383, 384 Wong, Philip MD 98 Wong, William DPM 516 Woo, Kyung DDS 160, 384 Wood, Wayne OD 302, 303, 539 Woodbridge Rehab & Health Center 621 Woods, Andrea MD 358 Woods, Reginald MD 294 Woodyard, John PA 690 Woolwine, Joshua OD 232, 233 World Wide Medical Services Inc 619 Worlinsky, Courtney DMD 384 Worobel, Michael DO 544 Wouters, Anna MD 408 Wright, Alene MD 326 Wright, Carl DDS 325 Wright, David MD 168 Wright, Gail MD 330 Wright, Melissa ARNP 651, 724 Wright-Browne, Vance MD 528 Wrights Healthcare & Rehab Center 638 Wyble, Lance MD 181 Wynnephillips, Heather ARNP 661 X Xtra Care Pharmacy Xtra Discount Drugs Xu, Su MD

759 766 119

Y Yakubu, Elizabeth MD 29 Yale, Steven MD 572 Yali, Patricia ARNP 706 Yamamura, Kenneth MD 309, 315 Yamani, Mohammad MD 50 Yan, Ben MD 390 Yancey, April OD 303 Yankeloff, Kristina SLP 695 Yankowitz, Jerome MD 210, 494 Yantorni, Lauren ARNP 652, 661, 725, 726 Yathiraj, Sanjay MD 291 Yee, Daniel OD 426 Yelverton Jr, Robert MD 210 Yeung, Vincent DDS 515

PROVIDER INDEX Y - cont. Yodalys Home Health Corp Yoho, Thomas DDS Young, Caroline ARNP Young, Carrie ARNP Young, Joyce ARNP Young, Juan MD Young, Kera DDS Young, Shara MD Young, Shelley MD Youngtan, Alison MD Your Family Walk In Clinic LLC Yu, Lina DMD

617 160 672 715 677 125 259 408 408 72 630 478

Zmiyiwsky, Mark DDS 286 Zoher, Mina MD 81 Zook, Matthew MD 118, 317, 363 Zuniga-Pedrianes, Danilo MD 34 Zussman, Matthew MD 97 Zuzga, Mark MD 348, 453 Zweibach, Stephen MD 210

Z Z Orange Pharmacy 766 Zaffar, Nauman MD 72 Zaffer, Syed MD 260 Zagata, Mateusz MD 79 Zaglul, Jose MD 576 Zaidi, Syed MD 592 Zaki, Fady DDS 286 Zaki, Khaja MD 315 Zaldana, Sabrina ARNP 665 Zalepuga, Rimantas MD 278 Zambito, Ashlie ARNP 665 Zambrano, Regina MD 387 Zanchi, Dragos MD 266 Zand, Maximus DMD 160, 384 Zapert, Edward DDS 91 Zariffard, Ehsan DMD 160, 384 Zarling Felts, Jaclyn SLP 742 Zarranz, Robert MD 458 Zayas, Egberto MD 180 Zdrubecky, Carrie OT 692 Zeitler, Christine SLP 719 Zeitlin, Laurence MD 368 Zeledon, Jorge MD 93 Zephyrhills Brace&Limb 628 Zern, Brittany PsyD 574 Zervogiannis, Panagiotis MD 175 Zhao, Wenying MD 29, 64, 65 Zhu, Hui MD 237 Zide, Stacy MD 34 Ziegler, Lane DO 390 Ziesman, Krista ARNP 679 Zimmerman, Linda ARNP 672 Zipeto, Teresa ARNP 659

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Discrimination is Against the Law Staywell complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Staywell does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Staywell:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as: - Qualified sign language interpreters - Written information in other formats (large print, audio, Braille, accessible electronic formats, other formats) • Provides free language services to people whose primary language is not English, such as: - Qualified interpreters - Information written in other languages

If you need these services, contact Staywell at 1-866-334-7927 (TTY: 1-877-247-6272), Monday–Friday from 8 a.m. to 7 p.m., for help or you can ask Member Services to put you in touch with a Civil Rights Coordinator who works for Staywell. If you believe that Staywell has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Staywell, Grievance Department, P.O. Box 31384, Tampa, FL 33631-3384; Telephone 1-866-530-9491; TTY number 1-877-247-6272; Fax: 1-866-388-1769; [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, a Staywell Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

FL035974_CAD_INS_ENG State Approved 02222017

©WellCare 2016 FL_10_16 FL6CADLAN79485E_1016

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ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-866-334-7927 (TTY: 1-877-247-6272).

©WellCare 2016 FL_10_16 FL6CADLAN79485E_1016

79485

FL035974_CAD_INS_ENG State Approved 02222017

1-866-334-7927 (TTY/TDD 1-877-247-6272) www.wellcare.com/Florida