PELICAN PRIMARY CARE, LLC (NPI# 1386050540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386050540 |
| Entity Type | Organization |
| Organization Name | PELICAN PRIMARY CARE, LLC |
| Other Organization Name | PELICAN PRIMARY CARE |
| Practice Address |
23421 Walden Center Dr Ste 100 Bonita Springs FL 34134-4911 |
| Mailing Address |
1217 Piper Blvd Ste 104 Naples FL 34110-1433 |
| Practice Telephone | 2395142005 |
| Practice Fax Number | 2395930067 |
| Mailing Telephone | 2395142005 |
| Mailing Fax Number | 2395930067 |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |
| Authorized Official Name | JASON RICHICHI (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 2395142005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 041799800 | 05 |
| Other Name | Type Code |
|---|---|
| Pelican Primary Care | Doing Business As Name - Organization |
| Street Address |
23421 WALDEN CENTER DR STE 100 |
| City | BONITA SPRINGS |
| State | FL |
| Zip Code | 34134-4911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255803706 | Sheila Mourick | Home Health | 3920 Via Del Ray, Suite 4, Bonita Springs, FL 34134 | 2018-12-21 |
| 1447702162 | Averie Bendana | Hearing Instrument Specialist | 15 8th St Suite B, Hoglund Family Hearing, Bonita Springs, FL 34134 | 2016-10-28 |
| 1366990830 | Jordania Psychiatry LLC | Clinic/Center | 25111 Pennyroyal Dr, Bonita Springs, FL 34134 | 2016-09-14 |
| 1447682497 | Shancy Varghese Kanacheril | Pharmacist | 25121 S. Tamiami Trail, Bonita Springs, FL 34134 | 2013-08-01 |
| 1861762163 | Alyssa Haraczy | Pharmacist | 25121 S. Tamiami Trl, Bonita Springs, FL 34134 | 2012-01-04 |
| 1982905659 | Jessica Ann Rosen | Speech-Language Pathologist | 3384 Woods Edge Cir Ste 104, Bonita Springs, FL 34134 | 2010-11-10 |
| 1902116718 | Keenan Chiropractic Pa | Chiropractor | 3388 Woods Edge Circle Suite 102, Bonita Springs, FL 34134 | 2010-10-14 |
| 1659683076 | Amy Marie Mcneal | Massage Therapist | 28811 S. Tamiami Trail Unit 13-14, Bonita Springs, FL 34134 | 2010-07-14 |
| 1740509157 | Sarah Churton | Dermatology | 23471 Walden Center Drive, Suite 300, Bonita Springs, FL 34134 | 2010-05-25 |
| 1609003516 | Ram Prasad Kafle | Family Medicine | 26800 S Tamiami Trl Ste 340, Bonita Springs, FL 34134 | 2009-06-18 |
| Find all providers in zip 34134 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639612484 | Bonita Medical Care Center,inc | Family Medicine | 26455 Old 41 Rd, Suite 18, Bonita Springs, FL 34135-5124 | 2016-11-28 |
| 1437437472 | Scott Michael Mcnaughton | Family Medicine | 3625 Heron Point Ct, Bonita Springs, FL 34134-2969 | 2011-07-25 |
| 1982934915 | Athina Lynn Kyritsis | Family Medicine | 25243 Elementary Way, Suite 103, Bonita Springs, FL 34135 | 2010-01-14 |
| 1609003516 | Ram Prasad Kafle | Family Medicine | 26800 S Tamiami Trl Ste 340, Bonita Springs, FL 34134 | 2009-06-18 |
| 1639327919 | Frances I Romero | Family Medicine | 24830 Burnt Pine Dr Ste 3, Bonita Springs, FL 34134-1974 | 2008-08-29 |
| 1235399775 | Maria Espinoza Avila | Family Medicine | 11921 Saradrienne Ln, Suite 380, Bonita Springs, FL 34135-5911 | 2008-06-09 |
| 1275658536 | Mark D Mcallister | Family Medicine | 24040 S Tamiami Trl Ste 202, Bonita Springs, FL 34134-7040 | 2007-03-19 |
| 1033289103 | Anthony J Williamitis | Family Medicine | 9200 Bonita Beach Rd, Ste 105, Bonita Springs, FL 34135 | 2006-11-08 |
| 1689743890 | Albert G Alessi | Family Medicine | 9400 Bonita Beach Rd Se Ste 102, Bonita Springs, FL 34135-4515 | 2006-11-06 |
| 1104900034 | Raymond Carrelle | Family Medicine | 24810 Burnt Pine Dr Ste 3, Bonita Springs, FL 34134 | 2006-10-25 |
| Find all providers in BONITA SPRINGS | ||||
| City | BONITA SPRINGS |
| Zip Code | 34134 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.