Ricardo Arsenio Revilla (NPI# 1326255142, PAC ID# 5395839351) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1326255142 |
| PAC ID by PECOS | 5395839351 |
| Professional Enrollment ID | I20110120000451 |
| Full Name | Ricardo Arsenio Revilla |
| Organization Legal Name | SUWANNEE EMERGENCY GROUP LLC |
| Address |
1100 11th St Sw Live Oak FL 32064-3608 |
| Phone Number | 38636208003608 |
| Gender | M |
| Graduation Year | 1988 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1850675612 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100026 | BAY MEDICAL CENTER SACRED HEART HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 1100 11th St Sw, Live Oak, FL 32064-3608 | 38636208003608 | SUWANNEE EMERGENCY GROUP LLC |
| 615 N Bonita Ave, Panama City, FL 32401-3623 | 8507691511 | JUNCO EMERGENCY PHYSICIANS LLC |
| Organization Legal Name | SUWANNEE EMERGENCY GROUP LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William C Chisholm | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Babak Saadatmand | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Ryan Hillman Reynolds | Nurse Practitioner | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Mahendra R Sheth | Vascular Surgery | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Staccie Anne Allen | Nurse Practitioner | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Matthew Odom | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Garrett H Chumney | Family Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| David R Carter | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Street Address |
1100 11TH ST SW |
| City | LIVE OAK |
| State | FL |
| Zip | 32064-3608 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David G Riehn | Anesthesiology | Ams National LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Margaret M Grissinger | Certified Registered Nurse Anesthetist (crna) | Ams National LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| William C Chisholm | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Babak Saadatmand | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| J Michael Powers | Anesthesiology | Ams National LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Ryan Hillman Reynolds | Nurse Practitioner | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Mahendra R Sheth | Vascular Surgery | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Leona E Westbrook Chilcott | Certified Registered Nurse Anesthetist (crna) | Ams National LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Willy Crna Van Gent Jr. | Certified Registered Nurse Anesthetist (crna) | Ams National LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Staccie Anne Allen | Nurse Practitioner | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John A Workman | Chiropractic | 216 Duval St Nw, Live Oak, FL 32064-1723 | |
| Andrew Clyde Bass | General Practice | 315 Scriven Ave Sw, Live Oak, FL 32064-2222 | |
| Bruce C Ornstein | Podiatry | 609 5th St Sw, Suite 4, Live Oak, FL 32064-2239 | |
| Michael W Wood | Chiropractic | 328 Howard St W, Live Oak, FL 32064-2306 | |
| Michelle D Morris | Nurse Practitioner | Live Oak Hma Medical Group, LLC | 1116 Sw 11th St, Live Oak, FL 32064-3608 |
| Gabriel B Mufuka | Internal Medicine | 1116 11th St Sw, Live Oak, FL 32064-3608 | |
| Daniel J Messcher | Family Medicine | Live Oak Hma Medical Group, LLC | 1100 Sw 11th St, Live Oak, FL 32064-3608 |
| Dennis M Lewis | General Surgery | Live Oak Hma Medical Group, LLC | 1100 Sw 11th St, Live Oak, FL 32064-3608 |
| Callie A Smith | Nurse Practitioner | Live Oak Hma Medical Group, LLC | 1100 Sw 11th St, Live Oak, FL 32064-3608 |
| Matthew Odom | Emergency Medicine | Suwannee Emergency Group LLC | 1100 11th St Sw, Live Oak, FL 32064-3608 |
| Find all physicians in zip 32064 | |||
| City | LIVE OAK |
| Zip Code | 32064 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LIVE OAK + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Ricardo Arsenio Revilla.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.