Cheryl Rae Blank (NPI# 1407286479, PAC ID# 6901035179) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1407286479 |
| PAC ID by PECOS | 6901035179 |
| Professional Enrollment ID | I20140626002516 |
| Full Name | Cheryl Rae Blank |
| Organization Legal Name | LEGACY HEALTH MEDICAL GROUP, LLC |
| Address |
3600 Oak Manor Ln Suite 46 Largo FL 33774-1214 |
| Phone Number | 7275964870 |
| Gender | F |
| Graduation Year | 2013 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5193962173 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 | 7275964870 | LEGACY HEALTH MEDICAL GROUP, LLC |
| Organization Legal Name | LEGACY HEALTH MEDICAL GROUP, LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amber Nicole Russo | Nurse Practitioner | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 |
| Priyadarshini G Rao | Internal Medicine | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Sharon L Diamond | Nurse Practitioner | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Largo, FL 33774-1212 |
| Maryana Henson | Nurse Practitioner | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Collette Palmisano | Nurse Practitioner | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 |
| Sunil Pokharel | Internal Medicine | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 |
| Brent J Lataille | Nurse Practitioner | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Connie M Horne | Internal Medicine | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Sunit Srivastava | Internal Medicine | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Danielle Caraballo | Nurse Practitioner | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Street Address |
3600 OAK MANOR LN SUITE 46 |
| City | LARGO |
| State | FL |
| Zip | 33774-1214 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amber Nicole Russo | Nurse Practitioner | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 |
| Sharon L Diamond | Nurse Practitioner | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Largo, FL 33774-1212 |
| Collette Palmisano | Nurse Practitioner | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 |
| Sunil Pokharel | Internal Medicine | Legacy Health Medical Group, LLC | 3600 Oak Manor Ln, Suite 46, Largo, FL 33774-1214 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James A Napier | Osteopathic Manipulative Medicine | 1603 Indian Rocks S Rd, Largo, FL 33774-1026 | |
| Vicki G Pappageorge | Family Practice | 1603 Indian Rocks S Rd, Largo, FL 33774-1026 | |
| Eric C Rost | Radiation Oncology | 1835 Indian Rocks Rd S, Largo, FL 33774-1030 | |
| John Hill West | Radiation Oncology | Tampa Bay Oncology Center, Inc | 1835 Indian Rocks Rd S, Largo, FL 33774-1030 |
| Priyadarshini G Rao | Internal Medicine | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Maryana Henson | Nurse Practitioner | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Brent J Lataille | Nurse Practitioner | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Connie M Horne | Internal Medicine | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Sunit Srivastava | Internal Medicine | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Danielle Caraballo | Nurse Practitioner | Legacy Health Medical Group, LLC | 1 Kent Dr, Largo, FL 33774-1033 |
| Find all physicians in zip 33774 | |||
| City | LARGO |
| Zip Code | 33774 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LARGO + NURSE PRACTITIONER |
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| 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.