MEDICARE: PHYSICIANS CARE OF KEYSTONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0049847	FL

General Provider Information

NPI Number	:	1154512432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS CARE OF KEYSTONE

Provider Business Mailing Address
First Line	:	6542 TRIEST AVE
Second Line	:
City	:	KEYSTONE HEIGHTS
State	:	FL
Zip	:	32656-9393
Country	:	US
Telephone Number	:	352-473-7288
Fax Number	:	352-473-9365

Provider Business Practice Location Address
First Line	:	6542 TRIEST AVE
Second Line	:
City	:	KEYSTONE HEIGHTS
State	:	FL
Zip	:	32656-9393
Country	:	US
Telephone Number	:	352-473-7288
Fax Number	:	352-473-9365

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GEORGE L RESTEA
Credential	:	MD
Telephone Number	:	352-473-7288

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/05/2007

Similar Medicare Providers

1881664951 — GEORGE L RESTEA MD
Practice Location Address:

6542 TRIEST AVE
KEYSTONE HEIGHTS, FL
32656-9393

Practice Phone: 352-473-7288
Practice Fax: 352-473-9365

1346541190 — VIRGINIA STEWART APRN
Practice Location Address:

6542 TRIEST AVE
KEYSTONE HEIGHTS, FL
32656-9393

Practice Phone: 352-473-7288
Practice Fax:

1780537027 — BRITTANY TILLQUIST
Practice Location Address:

5343 COUNTY ROAD 352
KEYSTONE HEIGHTS, FL
32656-8200

Practice Phone: 352-286-9165
Practice Fax:

1790636587 — NATALIE PONS APRN
Practice Location Address:

6651 WOODLAND DR
KEYSTONE HEIGHTS, FL
32656-9293

Practice Phone: 352-359-4621
Practice Fax:

1780683243 — DR. RICHARD C TULLER D.C.
Practice Location Address:

310 S LAWRENCE BLVD
KEYSTONE HEIGHTS, FL
32656-9219

Practice Phone: 352-473-7213
Practice Fax: 352-473-7214

1902899958 — DR. IFTIKHAR FAZAL HAQ D.O.
Practice Location Address:

100 COMMERCIAL DR
KEYSTONE HEIGHTS, FL
32656-6802

Practice Phone: 352-473-6595
Practice Fax: 352-473-6597

Directions to “PHYSICIANS CARE OF KEYSTONE ” Practice Location

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