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NPI Code Detail

MEDICARE: ANSIBLE PROFESSIONALS LLC

MEDICARE: ANSIBLE PROFESSIONALS LLC
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
1261Q00000XClinic/Center
2207RP1001XPulmonary Disease Physician

General Provider Information

NPI Number : 1205588324
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANSIBLE PROFESSIONALS LLC
Provider Business Mailing Address
First Line : 249 CENTRAL PARK AVE STE 300
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-3271
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 249 CENTRAL PARK AVE STE 300
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-3271
Country : US
Telephone Number : 877-267-4253
Fax Number : 877-395-9003
Authorized Official
Title or Position : PRESIDENT
Name : STEVEN WINIARSKI
Credential : DO
Telephone Number : 877-267-4253
Provider Enumeration Date : 01/20/2022
Last Update Date : 12/16/2024

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Directions to “ANSIBLE PROFESSIONALS LLC ” Practice Location

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