2018PROVIDERDIRECTORY

List of network doctors and specialists

UnitedHealthcare Dual Complete RP (Regional PPO SNP)

UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP)

Florida

Brevard, Flagler, Indian River, Lake, Marion, Orange, Osceola, Seminole, Sumter and Volusia

Counties

For more information, please contact Customer Service at:

Toll-Free 1-866-842-4968, TTY 7118 a.m. - 8 p.m. local time, 7 days a week

www.UHCCommunityPlan.com

Y0066_170626_143320_NM

This page is intentionally left blank.

Introduction

Your plan

PROVIDER DIRECTORYThis directory provides a list of your plans network providers.This directory is for the plans listed on the cover. It is not a complete list of network providers

available to you. You can search for a network provider and print a directory online, which is

updated weekly and available 24 hours a day, 7 days a week.

This directory is current as of July 10, 2018. Some network providers may have been added or

removed from our network after this directory was printed. We do not guarantee that each provider

is still accepting new members.

For the most up-to-date information about the plans network

providers in your area:

Visit www.UHCCommunityPlan.com or call Customer Service toll-free at 1-866-842-4968,

TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies,

a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on

the plans contract renewal with Medicare.

Providers are prohibited from discriminating against any member, with regard to quality of service

or accessibility of services, on the basis of race, ethnicity, national origin, religion, sex, age, mental

or physical disability or medical condition, sexual orientation, claims experience, medical history,

evidence of insurability, disability, genetic information, or source of payment.

This information is available for free in other languages. Please call Customer Service toll-free at the

number listed above.

Esta informacin est disponible sin costo en otros idiomas. Llame a nuestro Servicio al Cliente al

nmero gratuito indicado arriba.

This document may be available in an alternate format such as Braille, larger print or audio. Please

call Customer Service at the toll-free phone number listed above.

The provider network may change at any time. You will receive notice when necessary.

Y0066_170626_143320_NM

Introduction

IntroductionThis directory provides a list of the plans network providers. You may also receive services from

out-of-network providers. You do not need a referral to see any network or out-of-network provider.

You can see any provider (network or out-of-network) that participates in Medicare and accepts the

plan. To get detailed information about your health care coverage, please see your Evidence of

Coverage.

What is a primary care provider?A primary care provider (PCP) is the health care professional who provides most of your care.

Your PCP can help you:

Make smart lifestyle choices to help improve and maintain your health

Get preventive care and health screenings

Better understand your medical conditions

Coordinate any specialist care to help avoid duplicate and expensive tests.

Manage your prescriptions and identify possible harmful interactions

Select a primary care provider (PCP)You will need to choose one of our network providers to be your primary care provider (PCP). PCPs

are listed in the Primary Care Provider section of this directory. The term PCP will be used

throughout this directory. You may also receive services from out-of-network providers.

If you choose a PCP who is not taking new patients, we may assign you to a different PCP. If this

happens, you can switch to another PCP who is accepting new patients.

Your PCP plays an important role in your health care and we want you to be comfortable with the

provider you choose. If you want to switch providers, call Customer Service toll-free at

1-866-842-4968, 8 a.m. - 8 p.m. local time, 7 days a week. TTY users should call 711.

The difference between network and out-of-network providersNetwork providers are providers that your plan works with to provide your care. If you use a network

provider, your out-of-pocket costs, which are costs paid by you, may be lower. Out-of-network

providers are providers that we currently do not work with, so your out-of-pocket costs may be

higher.

The network providers listed in this directory have agreed to provide you with your health care

coverage. You can see a network specialist without getting a referral. In some cases, you may get

covered services from out-of-network providers. If you have been going to one network provider,

you are not required to continue going to that same provider. Check your Evidence of Coverage to

make sure your plan includes additional benefits or that you've signed up for optional supplemental

riders before making appointments for dental, vision or hearing services.

If I need emergency or urgent careA medical emergency is when you, or any other ordinary person with an average knowledge of

health and medicine, believe that you have symptoms that require immediate medical care to

Introductionprevent death, loss of a limb, or loss of function of a limb. The medical symptoms may be an illness,

injury, severe pain, or a medical condition that is quickly getting worse.

If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest

emergency room or hospital. Emergency care can always be obtained in or out of the service area

from the nearest available provider. Emergency services are also covered whether a provider is in

our network or not. You or someone else should call and tell us about your emergency care, usually

within 48 hours.

Urgently needed services is a non-emergency, unforeseen medical illness, injury, or condition, that

requires immediate medical care. When out of the service area, urgent care may be obtained from

the first available provider whether the provider is in our network or not. In addition, when out of the

service area, you can obtain dialysis treatment from any qualified dialysis provider.

Out-of-network providers are under no obligation to treat Plan members, except in emergency

situations. For a decision about whether we will cover an out-of-network service, we encourage you

or your provider to ask us for a pre-service organization determination before you receive the

service. Please call our customer service number or see your Evidence of Coverage for more

information, including the cost sharing that applies to out-of-network services.

If you get a billThere may be times when you get a bill from a provider for the full cost of medical care you have

received. If you get a bill, contact us. In many cases, you should send this bill to us instead of

paying it. We will look at the bill and decide whether the services should be covered. If we decide

they should be covered, we will pay the provider directly. Please see your Evidence of Coverage for

more information.

If youre on Medicare and MedicaidIf youre a Qualified Medicare Beneficiary (QMB), your doctor may not bill you for deductibles,

copays or coinsurance for Medicare-covered services, except for Part D prescription drug copays.

Please show your member ID card and your state-issued Medicaid member ID card when you see

the doctor or use other plan services. This will help ensure youre billed for the correct amount.

Accessing your mental health benefitsTo access your mental health benefits, call the toll-free mental health number on your member ID

card. When you call, a representative will check your eligibility and get basic information about you

and your situation. Depending on the help you need, a clinician may talk with you and recommend

a provider and treatment plan. If you prefer, your PCP may call and arrange a referral for you. Your

personal information will be kept strictly confidential.

Organ transplant servicesYour plan has a nationwide network of facilities that perform organ transplants (including the heart,

lung, liver, intestine, kidney, bone marrow and/or pancreas). Solid organ transplants must be

performed at a facility that is currently Medicare-approved for your specific type of transplant. The

plans hospital network for organ transplant services is different than the network shown in the

Hospitals section of this provider directory. Some hospitals in the plans network for other

medical services are not in the plans network for transplant services. The complete list of

Medicare-approved facilities in your plans network may change throughout the year. For

information on network facilities for transplant services, please call Customer Service toll-free at

Introduction1-866-842-4968, TTY 711 or refer to the transplant vendor website information listed in the

National Vendors section of this provider directory.

What is the service area for your plan?Your service area is listed below.

UnitedHealthcare Dual Complete RP (Regional PPO SNP)

Florida - Alachua, Baker, Bay, Bradford, Brevard, Broward, Calhoun, Charlotte, Citrus, Clay, Collier,

Columbia, DeSoto, Dixie, Duval, Escambia, Flagler, Franklin, Gadsden, Gilchrist, Glades, Gulf,

Hamilton, Hardee, Hendry, Hernando, Highlands, Hillsborough, Holmes, Indian River, Jackson,

Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Martin, Miami-

Dade, Monroe, Nassau, Okaloosa, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas,

Polk, Putnam, Santa Rosa, Sarasota, Seminole, St. Johns, St. Lucie, Sumter, Suwannee, Taylor,

Union, Volusia, Wakulla, Walton, and Washington counties

UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP)

Florida - Alachua, Baker, Bay, Bradford, Brevard, Broward, Calhoun, Charlotte, Citrus, Clay, Collier,

Columbia, DeSoto, Dixie, Duval, Escambia, Flagler, Franklin, Gadsden, Gilchrist, Glades, Gulf,

Hamilton, Hardee, Hendry, Hernando, Highlands, Hillsborough, Holmes, Indian River, Jackson,

Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Martin, Miami-

Dade, Monroe, Nassau, Okaloosa, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas,

Polk, Putnam, Santa Rosa, Sarasota, Seminole, St. Johns, St. Lucie, Sumter, Suwannee, Taylor,

Union, Volusia, Wakulla, Walton, and Washington counties

How do you find network providers in your area?Network providers in your area are listed in the following sections of this directory. To find a

provider using this directory, turn to the Table of Contents on the next page and see where each

section begins. Go to the section of the type of provider you are looking for. Once you are in that

section, locate the city you live in. Under each city you will find a list of providers in alphabetical

order.

You may have more providers to choose from if the service area shown above is larger than the

service area shown on the front of this directory. You can also search online at

www.UHCCommunityPlan.com, which is updated weekly and available 24 hours a day, 7 days a

week.

If you have questions about your plan or require assistance in selecting a PCP, please call our

Customer Service Department toll-free at 1-866-842-4968, TTY 711. Or visit

www.UHCCommunityPlan.com.

National Vendors............................................................................................................................................................................. 3

Primary Care Providers............................................................................................................................................................ 15

Specialists......................................................................................................................................................................................239

Skilled Nursing Facilities................................................................................................................................................... 1301

Hospitals......................................................................................................................................................................................1307

Urgent Care/Surgicenters................................................................................................................................................ 1315

Ancillary....................................................................................................................................................................................... 1325

Acupuncture / Chiropractic.............................................................................................................................................1555

Dental............................................................................................................................................................................................ 1603

Vision............................................................................................................................................................................................. 1651

Index...............................................................................................................................................................................................1747

1

Table of Contents

2

This page is intentionally left blank.

National Vendors The following national vendors are available to provide services toUnitedHealthcare customers throughout the United States regardless of where you receive theservices.

Provider(s) Phone Number WebSite

Cardiac Diagnostic - Cardiac Monitoring Services

LifeWatch 1-877-774-9846 www.lifewatch.com

Preventice Services 1-888-747-1442 www.preventicesolutions.com/services/preventice-services.html

Cardiac Diagnostic - Cardiac Monitoring Services & Home INR Monitor/test strips

CardioNet 1-888-312-2328 www.cardionet.com

Convenience Care Clinic

MinuteClinic 1-866-389-ASAP (2727) www.minuteclinic.com

RediClinic 1-866-607-7334 www.rediclinic.com/riteaid

The Little Clinic 1-877-852-2677 http://www.thelittleclinic.com

Walgreens Healthcare Clinic 1-866-825-3227 www.walgreens.com/topic/pharmacy/healthcare-clinic

Dialysis

DaVita Dialysis 1-866-475-7757 ext. 253706 www.davita.com

Dialysis Clinic, Inc See website www.dciinc.org

Fresenius Medical Care 1-866-434-2597 www.fmcna.com

Home Dialysis Services LLC 1-815-741-6830 www.dccdialysis.com

DME - AED - wearable defibrillator

ZOLL Lifecore 1-800-543-3267 www.zoll.com

DME - Ambulatory Infusion Pumps

InfuSystem Inc 1-800-962-9656 www.infusystem.com

DME - Bone Growth Stimulator

Bioventus 1-800-396-4325 www.bioventusglobal.com

DJO 1-800-321-9549 www.djortho.com

EBI 1-800-526-2579 www.biomet.com

Orthofix 1-800-535-4492 www.orthofix.com

DME - Breast pump purchase

Edgepark Medical Supplies 1-888-394-5375 www.edgepark.com

Medline Industries 1-800-633-5463 www.medline.com

Walmart Stores Inc. (d/b/aWalmart and Sams Club)

1-800-273-3455 www.walmart.com

3

Provider(s) Phone Number WebSite

DME - Commodity, oxygen, respiratory

Lincare - may be knownlocally by a different name;refer to website

See website www.lincare.com

Rotech Healthcare - may beknown locally by a differentname; refer to website

See website www.rotech.com

DME - Commodity, oxygen, respiratory, negative pressure wound care, manual wheelchairs

Apria Healthcare 1-800-277-4288 www.apria.com

DME - CPM/Continuous Passive Motion

Otto Bock Healthcare 1-800-328-4058 www.ottobockus.com

DME - CPM/continuous passive motion, Thermocomp, TENS

Kinex Medical Company 1-800-845-6364 www.kinexmedical.com

DME - Diabetic insulin pump and pump supplies

Insulet Corporation 1-800-591-3455 www.myomnipod.com

MiniMed Distribution 1-877-576-6113 www.minimed.com

DME - Dynamic Splinting; Bracing & Orthotics

Dynasplint Systems 1-800-638-6771 www.dynasplint.com

DME - Home INR Monitor/test strips

Roche Diagnostics Corp 1-800-779-7616 www.coaguchek.com/coaguchek_patient/en/home/products/how_to_get_a_coaguchek.html

DME - Home PT/INR

Alere Home Monitoring 1-877-262-4669 www.ptinr.com/

DME - Incontinence, diapers, soft goods and wound care supplies

Medline Industries 1-800-633-5463 www.medline.com

DME - Mail order disposable medical supplies including Medicare-covered diabetic supplies (bloodglucose monitors, test strips and lancets)

Byram Healthcare 1-877-902-9726 www.byramhealthcare.com

Edgepark Medical Supplies 1-888-394-5375 www.edgepark.com

McKesson Patient CareSolutions

1-855-404-6727 www.mckesson.com/providers/home-care/mckesson-patient-care-solutions

DME - Mobility products - custom/complex power wheelchairs and seating systems

Hoveround Corporation 1-888-225-1547 www.hoveround.com/MobilityNow

Numotion 1-888-232-1333 www.numotion.com

4

Provider(s) Phone Number WebSite

DME - Negative pressure wound pump and wound care surfaces

KCI USA 1-800-275-4524 www.kci1.com

DME - Orthotics and Prosthetics

Linkia Orthotics &Prosthetics

1-877-754-6542 www.linkia.com

DME - Respiratory high frequency chest compression oscillation system (vest)

Advanced Respiratory 1-800-826-4224 www.thevest.com

Electromed 1-800-462-1045 www.smartvest.com

RespirTech 1-800-793-1261 www.respirtech.com

DME - Speech generating device

Prentke Romich 1-800-268-5224 www.prentrom.com

Tobii Dynavox Systems 1-866-396-2869 www.dynavoxtech.com/tobii-dynavox

DME - TENS units

Electrostim MedicalServices, Inc

1-800-588-8383 www.wecontrolpain.com

Zynex Medical 1-800-495-6670 www.zynexmed.com

DME - Wound care supplies for residents of nursing homes

Gordian Medical, Inc 1-800-568-5514 www.amtwoundcare.com

Hearing Aid Services - Hearing aid services / hearing testing, evaluation, hearing aid selection andfitting

hi HealthInnovations 1-866-926-6632 www.hihealthinnovations.com

Hearing Aid Services - Hearing testing, evaluation, hearing aid selection and fitting

EPIC Hearing Health Care 1-866-956-5400 www.epichearing.com

Home Health

Bayada Nurses 1-800-305-3000 / 1-888-422-9232

www.bayada.com

Heartland HealthcareServices

1-800-736-4427 / 1-419-252-5500

www.hcr-manorcare.com orwww.heartlandhomehealth.com

Innovative Senior Care See website www.brookdaleliving.com/Innovative-senior-care.aspx

Maxim Health Care Services 1-800-899-9525 www.maximhomecare.com

PSA Healthcare 1-770-441-1580 www.psahealthcare.com

Home Infusion

Basic Home Infusion 1-888-822-7428 www.basichomeinfusion.com

Lincare Infusion Services See website www.lincare.com

5

Provider(s) Phone Number WebSite

Home Infusion - TPN, Enteral and Synagis

BioScrip Infusion Services 1-866-788-7710 www.bioscrip.com

Home Sleep Testing

NovaSom 1-877-753-3776 www.novasom.com

Virtuox 1-877-337-7111 www.virtuox.net

Watermark Medical 1-877-710-6999 http://www.watermarkmedical.com/

Hospice - Home and inpatient

AseraCare Hospice See website www.aseracare.com

Heartland HealthcareServices

1-800-736-4427 / 1-419-252-5500

www.hcr-manorcare.com orwww.heartlandhomehealth.com

Laboratory

True Health Diagnostics 1-800-268-5224 www.truehealthdiag.com

Laboratory - Anatomic pathology - including dermatopathology

Bako Integrated PhysicianSolutions

1-877-376-7284 www.bakocts.com

Laboratory - Anatomic pathology - including dermatopathology, gastroenterology, genitourinary,hematology and gynecological pathology

AmeriPath 1-800-354-3449 www.ameripath.com

StrataDx Pathology 1-800-325-7284 www.stratadx.com

Laboratory - BRCA for breast & ovarian cancer; COLARIS for colon & endometrial cancer; MELARISfor melanoma & pancreatic cancer; Theraguide 5-FU

Myriad Genetic Laboratories 1-800-469-7423 www.myriad.com

Laboratory - Clinical, pathology and genetic testing

ARUP Labs 1-800-522-2787 www.aruplab.com

BioReference Laboratories 1-800-229-5227 www.bioreference.com

Laboratory Corporation ofAmerica

1-888-522-2677 (1-888-LABCORP)

www.labcorp.com

Lineagen, Inc 1-801-931-6200 www.lineagen.com

Laboratory - Dialysis testing

Nationwide LaboratoryServices

1-888-377-3522 www.nationwidelab.com

Laboratory - Drug testing, medication monitoring

Dominion Diagnostics 1-800-511-8427 / 1-800-711-6974

www.dominiondiagnostics.com

6

Provider(s) Phone Number WebSite

Laboratory - Fecal DNA screening

Exact Sciences Laboratories 1-844-870-8870 www.cologuardtest.com

Laboratory - Genetic testing

Foundation Medicine, Inc. 1-888-988-3639 www.foundationmedicine.com

GeneDx 1-301-519-2100 www.genedx.com

Natera, Inc 1-650-249-9090 www.natera.com

Sequenom Laboratories 1-877-821-7266 www.sequenom.com

Laboratory - Genetic testing (OncotypeDx)

Genomic Health 1-888-662-6897 (1-888-ONCOTYPE)

www.genomichealth.com

Laboratory - Molecular Diagnostics

ColorGenomics 1-650-651-7130 www.color.com

Veracyte 1-888-9AFIRMA www.veracyte.com

Laboratory - Molecular Oncology

NeoGenomics Laboratories,Inc

1-866-776-5907 neogenomics.com

Laboratory - Nerve Pathology (ENFD)

Therapath Neuropathology 1-800-681-4338 www.therapath.com

Laboratory - Oncometrix, hematopathology, gastrointestinal pathology, dermatopathology,gynecologic pathology

Poplar Healthcare 1-888-244-7284 www.poplarhealthcare.com

Laboratory - Predictive genetic testing for breast cancer patients (MammaPrint)

Agendia 1-888-321-2732 www.agendia.com

Laboratory - Predictive genetic testing for cardiac abnormalities

CardioDx 1-866-941-4996 www.cardiodx.com

Laboratory - Prenatal testing

Ariosa Diagnostics 1-855-927-4672 www.ariosadx.com

PerkinElmer Laboratories 1-888-762-4000 www.perkinelmer.com

Laboratory - Specialty genetic testing

CBLPath 1-877-225-7284 www.cblpath.com

Integrated Genetics 1-800-357-5744 www.integratedgenetics.com

Invitae Corporation 1-800-436-3037 www.invitae.com

7

Provider(s) Phone Number WebSite

Laboratory - Specialty infectious disease diagnostic testing, molecular biology, immunology andserology

Medical DiagnosticLaboratories

1-877-269-0090 www.mdlab.com

Laboratory - Specialty laboratory

Ambry Genetics 1-866-262-7943 www.ambrygen.com

Counsyl 1-888-COUNSYL (1-888-268-6795)

www.counsyl.com

Laboratory - Specialty oncology genetic testing

Integrated Oncology 1-800-447-5816 www.integratedoncology.com

Laboratory - Therapeutic medication monitoring, drug testing

Aegis Sciences Corporation 1-800-533-7052 www.aegislabs.com

Alere Toxicology 1-800-340-4029 www.aleretoxicology.com

Essential Testing 1-855-623-0623 www.etlab.org

Millennium Health 1-877-451-3534 www.milleniumlaboratories.com

Precision Diagnostics 1-800-635-6901 www.precisiondxlab.com

Rennova Health 1-844-RENNOVA www.rennovahealth.com

Tribal Diagnostics 1-405-896-2978 www.tribaldiagnostics.com

Other Specialty Services - Optical services - medical benefits only

Shopko Eyecare 1-800-791-7333 www.shopko-optical.com

Other Specialty Services - Urgent care services

Concentra Health Services See website www.concentra.com

Other Specialty Services - Womens health - high risk OB / prenatal care

Optum Women's andChildren's Health

1-800-950-3963 www.alere.com

Specialty Pharmacy

AllianceRx Walgreens Prime 1-888-282-5166 www.walgreenshealth.com

BriovaRx SpecialtyPharmacy

1-866-218-7398 www.briovarx.com

Specialty Pharmacy - Carticel, Elelyso and Prolastin

Dohmen Life ScienceServices

1-866-336-1336 www.dohmen.com

Specialty Pharmacy - Limited Distribution Specialty Drugs

Biologics 1-800-856-1984 www.biologicsinc.com

Caremark 1-877-287-1234 www.cvsspecialty.com

8

Provider(s) Phone Number WebSite

Specialty Pharmacy - Xiaflex

US Bioservices 1-888-518-7246 www.usbioservices.com

Specialty Pharmacy and Home Infusion - Limited Distribution Drugs

Accredo 1-800-803-2523 www.accredo.com

BriovaRx Infusion Services 1-877-306-4036 www.axelacare.com

Option Care 1-866-827-8203 www.optioncare.com

Transportation - Fixed-Wing Air Ambulance

AirCARE1 International 1-877-760-7760 www.airambulanceone.com

AMR Air Ambulance 1-800-424-7060 www.amr-airambulance.com

Castle International See website www.castlemedflight.com

Medway Air Ambulance 1-800-233-0655 www.medwayairambulance.com

Urgent Care - Urgent care services

MedExpress Urgent Care See website www.medexpress.com

Vaccine Program - Influenza (Trivalent, Quadrivalent, High Dose, Intradermal), Pneumonia,Zostavax, Tdap, Meningococcal, Hepatitis B, HPV , MMR, MMRV, Varicella, Hepatitis A/B combo.TDAP (Tetanus, Diphtheria & Pertussis), Shingles (Zostavax), Meningitis, HPV, and Hepatitis B (age15 and up). Worksite Clinics and Retail locations

Albertsons (d/b/aAlbertsons Sav-on,Albertsons Osco)

1-877-276-9637 www.albertsons.com/pharmacy/immunizations/

CVS Pharmacy (d/b/a CVSPharmacy, Longs Drug,CarePlus Pharmacy)

1-888-358-7468 www.cvs.com/promo/promoLandingTemplate.jsp?promoLandingId=get-vaccinated

Harris Teeter See website www.harristeeter.com/in_our_stores/departments/pharmacy/flu_shots/details.aspx

H-E-B 1-210-938-8357 www.heb.com/pharmacy/services/immunizations.jsp

Kmart Pharmacy 1-800-349-0764 www.pharmacy.kmart.com

Meijer Pharmacy 1-877-363-4537 www.meijer.com/pharmacy

New Albertsons d/b/a AcmeSav-on, Jewel-Osco, StarMarkets, Shaws Osco,Safeway

1-877-276-9637 www.acmemarkets.com/pharmacy/immunizations/

Publix Pharamcy 1-800-242-1227 www.publix.com/pharmacy-wellness/pharmacy/preventive-care/vaccinations

9

Provider(s) Phone Number WebSite

Rite Aid Pharmacy 1-800-RITEAID / 1-800-748-3243

www.riteaid.com

Safeway, Inc. (d/b/aSafeway, Carrs, Pak'N Save,Pavilions, Randalls, TomThumb, Vons)

1-877-723-3929 www.safeway.com/shopstores/pharmacy

ShopKo Pharmacy 1-800-791-7333 http://pharmacy.shopko.com/flushots

The Kroger Co. (d/b/a FredMeyer, Smiths Food & DrugCenter, Ralphs Grocery,Dillons, Tom Thumb, KwikShop, Frys, King Soopers,Jay C, QFC, Bakers, CityMarket, Owens, Payless,Gerbes, Roundy's, Copps,Mariano's, Metro Market,Pick 'N Save)

See website www.kroger.com/topic/pharmacy/#/vaccinations-made-easy

United Supermarkets (d/b/aUnited Supermarket,Albertsons Market, Amigos,Market Street)

1-877-276-9637 www.unitedsupermarkets.com

Walmart Stores Inc. (d/b/aWalmart and Sams Club)

See website www.walmart.com

Vaccine Program - Influenza (Trivalent, Quadrivalent, High Dose, Intradermal), Pneumonia,Zostavax, Tdap, Meningococcal, Hepatitis B, TDAP (Tetanus, Diphtheria & Pertussis), Shingles(Zostavax), Meningitis, and Hepatitis B (age 18 and up). Worksite Clinics and Retail locations

Walgreens Immunization(d/b/a Walgreens, DuaneReade)

1-800-925-4733 https://www.walgreens.com/pharmacy/immunization

DME - DURABLE MEDICAL EQUIPMENT is certain medical equipment that is ordered by yourdoctor for use at home. DME includes but is not limited to: wheelchairs, crutches, hospital bed, IVinfusion pump, oxygen equipment, nebulizer, and walker.HOME HEALTH/HOME INFUSION CARE can either be a licensed facility or medical personnel thatcan provide health care services in the home. Services include but are not limited to nursing visits forinfusion services or wound care.LABORATORY means diagnostic testing including routine blood and urine analysis, anatomicpathology, surgical pathology, and specialty or esoteric services.SPECIALTY PHARMACY PROVIDER provides specific drug products directly to customers orphysicians.WOMEN'S HEALTH is limited to home uterine monitoring services.

10

NOTE: We only cover blood glucose monitors and test strips from the following brands: OneTouchUltra2 , OneTouch UltraMini, OneTouch Verio, OneTouch Verio IQ, OneTouch Verio Flex,ACCU-CHEK Nano SmartView, ACCU-CHEK Aviva Plus, ACCU-CHEK Guide, and ACCUCHEKAviva Connect. Other brands are not covered by our plan.

11

12

This page is intentionally left blank.

13

This page is intentionally left blank.

14

This page is intentionally left blank.

Florida

Brevard

Family Practice

*Abdurraqeeb, Obaydah A, DO3Provider #3346491002NPI #1316101264500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-F 8:00AM-5:00PMHospital Affiliations: UniversityHospital Of Ar, University Of TnMedical Center*Abdurraqeeb, Obaydah A,DO3,8Provider #3346491003NPI #131610126417 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PMHospital Affiliations: UniversityHospital Of Ar, University Of TnMedical Center*Abdurraqeeb, Obaydah A,DO3,8Provider #3346491004NPI #13161012645270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-F 8:00AM-5:00PMHospital Affiliations: UniversityHospital Of Ar, University Of TnMedical Center

*Abdurraqeeb, Obaydah A,DO3,8Provider #3346491005NPI #13161012642120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PMHospital Affiliations: UniversityHospital Of Ar, University Of TnMedical Center*Abdurraqeeb, Obaydah A,DO3,8Provider #3346491006NPI #1316101264775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-F 8:00AM-5:00PMHospital Affiliations: UniversityHospital Of Ar, University Of TnMedical Center*Abdurraqeeb, Obaydah A,DO3,8Provider #3346491007NPI #1316101264220 Barton Blvd Ste C14Rockledge, FL 32955(321) 639-5177Hours: M-F 8:00AM-5:00PMHospital Affiliations: UniversityHospital Of Ar, University Of TnMedical Center*Abiodun, Modupeola O, MD3,8,FProvider #005312858002NPI #1225326853951 N Washington AveTitusville, FL 32796(321) 268-6360Hours: M-F 8:00AM-5:00PM

*Abiodun, Modupeola O, MD3,8,FProvider #005312858004NPI #1225326853250 Harrison StTitusville, FL 32780(321) 267-1424Hours: M-F 8:00AM-5:00PM*Acosta, Alessandro Ale L,MD3,8, MProvider #000254520002NPI #14371221651317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center RockledgeAnderson, Thomas N, DO3,8, MProvider #002081722001NPI #17301615483040 N Wickham Rd Ste 104Melbourne, FL 32935(321) 428-4840Hours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center-melbourneArcand, Josee J, MD3,8, FProvider #002306995001NPI #171006172621 Suntree Pl Ste 102Melbourne, FL 32940(321) 255-7334Provider Language(s): FrenchHours: M-TH 8:30AM-5:00PMF 8:30AM-12:00PM

15

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

Ashta, Raman, MD3,8, FProvider #3116600004NPI #11444969935205 Babcock St NEPalm Bay, FL 32905(321) 729-1400Provider Language(s): HindiHours: M-F 8:00AM-5:00PMHospital Affiliations: CalumetMedical Center, Florida HospitalNew Smyrna, Mercy MedicalCenter, St Elizabeth HospitalBerk, Danny P, MD3,8, MProvider #003217866001NPI #18715887498057 Spyglass Hill Rd Ste 104Melbourne, FL 32940(321) 241-4877Hours: M-TH 8:00AM-5:00PMF 8:30AM-4:00PMBisset, Robert K, MD3,8, MProvider #000557464001NPI #15381533581220 N Highway A1a Ste 147Indialantic, FL 32903(321) 984-1333Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center1223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

Blythe, Stephen L, DO3,8, MProvider #1022768001NPI #1770685315275 W Cocoa Beach CswyCocoa Beach, FL 32931(321) 751-7222Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Boodhoo, Victor R, MD3,8, MProvider #001238319002NPI #1942203898250 Harrison StTitusville, FL 32780(321) 267-1424Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Buddha, Chaithanya D, MD3,8, FProvider #005188901001NPI #19223966132070 Us Highway 1 Ste 102Rockledge, FL 32955(321) 632-0552Hours: M-F 8:30AM-5:00PMCapraro, Francesca Q, MD3,8, FProvider #001409055001NPI #19523828301231 S Patrick DrSatellite Beach, FL 32937(321) 622-5432Hours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center

Chrieki, Milad, MD3,8, FProvider #001372089001NPI #11847082161800 W Hibiscus Blvd Ste 101Melbourne, FL 32901(321) 726-1600Hours: M-F 7:30AM-6:00PMHospital Affiliations: BuffaloGeneral Hospital, Erie CountyMedical Center*Cohen, Leon B A, MD8, MProvider #000256406001NPI #1558329607375 S Courtenay Pkwy Ste 1Merritt Island, FL 32952(321) 453-3420Provider Language(s): Dutch,Hebrew, SpanishHours: M-TH 8:00AM-5:00PMF 8:00AM-1:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge HospitalDas, Rajive K, MD3,8, MProvider #000491140001NPI #16593485481071 Port Malabar Blvd NE Ste111Palm Bay, FL 32905(321) 725-9800Provider Language(s): Bengali,HindiHours: M-W 9:30AM-5:00PMTH 9:30AM-12:00PMF 9:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

16

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

*Dilley, Frances L, MD8, FProvider #002543222001NPI #15088169501317 W Point DrCocoa, FL 32922(321) 636-2621Hours: M-F 8:00AM-5:00PMHospital Affiliations: BaptistHospital, Baylor S And W All StMed Center Fw, StewardRockledge Hospital, TexasHealth Harris Meth Hospital SWFw, Unity Health Harris MedicalCenter*Dilley, Frances L, MD3,8, FProvider #002543222003NPI #15088169507970 N Wickham Rd Ste 101Melbourne, FL 32940(321) 637-2908Hours: M-F 8:00AM-5:00PMHospital Affiliations: BaptistHospital, Baylor S And W All StMed Center Fw, StewardRockledge Hospital, TexasHealth Harris Meth Hospital SWFw, Unity Health Harris MedicalCenter, Wuesthoff MedicalCenter RockledgeDitz, Frank G, MD3,8, FProvider #002134115002NPI #11847041246420 3rd St Ste 104Rockledge, FL 32955(321) 253-3944Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge,Wuesthoff Medical Center-melbourne

*Everding, Kristine R, MD3,8, FProvider #001866235006NPI #1760568935240 N Wickham Rd Ste 204Melbourne, FL 32935(321) 308-5050Hours: M-F 8:00AM-5:00PMHospital Affiliations: PnMethodist Hospital, SanfordWorthington Medical Center,Wuesthoff Medical Center-melbourne*Everding, Kristine R, MD3,8, FProvider #1866235001NPI #17605689352222 S Harbor City Blvd Ste450Melbourne, FL 32901(321) 541-1715Hours: M-F 8:00AM-5:00PMHospital Affiliations: PnMethodist Hospital, SanfordWorthington Medical Center,Wuesthoff Medical Center-melbourneFarbowitz, Steven, MD3,8, MProvider #230299002NPI #16593263531800 W Hibiscus Blvd Ste 101Melbourne, FL 32901(321) 726-1600Provider Language(s): SpanishHours: M-F 7:30AM-6:00PMHospital Affiliations: LehighValley Hospital, St Lukes HealthNetwork

*Fotopoulos, Evangelia I, MD3,8,FProvider #3483727001NPI #17900149422222 S Harbor City Blvd Ste430Melbourne, FL 32901(321) 541-1746Hours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center-melbourne*Fotopoulos, Evangelia, MD3,8, FProvider #003483727004NPI #1790014942240 N Wickham Rd Ste 204Melbourne, FL 32935(321) 775-1300Hours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center-melbourne*Gayed, Esmata A, MD3,8, MProvider #001834515001NPI #18110076513021 W Eau Gallie Blvd Ste 101Melbourne, FL 32934(321) 255-0959Provider Language(s): ArabicHours: M-F 8:30AM-4:30PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

17

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Giorgianni, Stephen M, DO3,8,MProvider #003424680003NPI #16091826901341 Bedford Dr Ste BMelbourne, FL 32940(321) 610-7487Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, VieraHospital, Wuesthoff MedicalCenter Rockledge*Gottfried, Jeffrey S, MD3,8, MProvider #002138558003NPI #11646300911317 W Point DrCocoa, FL 32922(321) 636-2621Hours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center*Hagloch, Jay M, MD3,8, MProvider #001999763001NPI #11341100751220 N Highway A1a Ste 147Indialantic, FL 32903(321) 984-1333Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center1223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

*Hanna, Madonna, MD3,8, FProvider #005500391003NPI #1801145826250 Harrison StTitusville, FL 32780(321) 267-1424Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Hanna, Madonna, MD3,8, FProvider #5500391001NPI #18011458261849 Jess Parrish CtTitusville, FL 32796(321) 267-1424Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical CenterHaridopolos, Stephanie E,MD, FProvider #002191411001NPI #15482437851140 Broadband DrMelbourne, FL 32901(321) 733-0211Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay HospitalHernesman, Shane C, MD3,8, MProvider #001972512001NPI #19524126521980 N Atlantic Ave Ste 627Cocoa Beach, FL 32931(321) 453-5233Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital

*Hyvonen, Pauline E, MD3,8, FProvider #836143001NPI #13462310731220 N Highway A1a Ste 147Indialantic, FL 32903(321) 984-1333Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center1223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center205 E Nasa BlvdMelbourne, FL 32901(321) 984-1333Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical CenterIonescu, Ludmilla N, MD3,8, FProvider #002536167002NPI #1568498145304 Barefoot BlvdSebastian, FL 32976(772) 664-8205Provider Language(s): Russian,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: Indian RiverMedical Center, RobinsonMemorial Hospital, SebastianRiver Medical Center, UhPortage Medical CenterIreland, Brian L, DO3,8, MProvider #003325500002NPI #12252751831380 S Patrick DrSatellite Beach, FL 32937(321) 773-2659Hours: M-TH 8:00AM-5:00PMF 8:00AM-12:00PM

18

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Ireland, Mark L, DO3,8, MProvider #000551705001NPI #19826867961380 S Patrick Dr Ste 1Satellite Beach, FL 32937(321) 773-2659Hours: M-TH 8:00AM-5:00PMF 8:00AM-12:00PMHospital Affiliations: WuesthoffMedical Center-melbourne*Jabonite, Joni, MD3,8, FProvider #6193352001NPI #14172907922120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PM*Jabonite, Joni, MD3,8, FProvider #6193352004NPI #1417290792220 Barton Blvd Unit C14Rockledge, FL 32955(321) 639-4927Hours: M-F 8:00AM-5:00PM*Jerkins, Oscar H, MD3,8, MProvider #001902878001NPI #10230284619 Orange AveRockledge, FL 32955(321) 433-2660Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge

Jetton, Timothy D, MD3,8, MProvider #2027927002NPI #12957081398085 Spyglass Hill Rd Ste 109Melbourne, FL 32940(321) 701-3155Hours: M-F 8:00AM-5:00PMHospital Affiliations: FloridaHospital Heartland Med Center,Physicians Regional MedicalCenterJohnson, Lena, MD3,8, FProvider #006039852001NPI #12858214132400 N Courtenay Pkwy Ste100Merritt Island, FL 32953(321) 301-4869Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Johnston, Donna J, MD3,8, FProvider #001983860001NPI #14472534638061 Spyglass Hill Rd Ste 104aMelbourne, FL 32940(321) 751-7041Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge,Wuesthoff Medical Center-melbourne

*Kane, Maile N, DO3,8, FProvider #001652801001NPI #11745525171186 Highway A1aSatellite Bch, FL 32937(321) 779-3370Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Medical Center Of Trinity,Morton Plant North BayHospital, Regional Med CenterBayonet Point, WuesthoffMedical Center-melbourne*Kanellopoulos, Nikolaos, MD3,8,MProvider #003488098001NPI #1760611867255 Borman Dr 2nd FlMerritt Island, FL 32953(321) 434-1640Hours: M-F 8:00AM-5:00PM*Kanellopoulos, Nikolaos, MD3,8,MProvider #003488098002NPI #1760611867699 W Cocoa Beach Cswy Ste502Cocoa Beach, FL 32931(321) 361-5537Hours: M-F 8:00AM-5:00PM*Kanellopoulos, Nikolaos, MD3,8,MProvider #003488098003NPI #1760611867701 W Cocoa Beach CswyCocoa Beach, FL 32931(321) 725-4500Hours: M-F 8:00AM-5:00PM

19

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Kelly, Kristin L, MD3,8, FProvider #002826505001NPI #18111886181317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): GermanHours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center*Knappman, John W, MD3,8, MProvider #001761501002NPI #10533848751317 W Point DrCocoa, FL 32922(321) 636-2621Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center-melbourne*Knappman, John W, MD3,8, MProvider #001761501003NPI #10533848752404 N Courtenay Pkwy Ste300Merritt Island, FL 32953(321) 452-4470Hours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge,Wuesthoff Medical Center-melbourne

*Lai, Ming T, MD3,8, FProvider #001006890001NPI #1124023890910 Malabar Rd SE Ste 2Palm Bay, FL 32907(321) 768-2356Provider Language(s): Chinese,Portuguese, SpanishHours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital*Laird, Timothy P, MD3,8, MProvider #001451447001NPI #12250389122120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: CapeCanaveral Hospital, HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital, VieraHospital, Wuesthoff MedicalCenter Rockledge*Lamothe, Francis, MD3,8, MProvider #3753345001NPI #11241979595270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center, JfkMedical Center

*Lamothe, Francis, MD3,8, MProvider #3753345002NPI #112419795917 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center, JfkMedical Center*Lamothe, Francis, MD3,8, MProvider #3753345003NPI #11241979592120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, JfkMedical Center*Lamothe, Francis, MD3,8, MProvider #3753345005NPI #1124197959500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center, JfkMedical Center

20

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Lang, Eric L, DO3,8, MProvider #688806001NPI #14170424901301 W Eau Gallie Blvd Ste 112Melbourne, FL 32935(321) 255-5915Hours: M-TU 9:00AM-5:00PMW 1:00PM-8:00PMTH-F 9:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center Rockledge*Leathers-murmer, Andrea L,MD3,8, FProvider #003529070004NPI #160900379795 Bulldog Blvd Ste 202Melbourne, FL 32901(321) 724-0455Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: GuadalupeCounty Hospital*Leathers-murmer, Andrea L,MD3,8, FProvider #003529070005NPI #16090037976100 Minton Rd NW Ste 104Palm Bay, FL 32907(321) 724-1172Provider Language(s): SpanishHours: M-F 8:30AM-5:00PMHospital Affiliations: GuadalupeCounty Hospital*Mangra, Chandra, MD3,8, FProvider #3309837004NPI #133630624017 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PMHospital Affiliations: ChiltonMedical Center, St JosephsHospital And Med Center

*Mangra, Chandra, MD3,8, FProvider #3309837005NPI #13363062405270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-F 8:00AM-5:00PMHospital Affiliations: ChiltonMedical Center, St JosephsHospital And Med Center*Mangra, Chandra, MD3,8, FProvider #3309837006NPI #13363062402120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PMHospital Affiliations: ChiltonMedical Center, St JosephsHospital And Med Center*Manion, Christopher, MD8, MProvider #002592726001NPI #1104937390951 N Washington AveTitusville, FL 32796(321) 268-6111Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical CenterMarino, Vincent P, MD3,8, MProvider #000257431001NPI #1215028105333 W Cocoa Beach Cswy SteDCocoa Beach, FL 32931(321) 868-7159Hours: M-TH 8:00AM-5:30PMF 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge Hospital, WuesthoffMedical Center Rockledge

*Mayor-davies, Judy A, MD3,8, FProvider #001983188001NPI #10432938302501 W New Haven AveMelbourne, FL 32904(321) 723-9411Hours: M-F 8:00AM-5:30PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, Shands LakeShore Regional Med Center,Wuesthoff Medical Center-melbourne*Mayor-davies, Judy A, MD3,8, FProvider #1983188002NPI #104329383095 Bulldog Blvd Ste 202Melbourne, FL 32901(321) 727-2990Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, Shands LakeShore Regional Med Center,Wuesthoff Medical Center-melbourne*McDougall, Jeffrey A, MD1,3,8,MProvider #001370145001NPI #19220892187125 Murrell RdMelbourne, FL 32940(321) 242-8790Hours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

21

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*McElynn, Kenneth R, MD3,8, MProvider #2250663002NPI #16392178707925 N Wickham RdMelbourne, FL 32940(321) 268-6111Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: BrookwoodMedical Center, WuesthoffMedical Center Rockledge*McKee, Kimberly D, MD3,8, FProvider #2233288001NPI #17008864217000 Spyglass Ct Ste 300Melbourne, FL 32940(321) 752-7555Hours: M-TH 8:00AM-5:00PMF 8:00AM-12:00PMHospital Affiliations: CapeCanaveral Hospital, WuesthoffMedical Center-melbourne*Miller, Andrea L, MD3,8, FProvider #3225836001NPI #11341568132120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical CenterRockledge, Wuesthoff MedicalCenter-melbourne

*Miller, Andrea L, MD3,8, FProvider #3225836002NPI #1134156813775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-TH 8:00AM-7:00PMF 8:00AM-6:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical CenterRockledge, Wuesthoff MedicalCenter-melbourne*Miller, Andrea L, MD3, FProvider #3225836003NPI #1134156813500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical CenterRockledge, Wuesthoff MedicalCenter-melbourne*Miller, Andrea L, MD3,8, FProvider #3225836004NPI #113415681317 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical CenterRockledge, Wuesthoff MedicalCenter-melbourne

*Miller, Andrea L, MD3,8, FProvider #3225836005NPI #11341568135270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical CenterRockledge, Wuesthoff MedicalCenter-melbourne*Miller, Andrea L, MD3,8, FProvider #3225836006NPI #1134156813220 Barton Blvd Ste C14Rockledge, FL 32955(321) 639-5177Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical CenterRockledge, Wuesthoff MedicalCenter-melbourneMishra, Poonam S, DO3,8, FProvider #001387147001NPI #1306836952401 N Wickham Rd Ste HMelbourne, FL 32935(321) 757-5105Provider Language(s): HindiHours: M-TU 8:30AM-5:00PMW 8:00AM-12:30PMTH 10:00AM-5:00PMF 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

22

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

*Mohamed, Khaled A, MD3,8, MProvider #1834811001NPI #1144289620220 Barton Blvd Unit C14Rockledge, FL 32955(321) 639-5177Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center*Mohamed, Khaled A, MD3, MProvider #1834811002NPI #1144289620500 N Washington Ave Ste 105Titusville, FL 32796(321) 264-5496Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center*Mohamed, Khaled A, MD3,8, MProvider #1834811003NPI #114428962017 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center

*Mohamed, Khaled A, MD3,8, MProvider #1834811004NPI #11442896205270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center*Mohamed, Khaled A, MD3,8, MProvider #1834811005NPI #11442896202120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center*Mohamed, Khaled A, MD3,8, MProvider #1834811006NPI #1144289620775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-TH 8:00AM-7:00PMF 8:00AM-6:00PMHospital Affiliations: HolmesRegional Medical Center

*Naoumoff, Stephane M B,MD1,3,8, FProvider #2129682001NPI #13462129331395 N Courtenay Pkwy Ste100Merritt Island, FL 32953(321) 453-5252Provider Language(s): FrenchHours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, WuesthoffMedical Center Rockledge*Nettleton, Benjamin R, DO3,8, MProvider #003061226007NPI #11646989325005 Port St John Pkwy Ste2500Cocoa, FL 32927(321) 268-6834Hours: M-F 8:00AM-8:00PMHospital Affiliations: Our Lady OfLourdes Hospital At Pasco,Parrish Medical Center*Nevarez-carrillo, Eduardo R,MD3,8, MProvider #002760378001NPI #13867856241223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, Wuesthoff MedicalCenter-melbourne

23

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

Nichols, James T, MD3,8, MProvider #000067729001NPI #10038420481315 Garden StTitusville, FL 32796(321) 268-0128Hours: M-F 9:00AM-12:00PMHospital Affiliations: ParrishMedical Center*Ojha, Ashish, MD3,8, MProvider #002337226001NPI #10139056451223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital730 Malabar RdMalabar, FL 32950(321) 409-6800Hours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay HospitalO'neill, Oscar, MD3,8, MProvider #002711378002NPI #18210754411223 Gateway DrMelbourne, FL 32901(321) 725-4500Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, LehighValley Hospital, Lehigh ValleyHospital Muhlenberg

*Parvus, Dirk F, MD3,8, MProvider #002447611006NPI #1912951435590 Malabar Rd SE Ste 7Palm Bay, FL 32907(321) 676-3535Provider Language(s): AfrikaansHours: M-F 8:00AM-5:00PMHospital Affiliations: ClevelandClinic Foundation, SebastianRiver Medical Center*Paul, Rajee N, MD3,8, FProvider #002812866001NPI #13361331561045 N Courtenay PkwyMerritt Island, FL 32953(321) 452-9255Provider Language(s): HindiHours: M-F 8:00AM-5:00PMHospital Affiliations: MunroeRegional Medical CenterPejic, Branko D, MD1,3,8, MProvider #001901289001NPI #15483717276305 Pleasant AveCocoa, FL 32927(321) 631-7572Provider Language(s): Bosnian,Croatian, Hungarian, SerbianHours: M-TH 10:00AM-5:00PMF 10:00AM-1:00PMHospital Affiliations: CapeCanaveral Hospital, ParrishMedical Center, StewardRockledge Hospital, WuesthoffMedical Center Rockledge

*Pinkowski, Mark K, MD3,8, MProvider #001239030003NPI #12452039751317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Pinkowski, Mark K, MD3,8, MProvider #1239030001NPI #12452039751004 Beverly Dr Ste CRockledge, FL 32955(321) 433-3322Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center RockledgePinsky, Mark F, DO3,8, MProvider #001874940001NPI #18614851958045 Spyglass Hill RdMelbourne, FL 32940(321) 255-2289Hours: SU-SA 12:00AM-11:59PMHospital Affiliations: HolmesRegional Medical Center*Potts, Charles E, MD, MProvider #000345808001NPI #1689868622500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-F 8:00AM-5:00PM

24

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

*Potts, Charles E, MD8, MProvider #000345808002NPI #168986862217 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PM*Potts, Charles E, MD8, MProvider #000345808003NPI #16898686225270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 722-5959Hours: M-F 8:00AM-5:00PM*Potts, Charles E, MD8, MProvider #000345808004NPI #16898686227227 N Highway 1Cocoa, FL 32927(321) 877-2740Hours: M-F 8:00AM-5:00PM*Potts, Charles E, MD8, MProvider #000345808005NPI #16898686222120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PM*Potts, Charles E, MD8, MProvider #000345808006NPI #1689868622775 Malabar RdMalabar, FL 32950(321) 733-0642Hours: M-F 8:00AM-5:00PM*Potts, Charles E, MD8, MProvider #000345808007NPI #1689868622220 Barton Blvd Unit C14Rockledge, FL 32955(321) 639-5177Hours: M-F 8:00AM-5:00PM

*Quintyne, David R, DO3, MProvider #1816169002NPI #1144211152500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Orlando Regional MedicalCenter*Quintyne, David R, DO3,8, MProvider #1816169003NPI #114421115217 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Orlando Regional MedicalCenter*Quintyne, David R, DO3,8, MProvider #1816169004NPI #11442111525270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Orlando Regional MedicalCenter

*Quintyne, David R, DO3,8, MProvider #1816169005NPI #11442111522120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Orlando Regional MedicalCenter*Quintyne, David R, DO3,8, MProvider #1816169006NPI #1144211152775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-TH 8:00AM-7:00PMF 8:00AM-6:00PMHospital Affiliations: HolmesRegional Medical Center,Orlando Regional MedicalCenter*Quintyne, David R, DO3,8, MProvider #1816169007NPI #1144211152220 Barton Blvd Unit C14Rockledge, FL 32955(321) 639-5177Hours: M-TH 8:00AM-7:00PMF 8:00AM-5:00PMSA 8:00AM-1:00PMHospital Affiliations: HolmesRegional Medical Center,Orlando Regional MedicalCenter

25

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Restrepo, Ana L, MD3,8, FProvider #002958748001NPI #18414882771223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center*Rois Romero, Ricardo A, MD3,8,MProvider #001018923009NPI #1912025503701 W Cocoa Beach CswyCocoa Beach, FL 32931(321) 868-5871Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, FairfieldMedical Center, Kittitas ValleyCommunity Hospital, VieraHospital*Rose, Lisa R, MD3,8, FProvider #2571907001NPI #1982740585220 Barton Blvd Unit C-14Rockledge, FL 32955(321) 241-6800Hours: M-F 8:00AM-5:00PM*Rose, Lisa R, MD3,8, FProvider #2571907002NPI #1982740585500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-F 8:00AM-5:00PM*Rose, Lisa R, MD3,8, FProvider #2571907003NPI #198274058517 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PM

*Rose, Lisa R, MD3,8, FProvider #2571907004NPI #19827405855270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-F 8:00AM-5:00PM*Rose, Lisa R, MD3,8, FProvider #2571907005NPI #19827405852120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PM*Rose, Lisa R, MD3,8, FProvider #2571907006NPI #1982740585775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-F 8:00AM-5:00PM*Rossi, Catherine M, MD3,8, FProvider #001370150001NPI #18412748831223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center7125 Murrell RdMelbourne, FL 32940(321) 242-8790Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

*Schmidt, Caroliese E, MD3,8, FProvider #001436163001NPI #16098788831275 S Patrick Dr Ste HSatellite Beach, FL 32937(321) 777-0600Hours: M-TH 9:00AM-5:00PMF 9:00AM-12:00PMHospital Affiliations: HolmesRegional Medical Center,Steward Rockledge Hospital,Wuesthoff Medical Center-melbourneSchneider, Susan G, MD1,3,8, FProvider #001796055001NPI #18513703572400 N Courtenay Pkwy Ste100Merritt Island, FL 32953(321) 985-9097Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, ParrishMedical Center, StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Schoen-kiewert, Erich S, MD, MProvider #001405355004NPI #1891735650500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-F 8:00AM-5:00PM*Schoen-kiewert, Erich S, MD8,MProvider #001405355005NPI #189173565017 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PM

26

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

*Schoen-kiewert, Erich S, MD8,MProvider #001405355006NPI #18917356505270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 722-5959Hours: M-F 8:00AM-5:00PM*Schoen-kiewert, Erich S, MD8,MProvider #001405355007NPI #18917356507227 N Highway 1Cocoa, FL 32927(321) 877-2740Hours: M-F 8:00AM-5:00PM*Schoen-kiewert, Erich S, MD8,MProvider #001405355008NPI #18917356502120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PM*Schoen-kiewert, Erich S, MD8,MProvider #001405355009NPI #1891735650775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-F 8:00AM-5:00PM*Schoen-kiewert, Erich S, MD8,MProvider #001405355010NPI #1891735650220 Barton Blvd Unit C14Rockledge, FL 32955(321) 639-5177Hours: M-F 8:00AM-5:00PM

*Schuck, Theodore J, DO3, MProvider #3632954001NPI #1861703217500 N Washington Ave Ste 105Titusville, FL 32796(321) 268-0267Hours: M-F 8:00AM-5:00PM*Schuck, Theodore J, DO3,8, MProvider #3632954002NPI #186170321717 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PM*Schuck, Theodore J, DO3,8, MProvider #3632954003NPI #18617032175270 Babcock St NE Ste 1Palm Bay, FL 32905(321) 241-6800Hours: M-F 8:00AM-5:00PM*Schuck, Theodore J, DO3,8, MProvider #3632954004NPI #18617032172120 Sarno RdMelbourne, FL 32935(321) 241-6800Hours: M-F 8:00AM-5:00PM*Schuck, Theodore J, DO3,8, MProvider #3632954005NPI #1861703217775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-F 8:00AM-5:00PM*Schuck, Theodore J, DO3,8, MProvider #3632954006NPI #1861703217220 Barton Blvd Unit C14Rockledge, FL 32955(321) 639-5177Hours: M-F 8:00AM-5:00PM

*Sciortino, Vincent, MD3,8, MProvider #002601428001NPI #12452908407000 Spyglass Ct Ste 130Viera, FL 32940(321) 751-7113Provider Language(s): SpanishHours: M-TH 8:30AM-4:30PMF 8:30AM-12:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Sciortino, Vincent, MD3,8, MProvider #002601428002NPI #1245290840701 W Cocoa Beach CswyCocoa Beach, FL 32931(321) 751-7113Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Serrano, Ricardo A, MD3,8, MProvider #001297178001NPI #162918035130 Fortenberry RdMerritt Island, FL 32952(321) 453-2267Provider Language(s): SpanishHours: M-F 9:00AM-4:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge Hospital, WuesthoffMedical Center Rockledge

27

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Skaden, Jibril, MD3,8, FProvider #006666044002NPI #1902281025390 Challenger RdCape Canaveral, FL 32920(321) 633-8640Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Skaden, Jibril, MD3,8Provider #006666044001NPI #19022810255005 Port St John Pkwy Ste2500Cocoa, FL 32927(321) 504-0556Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Slomin, Glenn R, DO3,8, MProvider #000983047002NPI #11644867831317 W Point DrCocoa, FL 32922(321) 636-2621Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Slomin, Glenn R, DO3,8, MProvider #000983047003NPI #1164486783240 N Wickham Rd Ste 300Melbourne, FL 32935(321) 308-5050Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

*Soto-varela, Myredsi, MD3,8, FProvider #002760372002NPI #14675937801223 Gateway DrMelbourne, FL 32901(321) 725-4500Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, Wuesthoff MedicalCenter-melbourne*Stewart, Charles S, MD3,8, MProvider #000737013001NPI #15785486321220 N Highway A1a Ste 147Indialantic, FL 32903(321) 984-1333Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center1223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center*Taraschi, Peter W, DO3,8, MProvider #000557618001NPI #17806608526100 Minton Rd NW Ste 102Palm Bay, FL 32907(321) 724-1171Provider Language(s): SpanishHours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital

*Todd, David, DO3,8, MProvider #001060338001NPI #1326003096775 Malabar RdMalabar, FL 32950(321) 722-8435Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital*Todd, David, DO3,8, MProvider #001060338011NPI #1326003096220 Barton Blvd Ste C14Rockledge, FL 32955(321) 639-5177Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital*Todd, David, DO3,8, MProvider #001060338012NPI #1326003096500 N Washington AveTitusville, FL 32796(321) 268-0267Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital

28

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

*Todd, David, DO3,8, MProvider #001060338013NPI #132600309617 Silver Palm AveMelbourne, FL 32901(321) 733-2021Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital*Todd, David, DO3,8, MProvider #001060338014NPI #13260030967227 N Highway 1Cocoa, FL 32927(321) 877-2740Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital*Torres, Maria C, MD3,8, FProvider #002450977001NPI #1104928167766 Country Club DrTitusville, FL 32780(321) 264-0778Provider Language(s): SpanishHours: M-TH 8:00AM-5:00PMF 8:00AM-12:00PMHospital Affiliations: ParrishMedical Center*Townsend, Petra E, MD3,8, FProvider #002813907003NPI #1033348073951 N Washington AveTitusville, FL 32796(321) 268-6795Hours: M-F 8:00AM-5:00PM

*Trout, Ronald V, MD3,8, MProvider #000999378001NPI #1194701607730 Malabar RdMalabar, FL 32950(321) 409-6800Hours: M-F 8:00AM-5:00PMHospital Affiliations: Palm BayCommunity Hospital, Palm BayHospital*Vargas, Victor M, MD3,8, MProvider #003475267001NPI #11049886251350 Hickory StMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital699 W Cocoa Beach Cswy Ste506Cocoa Beach, FL 32931(321) 434-1771Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital*Vargas, Victor M, MD3,8, MProvider #003475267002NPI #1104988625701 W Cocoa Beach CswyCocoa Beach, FL 32931(321) 868-5871Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital

*Wasil, Bushra I, MD3,8, FProvider #002916594003NPI #17000926081317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): Punjabi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: NovantHealth Matthews Medical Center*Wasil, Bushra I, MD3,8, FProvider #002916594004NPI #17000926082404 N Courtenay Pkwy Ste DMerritt Island, FL 32953(321) 453-3638Provider Language(s): Punjabi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: NovantHealth Matthews Medical Center*Wasil, Bushra I, MD3,8, FProvider #002916594005NPI #1700092608150 N Sykes Creek Pkwy Ste102Merritt Island, FL 32953(321) 453-3638Provider Language(s): Punjabi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: NovantHealth Matthews Medical CenterWolfington, Michael D, DO3,8, MProvider #1650781001NPI #18817789261800 W Hibiscus BlvdMelbourne, FL 32901(321) 726-1601Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

29

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

Geriatric Medicine

*Boodhoo, Victor R, MD8, MProvider #001238319002NPI #1942203898250 Harrison StTitusville, FL 32780(321) 267-1424Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Fermin, Eileen N, MD1,3,8, FProvider #002765877003NPI #12655533257901 Ron Beatty Blvd Ste 101Sebastian, FL 32976(772) 664-8171Provider Language(s): French,SpanishHours: M 8:00AM-5:00PMTU 1:00PM-5:00PMW-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center*Lupo, Giovanni, MD3,8, MProvider #2021774002NPI #12553940601032 Fieldstone DrMelbourne, FL 32940(321) 213-3622Provider Language(s): ItalianHours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center-melbourne

*Lupo, Giovanni, MD3,8, MProvider #2021774003NPI #1255394060240 N Wickham Rd Ste 108Melbourne, FL 32935(321) 724-4545Provider Language(s): ItalianHours: M-F 9:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center-melbourne*Morel, Guillermo F, MD1,3,8, MProvider #002765878002NPI #19928270917901 Ron Beatty Blvd Ste 101Sebastian, FL 32976(772) 664-8171Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical CenterSchneider, Susan G, MD1,3,8, FProvider #001796055001NPI #18513703572400 N Courtenay Pkwy Ste100Merritt Island, FL 32953(321) 985-9097Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, ParrishMedical Center, StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Tronetti, Pamela S, DO3,8, FProvider #2112652001NPI #1649258864805 Century Medical Dr Ste ATitusville, FL 32796(321) 268-6111Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center

Internal Medicine

*Aboutanos, Angela W, MD3,8, FProvider #1158371001NPI #17301585772222 S Harbor City Blvd Ste430Melbourne, FL 32901(321) 541-1777Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Aboutanos, Angela W, MD3,8, FProvider #1158371002NPI #1730158577240 N Wickham Rd Ste 300Melbourne, FL 32935(321) 541-1777Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Abraham, Bobby, MD3,8, MProvider #001120181002NPI #17806065411027 Florida Ave S Ste ARockledge, FL 32955(321) 504-3818Provider Language(s):MalayalamHours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital

30

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Abrahao, Paula, MD3,8, FProvider #003497470002NPI #19324715051425 Malabar Rd NEPalm Bay, FL 32907(321) 434-8121Provider Language(s):Portuguese, SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: Palm BayCommunity Hospital, Palm BayHospital*Alexander, Patricia A, MD3,8, FProvider #002351729002NPI #1093718959250 Harrison StTitusville, FL 32780(321) 267-1424Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Alexander, Patricia A, MD3,8, FProvider #002351729003NPI #1093718959390 Challenger RdCape Canaveral, FL 32920(321) 633-8640Hours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Anciro, Janet A, MD3,8, FProvider #001801807002NPI #15785382783972 W Eau Gallie Blvd Ste BMelbourne, FL 32934(321) 241-4908Provider Language(s): TagalogHours: M-TH 8:00AM-3:30PMF 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

Anderson, Kyle R, MD3,8, MProvider #000841433001NPI #17705763321223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital730 Malabar RdMalabar, FL 32950(321) 409-6800Hours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital*Apoltan, Ana M, MD3,8, FProvider #002475885002NPI #19523772776100 Minton Rd NW Ste 104Palm Bay, FL 32907(321) 724-1172Provider Language(s): RomanianHours: M-F 8:00AM-4:30PMHospital Affiliations: Hospital OfSaint Raphael, Midstate MedicalCenter, Yale New Haven Hospital*Atkinson, Andrew M, MD3,8, MProvider #000490424005NPI #1437126133240 N Wickham Rd Ste 110Melbourne, FL 32935(321) 541-1714Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

*Atkinson, Andrew M, MD3,8, MProvider #490424001NPI #14371261332222 S Harbor City Blvd Ste420Melbourne, FL 32901(321) 541-1714Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Aziz, Nabil W, MD3,8, MProvider #001274833001NPI #17806754051257 Florida Ave SRockledge, FL 32955(321) 631-1007Provider Language(s): SpanishHours: M-TH 9:00AM-5:00PMF 9:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge Hospital, WuesthoffMedical Center Rockledge*Baez, Raymond C, MD3,8, MProvider #1238905001NPI #11240912281317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center Rockledge

31

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Baez, Raymond C, MD3,8, MProvider #1238905002NPI #1124091228150 N Sykes Creek Pkwy Ste102Merritt Island, FL 32953(321) 453-3638Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: WuesthoffMedical Center Rockledge*Bakshi, Shakti D, MD3, MProvider #001892891001NPI #15482495356550 N Wickham Rd Ste 902Melbourne, FL 32940(321) 255-1947Provider Language(s): HindiHours: M 8:30AM-5:00PMTU 8:30AM-12:30PMW-TH 8:30AM-5:00PMF 8:30AM-12:30PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Balaji, Gobivenkata V, MD3,8, MProvider #001916939002NPI #1649230459298 Michigan Ave Ste 101Melbourne, FL 32901(321) 215-6899Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne

*Bennett, Lloyd, MD3,8, MProvider #001871577001NPI #11442821531350 Hickory StMelbourne, FL 32901(321) 434-1771Hours: M-F 8:00AM-5:00PMHospital Affiliations: Cox MedicalCenter Branson And RelatedClinic, Holmes Regional MedicalCenter, Sebastian River MedicalCenter, Steward RockledgeHospital, Wuesthoff MedicalCenter RockledgeBerger, Patrick J, DO3,8, MProvider #002461776001NPI #16291732735205 Babcock St NEPalm Bay, FL 32905(321) 728-5700Hours: M-F 8:00AM-4:00PMHospital Affiliations: CapeCanaveral Hospital, FloridaHospital Deland, Florida HospitalNew Smyrna, Holmes RegionalMedical Center, Palm BayCommunity Hospital, Palm BayHospital, Steward RockledgeHospital, Viera Hospital,Wuesthoff Medical CenterRockledgeBhat, Syed B, MD3,8, MProvider #002454004001NPI #11240631851350 Hickory StMelbourne, FL 32901(321) 434-1771Hours: M-F 8:00AM-5:00PMHospital Affiliations: CharlesCole Memorial Hospital, HolmesRegional Medical Center, StVincents Hospital

*Blecker, Edgar R, MD3,8, MProvider #002391651002NPI #19523881007901 Ron Beatty BlvdBarefoot Bay, FL 32976(772) 664-8171Provider Language(s): Italian,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: Indian RiverMedical Center, Sebastian RiverMedical CenterBrevard Medical Care8Provider #001809900006NPI #1184954109925 N Courtenay PkwyMerritt Island, FL 32953(321) 452-2016Hours: M-F 8:00AM-5:00PMBrevard Medical CareProvider #1809900001NPI #11849541095270 Babcock St NEPalm Bay, FL 32905(321) 729-9306Hours: M-F 8:00AM-5:00PMBrevard Medical Care8Provider #1809900002NPI #11849541093910 S Washington Ave Ste 112Titusville, FL 32780(321) 268-2005Hours: M-F 8:00AM-5:00PMBrevard Medical Care8Provider #1809900003NPI #1184954109655 S Apollo Blvd Ste 2Melbourne, FL 32901(321) 723-4644Hours: M-F 8:00AM-5:00PM

32

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Brevard Medical Care8Provider #1809900004NPI #11849541091305 Oak StMelbourne, FL 32901(321) 952-1502Hours: M-F 8:00AM-5:00PMBrevard Medical Care8Provider #1809900005NPI #11849541092194 Highway A1aIndian Harbour Beach, FL32937(321) 777-4461Hours: M-F 8:00AM-5:00PM*Burns, Beth A, DO3,8, FProvider #002960315001NPI #15583114648745 N Wickham RdMelbourne, FL 32940(321) 434-1771Hours: SU-SA 7:00AM-7:00PMHospital Affiliations: FloridaHospital Med Center, VieraHospitalChhindra, Jagdeep, MD3,8, MProvider #003466113001NPI #15180261372200 W Eau Gallie Blvd Ste 200Melbourne, FL 32935(508) 836-3663Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital

5200 Babcock St NE Ste 103Palm Bay, FL 32905(321) 312-4796Hours: M-F 8:30AM-4:30PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital*Cortes, Joyce M, MD3,8, FProvider #002480768001NPI #18818834786100 Minton Rd NW Ste 103bPalm Bay, FL 32907(321) 309-5100Hours: M-F 8:00AM-5:00PMHospital Affiliations: Shands LiveOak Regional Med Center*Dalsaniya, Keyurkumar, MD3,8,MProvider #003197747002NPI #16292472421350 Hickory StMelbourne, FL 32901(321) 434-1771Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, StLuke's Warren Hospital*Fermin, Eileen N, MD1,3,8, FProvider #002765877003NPI #12655533257901 Ron Beatty Blvd Ste 101Sebastian, FL 32976(772) 664-8171Provider Language(s): French,SpanishHours: M 8:00AM-5:00PMTU 1:00PM-5:00PMW-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center

Field, Brenda E, MD3,8, FProvider #002052091007NPI #14775222418000 Ron Beatty Blvd Ste B-3Micco, FL 32976(772) 664-1388Hours: M-TH 8:00AM-5:00PMF 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center*Florescu, Lucian L, MD3,8, MProvider #001238900002NPI #19725769321317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): French,German, Romanian, SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, WuesthoffMedical Center-melbourne*Florescu, Lucian L, MD3,8, MProvider #001238900003NPI #19725769328075 Spyglass Hill Rd Ste 101Melbourne, FL 32940(321) 752-0307Provider Language(s): French,German, Romanian, SpanishHours: M-TH 8:00AM-5:00PMF 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, WuesthoffMedical Center-melbourne

33

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

Garcia, Joven T, MD3,8, MProvider #003092612002NPI #19928656796080 Babcock St SEPalm Bay, FL 32909(321) 409-3073Provider Language(s): Chinese,MandarinHours: M-F 8:30AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, Wuesthoff MedicalCenter-melbourne*Geiger, Ralph B, MD3,8, MProvider #000043639003NPI #12452940731317 W Point DrCocoa, FL 32922(321) 636-2621Hours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center*Girjashanker, Ramesh N, MD3,8,MProvider #002290110002NPI #1144220880105 S Banana River BlvdCocoa Beach, FL 32931(321) 434-1771Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital, WuesthoffMedical Center Rockledge

*Grover, Anju, MD3,8, FProvider #002580748003NPI #13169795292010 W Eau Gallie Blvd Unit106Melbourne, FL 32935(321) 254-6338Provider Language(s): HindiHours: M 12:30PM-4:15PMTU-W 8:00AM-5:00PMTH-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourne*Gu, Yanqing N, MD3,8, FProvider #002338352001NPI #1841203528551 S Apollo Blvd Ste 103Melbourne, FL 32901(321) 984-2686Provider Language(s): Chinese,MandarinHours: M-F 9:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center*Guirguis, Hany S, MD3,8, MProvider #002335890002NPI #11644953051317 W Point DrCocoa, FL 32922(321) 636-2621Provider Language(s): ArabicHours: M-F 8:00AM-5:00PMHospital Affiliations: StewardRockledge Hospital, WuesthoffMedical Center Rockledge

*Hashmi-alikhan, Saira, MD3,8, FProvider #002403994001NPI #14078003298745 N Wickham RdMelbourne, FL 32940(321) 434-9358Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, StewardRockledge Hospital, VieraHospital, Wuesthoff MedicalCenter RockledgeHernandez Pons, Edgardo A,MD3,8, MProvider #005099715001NPI #15686930341223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PM7125 Murrell RdMelbourne, FL 32940(321) 242-8790Hours: M-F 8:00AM-5:00PMIsenman, Eric C, MD3,8, MProvider #002791261001NPI #16099311871223 Gateway DrMelbourne, FL 32901(321) 725-4500Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

34

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

*Itani, Nabil S, DO3,8, MProvider #002370827002NPI #1912009168875 Century Medical DrTitusville, FL 32796(321) 268-8787Provider Language(s): ArabicHours: M-F 8:00AM-5:00PMHospital Affiliations: ParrishMedical Center*Jain, Nitin, MD3,8, MProvider #002279002003NPI #17504783922010 W Eau Gallie Blvd Unit106Melbourne, FL 32935(321) 254-6338Hours: M 8:30AM-12:30PMTU 12:15PM-4:15PMW-F 8:30AM-12:30PMHospital Affiliations: HolmesRegional Medical Center, PalmBay Community Hospital, PalmBay Hospital, Wuesthoff MedicalCenter-melbourne*Jones, Cassi D, DO3,8, FProvider #005996514001NPI #14879411421317 W Point DrCocoa, FL 32922(321) 636-2621Hours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical CenterJones, Cassi D, DO3,8, FProvider #5996514004NPI #14879411428000 Ron Beatty Blvd Ste A-3Sebastian, FL 32976(772) 581-0334Hours: M-F 8:00AM-5:00PMHospital Affiliations: SebastianRiver Medical Center

*Kearney, James D, MD3,8, MProvider #001550841001NPI #1447393244580 N Wickham Rd Ste AMelbourne, FL 32935(321) 255-7118Hours: M-F 8:30AM-4:30PMHospital Affiliations: HolmesRegional Medical Center,Wuesthoff Medical Center-melbourneKhaing, Maung C, MD3,8, MProvider #002580823001NPI #18211486281251 Hickory StMelbourne, FL 32901(321) 723-3113Provider Language(s): BurmeseHours: M-F 9:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center, KaiserFoundation Hospital, Palm BayCommunity Hospital, Palm BayHospital*Krishnamurthy, Rajasri, MD3,8, FProvider #002747986001NPI #14574089321071 Port Malabar Blvd NE Ste109Palm Bay, FL 32905(321) 434-1771Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center730 Malabar Rd Ste AMalabar, FL 32950(321) 434-8140Hours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center

*Kumar, Aravind K, MD3,8, MProvider #002437704001NPI #18715390722795 W New Haven AveMelbourne, FL 32904(321) 622-8626Provider Language(s): HindiHours: M-F 8:30AM-5:30PMHospital Affiliations: HolmesRegional Medical Center,Kindred Hospital Melbourne,Wuesthoff Medical Center-melbourneKumar, Sasi M, MD3,8, MProvider #922628002NPI #1649202862389 Commerce Pkwy Ste 120Rockledge, FL 32955(321) 806-3949Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, WuesthoffMedical Center Rockledge*Kumar, Vinay K, MD3,8, MProvider #002257742002NPI #11846168492070 Us Highway 1 Ste 103Rockledge, FL 32955(321) 632-0552Hours: M-F 8:00AM-5:00PMHospital Affiliations: CapeCanaveral Hospital, StewardRockledge Hospital

35

Florida - Brevard

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Kundumadathil, Jayadevan N,MD3,8, MProvider #001810875001NPI #1912968918406 5th Ave Ste 102Indialantic, FL 32903(321) 473-8974Provider Language(s): HindiHours: M-F 8:00AM-5:00PMHospital Affiliations: HolmesRegional Medical Center*Kundumadathil, Jayadevan,MD3,8, MProvider #1810875002NPI #19129689183972 W Eau Gallie Blvd Ste BMe