Tracy Chapman, | |
200 N Lakemont Ave, Pediatric Inpt Care At Winter Park, Winter Park, FL 32792-3273 | |
(407) 303-2528 | |
(407) 303-2760 |
Full Name | Tracy Chapman |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 200 N Lakemont Ave, Winter Park, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700174000 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 5101019501 (Michigan) | Secondary |
208000000X | Pediatrics | OS12891 (Florida) | Primary |
Entity Name | Florida Hospital Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225034234 PECOS PAC ID: 0749186153 Enrollment ID: O20031208000807 |
Mailing Address | Practice Location Address |
---|---|
Tracy Chapman, 2501 N Orange Ave Ste 446, Orlando, FL 32804-4644 Ph: (407) 303-2528 | Tracy Chapman, 200 N Lakemont Ave, Pediatric Inpt Care At Winter Park, Winter Park, FL 32792-3273 Ph: (407) 303-2528 |
Dr. Nicholo J. Sartor, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1801 Lee Rd Ste 165, Winter Park, FL 32789 Phone: 407-975-0410 Fax: 407-975-0413 | |
Vanessa Alisa Gutierrez, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 200 N Lakemont Ave, Pediatric Inpt Care At Winter Park, Winter Park, FL 32792 Phone: 407-303-2528 Fax: 407-303-2760 | |
Dr. Shivani Verma, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2660 W Fairbanks Ave, Winter Park, FL 32789 Phone: 407-898-2767 Fax: 407-898-9443 | |
Clifford Allen Selsky, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2830 Casa Aloma Way, Winter Park, FL 32792 Phone: 407-335-4760 Fax: 877-695-8583 | |
Md Saif Al Haque, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2325 W Fairbanks Ave, Winter Park, FL 32789 Phone: 407-539-0311 | |
Dr. Danielle Charisse Wallace, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1801 Lee Rd Ste 165, Winter Park, FL 32789 Phone: 407-975-0410 Fax: 407-975-0413 | |
Dr. Frank Antolin Lopez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1992 Mizell Ave, Winter Park, FL 32792 Phone: 407-644-4844 Fax: 407-644-6101 |