| Bannel Associates Llc | |
|
405 W Oak St Kissimmee FL 34741-4931 | |
| (407) 955-6719 | |
| Not Available |
| Full Name | Bannel Associates Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 405 W Oak St, Kissimmee, Florida |
| Authorized Official Name and Position | Nelson Gonzalez Rodriguez (PRESIDENT) |
| Authorized Official Contact | 4073502120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bannel Associates Llc 405 W Oak St Kissimmee FL 34741-4931 Ph: (407) 955-6719 | Bannel Associates Llc 405 W Oak St Kissimmee FL 34741-4931 Ph: (407) 955-6719 |
| NPI Number | 1215623665 |
|---|---|
| Provider Enumeration Date | 04/17/2023 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/17/2023 |
| Medicare PECOS PAC ID | 6901240936 |
|---|---|
| Medicare Enrollment ID | O20240219001209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215623665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Antonio J Larranaga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073575320 PECOS PAC ID: 4082621339 Enrollment ID: I20060313000289 |
| Provider Name | Orly Pena Sanchez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447212295 PECOS PAC ID: 7315962859 Enrollment ID: I20081018000123 |
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