|
| |
|
1317 Edgewater Dr # 117 Orlando FL 32804-6350 | |
| (321) 754-9099 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1317 Edgewater Dr # 117, Orlando, Florida |
| Authorized Official Name and Position | Benson George Munyan (DIRECTOR) |
| Authorized Official Contact | 3217549099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3564 Avalon Park E Blvd Ste 1 Ipmb 3039 Orlando FL 32828-6350 Ph: (321) 754-9099 | 1317 Edgewater Dr # 117 Orlando FL 32804-6350 Ph: (321) 754-9099 |
| NPI Number | 1356925861 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Medicare PECOS PAC ID | 8022493600 |
|---|---|
| Medicare Enrollment ID | O20220917000635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356925861 | NPI | - | NPPES |
| 1AOUI | Other | FL | BCBS FLORIDA BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Benson George Munyan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205328390 PECOS PAC ID: 9931584513 Enrollment ID: I20220917000636 |
| Provider Name | Nicholas Taylor James |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104498252 PECOS PAC ID: 2264890698 Enrollment ID: I20230616001847 |
| Provider Name | Jessica Candelo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932863701 PECOS PAC ID: 6204286313 Enrollment ID: I20240102000595 |
Hispanic Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5134 Saint Charles Ln, Orlando, FL 32822 Phone: 407-382-9079 Fax: 407-657-6035 | |
Brighter Future Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6239 Edgewater Drive, Bldg V-1 Suite 2, Orlando, FL 32810 Phone: 407-298-9264 Fax: 407-298-9265 | |
Multilingual Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13538 Village Park Dr Unit 220, Orlando, FL 32837 Phone: 407-494-3787 Fax: 888-584-9071 | |
Mh At Orlando Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2431 Sand Lake Rd, Orlando, FL 32809 Phone: 855-876-8648 | |
The Meaningful Life Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11315 Corporate Blvd Ste 105, Orlando, FL 32817 Phone: 407-534-0186 Fax: 321-972-3982 | |
Evoyent Health Foundation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 S Orange Ave Ste 900, Orlando, FL 32801 Phone: 321-282-1999 |