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7065 Westpointe Blvd Ste 308 Orlando FL 32835-8758 | |
| (800) 840-2528 | |
| (407) 540-9552 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7065 Westpointe Blvd Ste 308, Orlando, Florida |
| Authorized Official Name and Position | Max Magnasco (OWNER) |
| Authorized Official Contact | 8008402528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 784719 Winter Garden FL 34778-4719 Ph: (800) 840-2528 | 7065 Westpointe Blvd Ste 308 Orlando FL 32835-8758 Ph: (800) 840-2528 |
| NPI Number | 1093025702 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 07/05/2022 |
| Certification Date | 07/05/2022 |
| Medicare PECOS PAC ID | 9234472788 |
|---|---|
| Medicare Enrollment ID | O20190523002823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093025702 | NPI | - | NPPES |
| 002803500 | Medicaid | FL | |
| 014778600 | Medicaid | FL | |
| 0045890-00 | Medicaid | FL | |
| 014148500 | Medicaid | FL |
| Provider Name | Hannah E Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881035178 PECOS PAC ID: 0648408344 Enrollment ID: I20131231001489 |
| Provider Name | Rebecca Ann Lauren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235557323 PECOS PAC ID: 7810120680 Enrollment ID: I20140501000265 |
| Provider Name | Jacy Mesch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396142576 PECOS PAC ID: 5294060505 Enrollment ID: I20190709001994 |
| Provider Name | Cora D Lawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497990808 PECOS PAC ID: 2860840691 Enrollment ID: I20231204003370 |
| Provider Name | Molly Giannotta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790260727 PECOS PAC ID: 5991154627 Enrollment ID: I20231206004374 |
| Provider Name | Christina Kathryn Tecson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518563691 PECOS PAC ID: 9638528045 Enrollment ID: I20231211002912 |
| Provider Name | Stephen Adam Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245550219 PECOS PAC ID: 1557710456 Enrollment ID: I20231218000041 |
| Provider Name | Toula Zoulas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669984514 PECOS PAC ID: 3476902313 Enrollment ID: I20231218001315 |
| Provider Name | Linda Ciotoli |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013283308 PECOS PAC ID: 8325498033 Enrollment ID: I20231221000601 |
| Provider Name | Lisa Signore-jarvis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790224467 PECOS PAC ID: 7416309281 Enrollment ID: I20240117001757 |
| Provider Name | Ariliz Pena Salses |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679209282 PECOS PAC ID: 9537512397 Enrollment ID: I20240129000089 |
| Provider Name | Nikaury Munoz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669830519 PECOS PAC ID: 2769826775 Enrollment ID: I20240219000328 |
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