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4359 Hunters Park Ln Orlando FL 32837-7614 | |
| (407) 251-6511 | |
| (407) 251-6513 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4359 Hunters Park Ln, Orlando, Florida |
| Authorized Official Name and Position | Yassar Chakfe (MANAGING MEMBER) |
| Authorized Official Contact | 4072516511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4359 Hunters Park Ln Orlando FL 32837-7614 Ph: (407) 251-6511 | 4359 Hunters Park Ln Orlando FL 32837-7614 Ph: (407) 251-6511 |
| NPI Number | 1124319587 |
|---|---|
| Provider Enumeration Date | 04/20/2011 |
| Last Update Date | 07/29/2018 |
| Medicare PECOS PAC ID | 5597936864 |
|---|---|
| Medicare Enrollment ID | O20110916000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124319587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Yassar Chakfe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427179860 PECOS PAC ID: 6002087384 Enrollment ID: I20110916000405 |
| Provider Name | Yuan Tian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982480414 PECOS PAC ID: 5496100034 Enrollment ID: I20231017001642 |
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