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8601 Commodity Circle Orlando FL 32819 | |
| (407) 605-2252 | |
| (855) 750-3960 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 8601 Commodity Circle, Orlando, Florida |
| Authorized Official Name and Position | Sterling Brodniak (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4076052253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8601 Commodity Circle Orlando FL 32819 Ph: (407) 605-2253 | 8601 Commodity Circle Orlando FL 32819 Ph: (407) 605-2252 |
| NPI Number | 1093356842 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 02/06/2024 |
| Certification Date | 08/02/2023 |
| Medicare PECOS PAC ID | 4587054614 |
|---|---|
| Medicare Enrollment ID | O20211206000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093356842 | NPI | - | NPPES |
| 113976900 | Medicaid | FL |
| Provider Name | Anjum Mobin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801961420 PECOS PAC ID: 2769418052 Enrollment ID: I20050708000412 |
| Provider Name | Craig Callam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538799747 PECOS PAC ID: 2365872561 Enrollment ID: I20200430000005 |
| Provider Name | Sterling Levie Brodniak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801056478 PECOS PAC ID: 3476783135 Enrollment ID: I20230706000918 |
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