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7350 Futures Dr Suite 16 Orlando FL 32819-9083 | |
| (407) 226-3733 | |
| (407) 226-3734 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7350 Futures Dr, Orlando, Florida |
| Authorized Official Name and Position | Fredesvinda Jacobs-alvarez (PRESIDENT/CEO) |
| Authorized Official Contact | 4072263733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7350 Futures Dr Suite 16 Orlando FL 32819-9083 Ph: (407) 226-3733 | 7350 Futures Dr Suite 16 Orlando FL 32819-9083 Ph: (407) 226-3733 |
| NPI Number | 1861557936 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 10/21/2023 |
| Certification Date | 10/21/2023 |
| Medicare PECOS PAC ID | 0446353718 |
|---|---|
| Medicare Enrollment ID | O20070307000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861557936 | NPI | - | NPPES |
| 271060900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | ME79634 (Florida) | Primary |
| Provider Name | Fredesvinda Jacobs Alvarez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063468668 PECOS PAC ID: 5193766624 Enrollment ID: I20050516000356 |
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