| Greater Orlando Psychiatric Associates, P.a. | |
|
1417 N Semoran Blvd Suite 203 Orlando FL 32807-3555 | |
| (407) 206-1106 | |
| (407) 206-1106 |
| Full Name | Greater Orlando Psychiatric Associates, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1417 N Semoran Blvd, Orlando, Florida |
| Authorized Official Name and Position | Ramon O. Martinez (PRESIDENT) |
| Authorized Official Contact | 4072061106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Orlando Psychiatric Associates, P.a. 1417 N Semoran Blvd Suite 203 Orlando FL 32807-3555 Ph: (407) 206-1106 | Greater Orlando Psychiatric Associates, P.a. 1417 N Semoran Blvd Suite 203 Orlando FL 32807-3555 Ph: (407) 206-1106 |
| NPI Number | 1669405387 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6709806284 |
|---|---|
| Medicare Enrollment ID | O20051129000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669405387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ramon Osvaldo Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457376964 PECOS PAC ID: 8628971900 Enrollment ID: I20051130000359 |
| Provider Name | Eduardo Ysern |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144231580 PECOS PAC ID: 2365545209 Enrollment ID: I20070414000055 |
| Provider Name | Barbara Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306026877 PECOS PAC ID: 3375617822 Enrollment ID: I20080801000346 |
| Provider Name | Susan Smith Bouldin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942503529 PECOS PAC ID: 5597981399 Enrollment ID: I20140731001831 |
| Provider Name | Maria L Valdes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144351636 PECOS PAC ID: 9234323866 Enrollment ID: I20161121001867 |
| Provider Name | Michele Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134677842 PECOS PAC ID: 3971856964 Enrollment ID: I20181020000605 |
| Provider Name | Jorel O Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336553684 PECOS PAC ID: 7618271131 Enrollment ID: I20190517001145 |
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