Lifesmart Medical Center Inc | |
251 Maitland Ave Ste 215 Altamonte Springs FL 32701 | |
(863) 256-9040 | |
Not Available |
Full Name | Lifesmart Medical Center Inc |
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Speciality | Community/Behavioral Health |
Location | 251 Maitland Ave Ste 215, Altamonte Springs, Florida |
Authorized Official Name and Position | Raul Castillo (OWNER) |
Authorized Official Contact | 7862344956 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lifesmart Medical Center Inc 251 Maitland Ave Ste 215 Altamonte Springs FL 32701 Ph: (863) 256-9040 | Lifesmart Medical Center Inc 251 Maitland Ave Ste 215 Altamonte Springs FL 32701 Ph: (863) 256-9040 |
NPI Number | 1942972468 |
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Provider Enumeration Date | 10/03/2021 |
Last Update Date | 08/27/2024 |
Certification Date | 08/27/2024 |
Medicare PECOS PAC ID | 9032585633 |
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Medicare Enrollment ID | O20221024001194 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942972468 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Joseph Secor-taddia |
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Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1225591506 PECOS PAC ID: 9830571116 Enrollment ID: I20220803000771 |
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