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5323 Millenia Lakes Blvd #121 Orlando FL 32839-3392 | |
| (407) 830-0773 | |
| (407) 830-1366 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5323 Millenia Lakes Blvd, Orlando, Florida |
| Authorized Official Name and Position | Romean Hamzehloui (GENERAL MANAGER) |
| Authorized Official Contact | 4078300773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
5323 Millenia Lakes Blvd #121 Orlando FL 32839-3392 Ph: (407) 830-0773 | 5323 Millenia Lakes Blvd #121 Orlando FL 32839-3392 Ph: (407) 830-0773 |
| NPI Number | 1962786483 |
|---|---|
| Provider Enumeration Date | 10/03/2011 |
| Last Update Date | 05/20/2014 |
| Medicare PECOS PAC ID | 4880869635 |
|---|---|
| Medicare Enrollment ID | O20111207000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962786483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | ME21787 (Florida) | Primary |
| Provider Name | Aloma P Alcober |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558314153 PECOS PAC ID: 4789576380 Enrollment ID: I20050926000915 |
| Provider Name | Eduardo Ysern |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144231580 PECOS PAC ID: 2365545209 Enrollment ID: I20070414000055 |
| Provider Name | Syed Hashimi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477658268 PECOS PAC ID: 7517953250 Enrollment ID: I20090623000733 |
| Provider Name | Marina Polur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639302078 PECOS PAC ID: 0446406904 Enrollment ID: I20120816000143 |
| Provider Name | Ibha Sedenu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467701177 PECOS PAC ID: 7618127721 Enrollment ID: I20121207000182 |
| Provider Name | Samantha D Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740703354 PECOS PAC ID: 8022351956 Enrollment ID: I20190516002297 |
| Provider Name | Cyndia Milord-giordani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598486912 PECOS PAC ID: 6305202862 Enrollment ID: I20230525002252 |
| Provider Name | Evangjelia Zylyftari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316415615 PECOS PAC ID: 6901264688 Enrollment ID: I20230628002018 |
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