| Myrtho Mompoint-branch Md Pa | |
|
2500 Discovery Dr Orlando FL 32826-3709 | |
| (407) 275-2203 | |
| (407) 282-7012 |
| Full Name | Myrtho Mompoint-branch Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2500 Discovery Dr, Orlando, Florida |
| Authorized Official Name and Position | Myrtho Mompoint-branch (PRESIDENT) |
| Authorized Official Contact | 4072752203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myrtho Mompoint-branch Md Pa 2500 Discovery Dr Orlando FL 32826-3709 Ph: (407) 275-2203 | Myrtho Mompoint-branch Md Pa 2500 Discovery Dr Orlando FL 32826-3709 Ph: (407) 275-2203 |
| NPI Number | 1689686412 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6406232354 |
|---|---|
| Medicare Enrollment ID | O20220930000823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689686412 | NPI | - | NPPES |
| 46298 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME73432 (Florida) | Primary |
| Provider Name | Myrtho M Branch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386675205 PECOS PAC ID: 7214313162 Enrollment ID: I20220930000956 |
| Provider Name | Erik Barba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396492609 PECOS PAC ID: 5799147625 Enrollment ID: I20230809003136 |
| Provider Name | Vanessa Quinzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215636378 PECOS PAC ID: 9436511276 Enrollment ID: I20230810004318 |
| Provider Name | Tiffany Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952189573 PECOS PAC ID: 2860939279 Enrollment ID: I20240802002452 |
| Provider Name | Patience Amune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437908365 PECOS PAC ID: 0749714491 Enrollment ID: I20241118000928 |
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