|
| |
|
2345 Sand Lake Rd Suite 200 Orlando FL 32809-9142 | |
| (407) 851-5121 | |
| (407) 851-0439 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2345 Sand Lake Rd, Orlando, Florida |
| Authorized Official Name and Position | Bhaskar Nandimandalam Raju (PRESIDENT) |
| Authorized Official Contact | 4078515121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 714 Windermere FL 34786-0714 Ph: (407) 851-5121 | 2345 Sand Lake Rd Suite 200 Orlando FL 32809-9142 Ph: (407) 851-5121 |
| NPI Number | 1528172731 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Medicare PECOS PAC ID | 1153367545 |
|---|---|
| Medicare Enrollment ID | O20050707000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528172731 | NPI | - | NPPES |
| 009616900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | ME91130 (Florida) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Bhaskar N Raju |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558397620 PECOS PAC ID: 7810934957 Enrollment ID: I20050411001041 |
| Provider Name | Hugo M Espinosa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215194949 PECOS PAC ID: 7416181342 Enrollment ID: I20131009000595 |
| Provider Name | Kenneth Ethan Lai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376893974 PECOS PAC ID: 8325266489 Enrollment ID: I20151201001118 |
| Provider Name | Katie Cutchin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710220579 PECOS PAC ID: 4284924531 Enrollment ID: I20160527001709 |
| Provider Name | Miladys N Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972669414 PECOS PAC ID: 8729340211 Enrollment ID: I20180321001010 |
| Provider Name | Idianise Josue Vildor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679060206 PECOS PAC ID: 8628333069 Enrollment ID: I20180605002956 |
| Provider Name | Rebeca Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962098095 PECOS PAC ID: 5799190823 Enrollment ID: I20210223000213 |
| Provider Name | Charmaine A Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669073474 PECOS PAC ID: 9638580418 Enrollment ID: I20210322001692 |
| Provider Name | Hector R Payares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275080558 PECOS PAC ID: 0547646887 Enrollment ID: I20221010002770 |
| Provider Name | Carmen Herbruger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922346477 PECOS PAC ID: 7810362365 Enrollment ID: I20230414000157 |
| Provider Name | Vijayalakshmi Kumaraguru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104425800 PECOS PAC ID: 6901264035 Enrollment ID: I20230622002141 |
| Provider Name | Syed Kamran Nayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134870355 PECOS PAC ID: 8921453093 Enrollment ID: I20231010000449 |
| Provider Name | Cynthia L Coe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528758463 PECOS PAC ID: 5890140859 Enrollment ID: I20231011000492 |
| Provider Name | Rebekah Marlie Irmler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356065544 PECOS PAC ID: 5193170975 Enrollment ID: I20231013002545 |
| Provider Name | Veona Patricia Sinanon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508569807 PECOS PAC ID: 4385099027 Enrollment ID: I20231016001882 |
| Provider Name | Lymarie M. Vilella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205280484 PECOS PAC ID: 5991151094 Enrollment ID: I20231025003995 |
| Provider Name | Krisnamor Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316611353 PECOS PAC ID: 0547616559 Enrollment ID: I20231027000954 |
| Provider Name | Molly Fragiacomo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952185258 PECOS PAC ID: 3173979796 Enrollment ID: I20231101003827 |
| Provider Name | Quaycian Janae Stewart-kodadar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265139828 PECOS PAC ID: 0446607048 Enrollment ID: I20231102003770 |
| Provider Name | Miriam Ruth Ormsby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902456429 PECOS PAC ID: 0749639516 Enrollment ID: I20231206001195 |
| Provider Name | Kathy Virella |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730553868 PECOS PAC ID: 4880050608 Enrollment ID: I20240105003488 |
| Provider Name | Michelle Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225489917 PECOS PAC ID: 2264976612 Enrollment ID: I20240627000232 |
| Provider Name | Daniel Eric Campbell Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215788682 PECOS PAC ID: 7416495254 Enrollment ID: I20240812003583 |
| Provider Name | Ma Cristina Molina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235983842 PECOS PAC ID: 1658811724 Enrollment ID: I20240904004023 |
Hispanic Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5134 Saint Charles Ln, Orlando, FL 32822 Phone: 407-382-9079 Fax: 407-657-6035 | |
Brighter Future Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6239 Edgewater Drive, Bldg V-1 Suite 2, Orlando, FL 32810 Phone: 407-298-9264 Fax: 407-298-9265 | |
Multilingual Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13538 Village Park Dr Unit 220, Orlando, FL 32837 Phone: 407-494-3787 Fax: 888-584-9071 | |
Mh At Orlando Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2431 Sand Lake Rd, Orlando, FL 32809 Phone: 855-876-8648 | |
The Meaningful Life Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11315 Corporate Blvd Ste 105, Orlando, FL 32817 Phone: 407-534-0186 Fax: 321-972-3982 | |
Evoyent Health Foundation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 S Orange Ave Ste 900, Orlando, FL 32801 Phone: 321-282-1999 |