| Panamerican Behavioral Health Services Of Florida Llc | |
|
6000 S Rio Grande Ave Suite 102 Orlando FL 32809-4650 | |
| (407) 982-7718 | |
| (407) 704-5953 |
| Full Name | Panamerican Behavioral Health Services Of Florida Llc |
|---|---|
| Speciality | Counselor |
| Location | 6000 S Rio Grande Ave, Orlando, Florida |
| Authorized Official Name and Position | Brendan Ramirez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3216639815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Panamerican Behavioral Health Services Of Florida Llc 6000 S Rio Grande Ave Suite 102 Orlando FL 32809-4650 Ph: (407) 982-7718 | Panamerican Behavioral Health Services Of Florida Llc 6000 S Rio Grande Ave Suite 102 Orlando FL 32809-4650 Ph: (407) 982-7718 |
| NPI Number | 1932511938 |
|---|---|
| Provider Enumeration Date | 05/24/2014 |
| Last Update Date | 05/03/2017 |
| Medicare PECOS PAC ID | 5799225439 |
|---|---|
| Medicare Enrollment ID | O20240910000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932511938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | HCC10102 (Florida) | Primary |
| Provider Name | Tammy L Tadom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982627352 PECOS PAC ID: 5890771208 Enrollment ID: I20040626000247 |
| Provider Name | Orlando Lazaro Ruano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013021138 PECOS PAC ID: 0749254225 Enrollment ID: I20040820000868 |
| Provider Name | Luis O Rivera-gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447375308 PECOS PAC ID: 9931509817 Enrollment ID: I20210615000438 |
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