| Physicians Collaborative Affiliates, Inc. | |
|
101 E Miller St Orlando FL 32806-2123 | |
| (407) 803-4016 | |
| (407) 803-4045 |
| Full Name | Physicians Collaborative Affiliates, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 101 E Miller St, Orlando, Florida |
| Authorized Official Name and Position | Rocco Coniglio (PRESIDENT) |
| Authorized Official Contact | 3305230593 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Collaborative Affiliates, Inc. 501 N Orlando Ave Suite 313, Pmb 185 Winter Park FL 32789-7313 Ph: (407) 803-4016 | Physicians Collaborative Affiliates, Inc. 101 E Miller St Orlando FL 32806-2123 Ph: (407) 803-4016 |
| NPI Number | 1588036040 |
|---|---|
| Provider Enumeration Date | 10/23/2015 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 7618271685 |
|---|---|
| Medicare Enrollment ID | O20160211001724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588036040 | NPI | - | NPPES |
| Provider Name | Aftab Qadir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972674349 PECOS PAC ID: 6002803053 Enrollment ID: I20090219000469 |
| Provider Name | Luis Allen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720035058 PECOS PAC ID: 2163574146 Enrollment ID: I20090722000670 |
| Provider Name | Crystal Browne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174142236 PECOS PAC ID: 7517358377 Enrollment ID: I20220105001436 |
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