| Psychiatric Consultants Of Central Florida, Llc | |
|
3389 W Vine St Suite 304 Kissimmee FL 34741-4665 | |
| (407) 962-7449 | |
| (407) 563-5491 |
| Full Name | Psychiatric Consultants Of Central Florida, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3389 W Vine St, Kissimmee, Florida |
| Authorized Official Name and Position | Ajith Kumar Potluri (OWNER) |
| Authorized Official Contact | 4079627449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Consultants Of Central Florida, Llc 3389 W Vine St Suite 304 Kissimmee FL 34741-4665 Ph: (407) 962-7449 | Psychiatric Consultants Of Central Florida, Llc 3389 W Vine St Suite 304 Kissimmee FL 34741-4665 Ph: (407) 962-7449 |
| NPI Number | 1174951891 |
|---|---|
| Provider Enumeration Date | 10/15/2013 |
| Last Update Date | 10/15/2013 |
| Medicare PECOS PAC ID | 0749415644 |
|---|---|
| Medicare Enrollment ID | O20131031000561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174951891 | NPI | - | NPPES |
| Provider Name | Ajith Kumar Potluri |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1194791392 PECOS PAC ID: 0749299931 Enrollment ID: I20131202000503 |
| Provider Name | Sunil K Koneru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316971062 PECOS PAC ID: 7214924984 Enrollment ID: I20180926002534 |
| Provider Name | Teliya Zyambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376178905 PECOS PAC ID: 7517380710 Enrollment ID: I20200707001074 |
| Provider Name | Ramiro Rangel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245973742 PECOS PAC ID: 7214315282 Enrollment ID: I20220602002417 |
| Provider Name | Veronica Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407543101 PECOS PAC ID: 3678927027 Enrollment ID: I20231003003985 |
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