Sarene Wallick Llc | |
235 S Maitland Ave Ste 104 Maitland FL 32751 | |
(407) 927-9718 | |
Not Available |
Full Name | Sarene Wallick Llc |
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Speciality | Social Worker |
Location | 235 S Maitland Ave Ste 104, Maitland, Florida |
Authorized Official Name and Position | Ruby Khalid (BILLER) |
Authorized Official Contact | 4079256072 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sarene Wallick Llc 235 S Maitland Ave Ste 104 Maitland FL 32751 Ph: (407) 927-9718 | Sarene Wallick Llc 235 S Maitland Ave Ste 104 Maitland FL 32751 Ph: (407) 927-9718 |
NPI Number | 1306156880 |
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Provider Enumeration Date | 10/18/2010 |
Last Update Date | 10/18/2010 |
Medicare PECOS PAC ID | 7416143607 |
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Medicare Enrollment ID | O20101130000954 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306156880 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | SW7232 (Florida) | Primary |
Provider Name | Sarene Malcha Wallick |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194817445 PECOS PAC ID: 3173719358 Enrollment ID: I20101130000924 |
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