| Umbrella Healthcare Solutions Llc | |
|
9225 N 3rd St Ste 203 Phoenix AZ 85020-2464 | |
| (602) 362-2983 | |
| (480) 565-4552 |
| Full Name | Umbrella Healthcare Solutions Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9225 N 3rd St Ste 203, Phoenix, Arizona |
| Authorized Official Name and Position | Mohamed Khalil (OWNER / CEO) |
| Authorized Official Contact | 6023622983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Umbrella Healthcare Solutions Llc 9225 N 3rd St Ste 203 Phoenix AZ 85020-2464 Ph: (602) 362-2983 | Umbrella Healthcare Solutions Llc 9225 N 3rd St Ste 203 Phoenix AZ 85020-2464 Ph: (602) 362-2983 |
| NPI Number | 1114603420 |
|---|---|
| Provider Enumeration Date | 06/22/2023 |
| Last Update Date | 08/24/2023 |
| Certification Date | 08/24/2023 |
| Medicare PECOS PAC ID | 1951763523 |
|---|---|
| Medicare Enrollment ID | O20230814002396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114603420 | NPI | - | NPPES |
| Provider Name | John D Lewis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255386413 PECOS PAC ID: 2769440643 Enrollment ID: I20041222000869 |
| Provider Name | Nicole Kay Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265918726 PECOS PAC ID: 5193065910 Enrollment ID: I20190314000187 |
| Provider Name | Jasmine Hope Cresanta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386273688 PECOS PAC ID: 4789014556 Enrollment ID: I20200417002251 |
| Provider Name | Theresa Jill Fryer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871917161 PECOS PAC ID: 9537581160 Enrollment ID: I20200626001193 |
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