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7221 Aloma Ave Suite 200 Winter Park FL 32792-7119 | |
| (407) 657-2111 | |
| (866) 725-4812 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 7221 Aloma Ave, Winter Park, Florida |
| Authorized Official Name and Position | Nicole Lozano (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4076572111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7221 Aloma Ave Suite 200 Winter Park FL 32792-7119 Ph: (407) 657-2111 | 7221 Aloma Ave Suite 200 Winter Park FL 32792-7119 Ph: (407) 657-2111 |
| NPI Number | 1407020837 |
|---|---|
| Provider Enumeration Date | 04/16/2008 |
| Last Update Date | 11/25/2024 |
| Medicare PECOS PAC ID | 3577639335 |
|---|---|
| Medicare Enrollment ID | O20080903000238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407020837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Eleuterio R Alilin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982775367 PECOS PAC ID: 5799759197 Enrollment ID: I20040823000348 |
| Provider Name | Ben Daniel Alilin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649308537 PECOS PAC ID: 4688766454 Enrollment ID: I20070824000134 |
| Provider Name | Monica Patino Antolin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487852869 PECOS PAC ID: 7113161704 Enrollment ID: I20130920000774 |
| Provider Name | Emmanuelle M Ballenilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629443676 PECOS PAC ID: 4486957164 Enrollment ID: I20160129002198 |
| Provider Name | Jillian Claire Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538892211 PECOS PAC ID: 1254793771 Enrollment ID: I20230816001102 |
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