| Chain Of Lakes Primary Care Llc | |
|
8976 Conroy Windermere Rd Orlando FL 32835-3128 | |
| (407) 217-2410 | |
| Not Available |
| Full Name | Chain Of Lakes Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8976 Conroy Windermere Rd, Orlando, Florida |
| Authorized Official Name and Position | Danielle Alhemovich (OWNER) |
| Authorized Official Contact | 3218484986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chain Of Lakes Primary Care Llc 8976 Conroy Windermere Rd Orlando FL 32835-3128 Ph: () - | Chain Of Lakes Primary Care Llc 8976 Conroy Windermere Rd Orlando FL 32835-3128 Ph: (407) 217-2410 |
| NPI Number | 1740912534 |
|---|---|
| Provider Enumeration Date | 06/29/2022 |
| Last Update Date | 03/12/2024 |
| Medicare PECOS PAC ID | 5597149740 |
|---|---|
| Medicare Enrollment ID | O20220907002087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740912534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Judith A Moss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013942317 PECOS PAC ID: 4284698861 Enrollment ID: I20150530000098 |
| Provider Name | Danielle Alhemovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831552611 PECOS PAC ID: 3476847385 Enrollment ID: I20190925002536 |
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