| Clermont Internal And Cosmetic Medicine Llc | |
|
290 Citrus Tower Blvd Suite 102 Clermont FL 34711-2783 | |
| (352) 404-5174 | |
| (352) 678-3430 |
| Full Name | Clermont Internal And Cosmetic Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 290 Citrus Tower Blvd, Clermont, Florida |
| Authorized Official Name and Position | Edriss Estime (OWNER/AUTHORIZED REP) |
| Authorized Official Contact | 3524045174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clermont Internal And Cosmetic Medicine Llc 290 Citrus Tower Blvd Suite 102 Clermont FL 34711-2783 Ph: (352) 404-5174 | Clermont Internal And Cosmetic Medicine Llc 290 Citrus Tower Blvd Suite 102 Clermont FL 34711-2783 Ph: (352) 404-5174 |
| NPI Number | 1437545472 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 09/25/2015 |
| Medicare PECOS PAC ID | 3870804057 |
|---|---|
| Medicare Enrollment ID | O20150615000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437545472 | NPI | - | NPPES |
| 014748100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Florida) | Primary |
| Provider Name | Edriss Estime |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720272859 PECOS PAC ID: 7517013196 Enrollment ID: I20131226000627 |
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