| East Colonial Family Medical Center, Inc | |
|
9464 E Colonial Dr Orlando FL 32817-4150 | |
| (407) 482-9788 | |
| (407) 482-7998 |
| Full Name | East Colonial Family Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9464 E Colonial Dr, Orlando, Florida |
| Authorized Official Name and Position | Thang C Pham (PRESIDENT) |
| Authorized Official Contact | 4074829788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Colonial Family Medical Center, Inc 9464 E Colonial Dr Orlando FL 32817-4150 Ph: (407) 482-9788 | East Colonial Family Medical Center, Inc 9464 E Colonial Dr Orlando FL 32817-4150 Ph: (407) 482-9788 |
| NPI Number | 1144523531 |
|---|---|
| Provider Enumeration Date | 12/07/2010 |
| Last Update Date | 10/31/2022 |
| Medicare PECOS PAC ID | 5698954758 |
|---|---|
| Medicare Enrollment ID | O20110121000784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144523531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME87463 (Florida) | Primary |
| Provider Name | Thang C Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336303346 PECOS PAC ID: 6305025461 Enrollment ID: I20110121000819 |
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