Eri Healthcare, Llc | |
3505 Lake Lynda Dr Ste 200 Orlando FL 32817-8333 | |
(407) 567-1907 | |
(407) 550-7469 |
Full Name | Eri Healthcare, Llc |
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Speciality | Internal Medicine |
Location | 3505 Lake Lynda Dr Ste 200, Orlando, Florida |
Authorized Official Name and Position | Ajoke S Bamisile (AUTHORIZED MEMBER) |
Authorized Official Contact | 4075671907 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Eri Healthcare, Llc 3505 Lake Lynda Dr Ste 200 Orlando FL 32817-8333 Ph: (407) 567-1907 | Eri Healthcare, Llc 3505 Lake Lynda Dr Ste 200 Orlando FL 32817-8333 Ph: (407) 567-1907 |
NPI Number | 1235710278 |
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Provider Enumeration Date | 04/20/2021 |
Last Update Date | 04/07/2024 |
Medicare PECOS PAC ID | 7719421692 |
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Medicare Enrollment ID | O20240702003501 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235710278 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Ajoke Bamisile |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215221528 PECOS PAC ID: 9335421080 Enrollment ID: I20170113000242 |
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