| Fairmount Walk-in Med Clinic | |
|
3750 Us 27 N. Suite 4-f Sebring FL 33870-1690 | |
| (863) 382-4949 | |
| (863) 382-3811 |
| Full Name | Fairmount Walk-in Med Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3750 Us 27 N., Sebring, Florida |
| Authorized Official Name and Position | Cirilo M Seralde (OWNER/TRUSTEE) |
| Authorized Official Contact | 8633824949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmount Walk-in Med Clinic 3750 Us 27 N. Suite 4-f Sebring FL 33870-1690 Ph: (863) 382-4949 | Fairmount Walk-in Med Clinic 3750 Us 27 N. Suite 4-f Sebring FL 33870-1690 Ph: (863) 382-4949 |
| NPI Number | 1588856306 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 01/10/2013 |
| Medicare PECOS PAC ID | 2163514670 |
|---|---|
| Medicare Enrollment ID | O20120206000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588856306 | NPI | - | NPPES |
| 21429 | Other | FL | VICTOR M SERALDE MCR UPIN |
| 41214C | Other | FL | MEDICARE PROVIDER CIRILO SERALDE FOR FAIRMOUNT CLINIC |
| K2401 | Other | FL | MEDICARE PART B GROUP PROVIDER |
| 28115A | Other | FL | VICTOR SERALDE PROVIDER NUMBER FOR FAIRMOUNT CLINIC |
| 10D0293128 | Other | CLIA GROUP NUMBER | |
| 54734 | Other | FL | CIRILO M SERALDE MCR UPIN |
| 259715200 | Other | FL | MEDIPASS PROVIDER NUMBER GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ME0043253 (Florida) | Primary |
| Provider Name | Cirilo Medina Seralde |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720093263 PECOS PAC ID: 5395902134 Enrollment ID: I20120208000944 |
| Provider Name | Victor M Seralde |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255449047 PECOS PAC ID: 8527228683 Enrollment ID: I20120327000618 |
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