| Family Medicine Institute Professional Limited Liability Company | |
|
15126 Shonan Gold Dr Winter Garden FL 34787-5684 | |
| (718) 924-1316 | |
| Not Available |
| Full Name | Family Medicine Institute Professional Limited Liability Company |
|---|---|
| Speciality | Family Medicine |
| Location | 15126 Shonan Gold Dr, Winter Garden, Florida |
| Authorized Official Name and Position | Yashel Wedderburn Landell (OWNER/PRESIDENT) |
| Authorized Official Contact | 4074594360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Institute Professional Limited Liability Company 15126 Shonan Gold Dr Winter Garden FL 34787-5684 Ph: (718) 924-1316 | Family Medicine Institute Professional Limited Liability Company 15126 Shonan Gold Dr Winter Garden FL 34787-5684 Ph: (718) 924-1316 |
| NPI Number | 1912609744 |
|---|---|
| Provider Enumeration Date | 03/17/2023 |
| Last Update Date | 03/21/2023 |
| Medicare PECOS PAC ID | 1951769926 |
|---|---|
| Medicare Enrollment ID | O20230623000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912609744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yashel Wedderburn Landell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245518638 PECOS PAC ID: 6204000904 Enrollment ID: I20141009001477 |
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