Gastroenterology And Nutrition Specialist Pa | |
2880 S Osceola Ave Orlando FL 32806-5431 | |
(407) 843-0443 | |
(407) 843-0442 |
Full Name | Gastroenterology And Nutrition Specialist Pa |
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Speciality | Internal Medicine |
Location | 2880 S Osceola Ave, Orlando, Florida |
Authorized Official Name and Position | Muhammad Asif Mohiuddin (PRESIDENT) |
Authorized Official Contact | 4078430443 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gastroenterology And Nutrition Specialist Pa 2880 S Osceola Ave Orlando FL 32806-5431 Ph: (407) 843-0443 | Gastroenterology And Nutrition Specialist Pa 2880 S Osceola Ave Orlando FL 32806-5431 Ph: (407) 843-0443 |
NPI Number | 1972658052 |
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Provider Enumeration Date | 01/25/2007 |
Last Update Date | 05/09/2014 |
Medicare PECOS PAC ID | 2668464967 |
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Medicare Enrollment ID | O20040330000557 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972658052 | NPI | - | NPPES |
262273400 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | ME79526 (Florida) | Primary |
Provider Name | Muhammad Asif Mohiuddin |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1265411185 PECOS PAC ID: 0547252850 Enrollment ID: I20110513000039 |
Provider Name | Ashley L Clark |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588171904 PECOS PAC ID: 8729322193 Enrollment ID: I20181212001260 |
Provider Name | Iris N Bosse |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073130688 PECOS PAC ID: 0941610026 Enrollment ID: I20201030000677 |
Provider Name | Heather Marie Korkowski |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922626647 PECOS PAC ID: 4385032549 Enrollment ID: I20211021001076 |
Provider Name | Analaura Vallejo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083326235 PECOS PAC ID: 9830560333 Enrollment ID: I20230119003135 |
Provider Name | Yariminette Delgado Olivo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871875351 PECOS PAC ID: 7012226343 Enrollment ID: I20230503003384 |
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