| Good Shepherd Primary Care, P.a. | |
|
1170 S Semoran Blvd Suite D Orlando FL 32807-1458 | |
| (407) 282-4142 | |
| (407) 282-7475 |
| Full Name | Good Shepherd Primary Care, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1170 S Semoran Blvd, Orlando, Florida |
| Authorized Official Name and Position | Maribel Aviles (PRESIDENT) |
| Authorized Official Contact | 4072824142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Primary Care, P.a. 1170 S Semoran Blvd Suite D Orlando FL 32807-1458 Ph: (407) 282-4142 | Good Shepherd Primary Care, P.a. 1170 S Semoran Blvd Suite D Orlando FL 32807-1458 Ph: (407) 282-4142 |
| NPI Number | 1306048343 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 07/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306048343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0066465 (Florida) | Primary |
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