| Hitchcock Health Institute Pa | |
|
7932 W Sand Lake Rd Suite 201 Orlando FL 32819-7263 | |
| (407) 578-3303 | |
| (407) 578-9144 |
| Full Name | Hitchcock Health Institute Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 7932 W Sand Lake Rd, Orlando, Florida |
| Authorized Official Name and Position | Lara Davis Hitchcock (OWNER/DOCTOR) |
| Authorized Official Contact | 4075783303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hitchcock Health Institute Pa 7932 W Sand Lake Rd Suite 201 Orlando FL 32819-7263 Ph: (407) 578-3303 | Hitchcock Health Institute Pa 7932 W Sand Lake Rd Suite 201 Orlando FL 32819-7263 Ph: (407) 578-3303 |
| NPI Number | 1225069917 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 04/27/2018 |
| Medicare PECOS PAC ID | 8527088244 |
|---|---|
| Medicare Enrollment ID | O20051128000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225069917 | NPI | - | NPPES |
| ME79029 | Other | FL | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME79029 (Florida) | Primary |
| Provider Name | Lara D Hitchcock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962457465 PECOS PAC ID: 9335169051 Enrollment ID: I20051129000182 |
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