| Ines Rutty Llc | |
|
871 Vineland Rd Ste B Winter Garden FL 34787-3938 | |
| (412) 251-9291 | |
| Not Available |
| Full Name | Ines Rutty Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 871 Vineland Rd Ste B, Winter Garden, Florida |
| Authorized Official Name and Position | Ines Alejandra Serrano Vilca (PHYSICIAN) |
| Authorized Official Contact | 4122519291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ines Rutty Llc 871 Vineland Rd Ste B Winter Garden FL 34787-3938 Ph: (412) 251-9291 | Ines Rutty Llc 871 Vineland Rd Ste B Winter Garden FL 34787-3938 Ph: (412) 251-9291 |
| NPI Number | 1902376783 |
|---|---|
| Provider Enumeration Date | 12/05/2018 |
| Last Update Date | 12/05/2018 |
| Medicare PECOS PAC ID | 7517205461 |
|---|---|
| Medicare Enrollment ID | O20190219001356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902376783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ines A Serrano Vilca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659808285 PECOS PAC ID: 6103198254 Enrollment ID: I20170824000038 |
| Provider Name | Angelo Rutty Espinoza |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1790169423 PECOS PAC ID: 5496063240 Enrollment ID: I20170919003627 |
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