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2940 Mallory Cir Ste 202 Celebration FL 34747-1818 | |
| (407) 269-8550 | |
| (407) 288-1010 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 2940 Mallory Cir Ste 202, Celebration, Florida |
| Authorized Official Name and Position | Keiler Moreno Rivero (OWNER) |
| Authorized Official Contact | 4072698550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1251 Emerson Park Blvd Apt 105 Celebration FL 34747-5371 Ph: (407) 269-8550 | 2940 Mallory Cir Ste 202 Celebration FL 34747-1818 Ph: (407) 269-8550 |
| NPI Number | 1861974073 |
|---|---|
| Provider Enumeration Date | 09/04/2018 |
| Last Update Date | 05/31/2022 |
| Medicare PECOS PAC ID | 6002153145 |
|---|---|
| Medicare Enrollment ID | O20190128000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861974073 | NPI | - | NPPES |
| 018667500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Keiler Moreno Rivero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659780625 PECOS PAC ID: 7911285325 Enrollment ID: I20161104001172 |
| Provider Name | Ernesto Velazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255973434 PECOS PAC ID: 3072942648 Enrollment ID: I20200402000245 |
| Provider Name | Jussep Orlando Fombellida Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831716067 PECOS PAC ID: 8224452792 Enrollment ID: I20200717000407 |
| Provider Name | Magaly Rosario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295186591 PECOS PAC ID: 6507249265 Enrollment ID: I20220813000842 |
| Provider Name | Dalienne Marie Juarbe Garcia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245821313 PECOS PAC ID: 1052796760 Enrollment ID: I20230621000918 |
| Provider Name | Dorisbel Matos-lizardo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215680459 PECOS PAC ID: 8224486261 Enrollment ID: I20231130002933 |
| Provider Name | Eduardo Frei Morera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205571460 PECOS PAC ID: 7012458987 Enrollment ID: I20240918003603 |
| Provider Name | Danelia Josefina Brito Garcia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700561172 PECOS PAC ID: 6002357597 Enrollment ID: I20240924003918 |
| Provider Name | Joanney Saunders |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174370647 PECOS PAC ID: 4981137296 Enrollment ID: I20241024004128 |
Orlando Health Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 61 Riley Rd, Celebration, FL 34747 Phone: 407-930-6900 | |
Center For Digestive Disease & Disorder At Celebration Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Celebration Pl Ste 400, Celebration, FL 34747 Phone: 407-566-0700 Fax: 407-566-0712 | |
Central Florida Infectious Disease Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 Celebration Pl Ste A120, Celebration, FL 34747 Phone: 407-353-6262 Fax: 888-965-5109 | |
Orlando Physicians Network Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 65 Riley Rd, Celebration, FL 34747 Phone: 407-635-3022 | |
Proact Health Solutions Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2940 Mallory Cir, Suite 201, Celebration, FL 34747 Phone: 855-672-2929 Fax: 877-471-0406 |