Km Family Physician | |
25 W Kaley Ave. Suite 300 B Orlando FL 32806-2939 | |
(407) 323-7618 | |
(407) 323-7618 |
Full Name | Km Family Physician |
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Speciality | Family Medicine |
Location | 25 W Kaley Ave., Orlando, Florida |
Authorized Official Name and Position | Karelina Muguercia (MANAGING MEMBER) |
Authorized Official Contact | 4073237618 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Km Family Physician 25 W Kaley Ave. Suite 300 B Orlando FL 32806-2939 Ph: (407) 323-7618 | Km Family Physician 25 W Kaley Ave. Suite 300 B Orlando FL 32806-2939 Ph: (407) 323-7618 |
NPI Number | 1356601702 |
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Provider Enumeration Date | 05/19/2012 |
Last Update Date | 05/29/2012 |
Medicare PECOS PAC ID | 3971752973 |
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Medicare Enrollment ID | O20121008000565 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356601702 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | ME100037 (Florida) | Primary |
Provider Name | Karelina Muguercia |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184806127 PECOS PAC ID: 4183796022 Enrollment ID: I20081216000426 |
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