| Lake Howell Family Medicine Associates | |
|
590 Ruby Ct Maitland FL 32751-5226 | |
| (407) 677-4867 | |
| (407) 677-4203 |
| Full Name | Lake Howell Family Medicine Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 590 Ruby Ct, Maitland, Florida |
| Authorized Official Name and Position | William Mark Silverman (PHYSICIAN OWNER) |
| Authorized Official Contact | 4076774867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Howell Family Medicine Associates 590 Ruby Ct Maitland FL 32751-5226 Ph: (407) 677-4867 | Lake Howell Family Medicine Associates 590 Ruby Ct Maitland FL 32751-5226 Ph: (407) 677-4867 |
| NPI Number | 1497713390 |
|---|---|
| Provider Enumeration Date | 05/02/2006 |
| Last Update Date | 10/15/2020 |
| Medicare PECOS PAC ID | 9739282047 |
|---|---|
| Medicare Enrollment ID | O20070307000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497713390 | NPI | - | NPPES |
| 373802700 | Medicaid | FL | |
| 33370 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS0003966 (Florida) | Primary |
| Provider Name | Christine Fontana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598903411 PECOS PAC ID: 5193876233 Enrollment ID: I20090630000516 |
| Provider Name | William M Silverman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083619639 PECOS PAC ID: 6608974027 Enrollment ID: I20100722000217 |
| Provider Name | Amanda Hogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518301886 PECOS PAC ID: 6305083254 Enrollment ID: I20130513000453 |
| Provider Name | Candice J Rosen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871958207 PECOS PAC ID: 2567768286 Enrollment ID: I20160307001525 |
| Provider Name | Thejaswi Bandikatla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346595139 PECOS PAC ID: 6800114919 Enrollment ID: I20190926002922 |
| Provider Name | Anna Lines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114433828 PECOS PAC ID: 7315372653 Enrollment ID: I20200115001305 |
| Provider Name | Linda K Salva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548301872 PECOS PAC ID: 6507964475 Enrollment ID: I20200811001056 |
| Provider Name | Cat M Huss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710485511 PECOS PAC ID: 9830528959 Enrollment ID: I20210923003122 |
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