| Lake Mary Infusion Center | |
|
105 Commerce St Ste 109 Lake Mary FL 32746-6228 | |
| (267) 939-1819 | |
| Not Available |
| Full Name | Lake Mary Infusion Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 105 Commerce St Ste 109, Lake Mary, Florida |
| Authorized Official Name and Position | Helen Bukritstky (PRESIDENT) |
| Authorized Official Contact | 2679391819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Mary Infusion Center 105 Commerce St Ste 109 Lake Mary FL 32746-6228 Ph: (267) 939-1819 | Lake Mary Infusion Center 105 Commerce St Ste 109 Lake Mary FL 32746-6228 Ph: (267) 939-1819 |
| NPI Number | 1104609866 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 08/14/2024 |
| Medicare PECOS PAC ID | 7214376243 |
|---|---|
| Medicare Enrollment ID | O20240423003079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104609866 | NPI | - | NPPES |
| Provider Name | Mukesh Wadhwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306843982 PECOS PAC ID: 9335183433 Enrollment ID: I20050618000058 |
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