| Lake Nona Medical Services | |
|
115 E Lancaster Rd Orlando FL 32809-6689 | |
| (407) 378-6686 | |
| (407) 378-4633 |
| Full Name | Lake Nona Medical Services |
|---|---|
| Speciality | General Practice |
| Location | 115 E Lancaster Rd, Orlando, Florida |
| Authorized Official Name and Position | Catherine M Arevalo (MD) |
| Authorized Official Contact | 5615749186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Nona Medical Services 115 E Lancaster Rd Orlando FL 32809-6689 Ph: (407) 378-6686 | Lake Nona Medical Services 115 E Lancaster Rd Orlando FL 32809-6689 Ph: (407) 378-6686 |
| NPI Number | 1285296798 |
|---|---|
| Provider Enumeration Date | 07/03/2019 |
| Last Update Date | 07/25/2019 |
| Medicare PECOS PAC ID | 3870825888 |
|---|---|
| Medicare Enrollment ID | O20191024000727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285296798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ehrentraud J Eichelbaum |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255518486 PECOS PAC ID: 3779700836 Enrollment ID: I20140813001547 |
| Provider Name | Catherine M Arevalo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548616378 PECOS PAC ID: 9335430362 Enrollment ID: I20180216001166 |
| Provider Name | Jorge E Alvarez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720396138 PECOS PAC ID: 3779891411 Enrollment ID: I20220331001363 |
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