| Lps Medical Group Llc | |
|
1310 N Main St Ste 105 Kissimmee FL 34744-4244 | |
| (407) 483-7975 | |
| (888) 772-5242 |
| Full Name | Lps Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1310 N Main St Ste 105, Kissimmee, Florida |
| Authorized Official Name and Position | Cruz Adelmis Santos (PHYSICIAN) |
| Authorized Official Contact | 4074764011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lps Medical Group Llc 1310 N Main St Ste 105 Kissimmee FL 34744-4244 Ph: (407) 483-7975 | Lps Medical Group Llc 1310 N Main St Ste 105 Kissimmee FL 34744-4244 Ph: (407) 483-7975 |
| NPI Number | 1003151903 |
|---|---|
| Provider Enumeration Date | 12/03/2012 |
| Last Update Date | 12/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003151903 | NPI | - | NPPES |
| 007-666-400 | Medicaid | FL | |
| 004173700 | Medicaid | FL | |
| FP292Y | Other | FL | MEDICARE PTAN |
| HI271A | Other | FL | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME107498 (Florida) | Primary |
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