| Medical Golden Clinic Llc | |
|
4365 Hunters Park Ln # 10 Orlando FL 32837-7614 | |
| (407) 413-3200 | |
| Not Available |
| Full Name | Medical Golden Clinic Llc |
|---|---|
| Speciality | General Practice |
| Location | 4365 Hunters Park Ln # 10, Orlando, Florida |
| Authorized Official Name and Position | Hector J Nieves-davila (CEO) |
| Authorized Official Contact | 7879556920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Golden Clinic Llc 11310 S Orange Blossom Trl Ste 109 Orlando FL 32837-9421 Ph: (407) 413-3200 | Medical Golden Clinic Llc 4365 Hunters Park Ln # 10 Orlando FL 32837-7614 Ph: (407) 413-3200 |
| NPI Number | 1073082236 |
|---|---|
| Provider Enumeration Date | 11/16/2018 |
| Last Update Date | 08/13/2019 |
| Medicare PECOS PAC ID | 3971849050 |
|---|---|
| Medicare Enrollment ID | O20190110000918 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073082236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ileana Aponte-camacho |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851537633 PECOS PAC ID: 1052587011 Enrollment ID: I20141220000028 |
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