| Mid Florida Adult Medicine Llc | |
|
280 Wekiva Springs Rd Suite 1000 Longwood FL 32779-5946 | |
| (407) 788-2273 | |
| (407) 389-2273 |
| Full Name | Mid Florida Adult Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 280 Wekiva Springs Rd, Longwood, Florida |
| Authorized Official Name and Position | Raul E Tamayo (OWNER) |
| Authorized Official Contact | 4077882273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Florida Adult Medicine Llc 280 Wekiva Springs Rd Suite 1000 Longwood FL 32779-5946 Ph: (407) 788-2273 | Mid Florida Adult Medicine Llc 280 Wekiva Springs Rd Suite 1000 Longwood FL 32779-5946 Ph: (407) 788-2273 |
| NPI Number | 1174832034 |
|---|---|
| Provider Enumeration Date | 09/27/2010 |
| Last Update Date | 09/27/2010 |
| Medicare PECOS PAC ID | 6406043652 |
|---|---|
| Medicare Enrollment ID | O20101214000549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174832034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ernesto L Izquierdo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629182662 PECOS PAC ID: 0547260127 Enrollment ID: I20070104000288 |
| Provider Name | Orlando A Benitez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225002033 PECOS PAC ID: 7719174986 Enrollment ID: I20101214000725 |
| Provider Name | Ivette Cardona Ruelle |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1356516827 PECOS PAC ID: 1153479076 Enrollment ID: I20161109002672 |
| Provider Name | Pedro Pablo Aragon Amargo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487124566 PECOS PAC ID: 6002156700 Enrollment ID: I20190315001053 |
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