| Mid Florida Infectious Diseases Md Llc | |
|
1239 E Lake Colony Dr Maitland FL 32751-6129 | |
| (407) 629-9400 | |
| Not Available |
| Full Name | Mid Florida Infectious Diseases Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1239 E Lake Colony Dr, Maitland, Florida |
| Authorized Official Name and Position | Laura Sahyoun (PROVIDER ADVOCATE) |
| Authorized Official Contact | 4077881906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Florida Infectious Diseases Md Llc Po Box 941359 Maitland FL 32794-1359 Ph: () - | Mid Florida Infectious Diseases Md Llc 1239 E Lake Colony Dr Maitland FL 32751-6129 Ph: (407) 629-9400 |
| NPI Number | 1265952246 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 06/21/2017 |
| Medicare PECOS PAC ID | 4981961570 |
|---|---|
| Medicare Enrollment ID | O20171207001002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265952246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Javier E Tello |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518917251 PECOS PAC ID: 8426124967 Enrollment ID: I20081113000389 |
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