| Orlando Advanced Primary Care Llc | |
|
331 N Maitland Ave Suite C-1 Maitland FL 32751-4762 | |
| (407) 644-2218 | |
| (407) 644-9260 |
| Full Name | Orlando Advanced Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 331 N Maitland Ave, Maitland, Florida |
| Authorized Official Name and Position | Sandeep Pandya (OWNER) |
| Authorized Official Contact | 4076442218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orlando Advanced Primary Care Llc 331 N Maitland Ave Suite C-1 Maitland FL 32751-4762 Ph: (407) 644-2218 | Orlando Advanced Primary Care Llc 331 N Maitland Ave Suite C-1 Maitland FL 32751-4762 Ph: (407) 644-2218 |
| NPI Number | 1104366426 |
|---|---|
| Provider Enumeration Date | 03/06/2017 |
| Last Update Date | 08/06/2019 |
| Medicare PECOS PAC ID | 4981971801 |
|---|---|
| Medicare Enrollment ID | O20170525000730 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104366426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME 123137 (Florida) | Primary |
| Provider Name | Shwetanshu M. Shukla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588861751 PECOS PAC ID: 2062559271 Enrollment ID: I20091021000060 |
| Provider Name | Sandeep Pandya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023371796 PECOS PAC ID: 9234369331 Enrollment ID: I20161206001437 |
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