| Orlando Primary Medicine, Llc | |
|
11616 Lake Underhill Rd Ste 205 Orlando FL 32825-4466 | |
| (407) 601-5308 | |
| (407) 482-8698 |
| Full Name | Orlando Primary Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11616 Lake Underhill Rd Ste 205, Orlando, Florida |
| Authorized Official Name and Position | Vineel Sompalli (MANAGER) |
| Authorized Official Contact | 4074827788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orlando Primary Medicine, Llc 11616 Lake Underhill Rd Ste 215 Orlando FL 32825-4465 Ph: (407) 601-5308 | Orlando Primary Medicine, Llc 11616 Lake Underhill Rd Ste 205 Orlando FL 32825-4466 Ph: (407) 601-5308 |
| NPI Number | 1376233346 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 05/11/2023 |
| Medicare PECOS PAC ID | 7810333192 |
|---|---|
| Medicare Enrollment ID | O20240308001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376233346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Adedeji A Onitiri |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639737273 PECOS PAC ID: 6709213200 Enrollment ID: I20200221002706 |
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