| Premier Infectious Disease Care Llc | |
|
2100 Aloma Ave Ste 204 Winter Park FL 32792-3301 | |
| (321) 422-3660 | |
| (407) 644-2981 |
| Full Name | Premier Infectious Disease Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2100 Aloma Ave Ste 204, Winter Park, Florida |
| Authorized Official Name and Position | Archana K Shah (OWNER) |
| Authorized Official Contact | 3214223660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Infectious Disease Care Llc 2100 Aloma Ave Ste 204 Winter Park FL 32792-3301 Ph: (321) 422-3660 | Premier Infectious Disease Care Llc 2100 Aloma Ave Ste 204 Winter Park FL 32792-3301 Ph: (321) 422-3660 |
| NPI Number | 1518156017 |
|---|---|
| Provider Enumeration Date | 10/20/2007 |
| Last Update Date | 10/16/2024 |
| Medicare PECOS PAC ID | 2668541285 |
|---|---|
| Medicare Enrollment ID | O20080521000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518156017 | NPI | - | NPPES |
| 8797400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME92663 (Florida) | Primary |
| Provider Name | Archana K Shah |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124096391 PECOS PAC ID: 6103852579 Enrollment ID: I20050718000187 |
| Provider Name | Mariangela Canaan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689876344 PECOS PAC ID: 4183776941 Enrollment ID: I20090709000325 |
| Provider Name | Wilisa Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811327521 PECOS PAC ID: 4284862277 Enrollment ID: I20140121001488 |
| Provider Name | Seema K Patel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235127671 PECOS PAC ID: 2163497967 Enrollment ID: I20161114002358 |
| Provider Name | Cristina Amado |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518257633 PECOS PAC ID: 8123309887 Enrollment ID: I20170111002958 |
| Provider Name | Rita Nwanyanwu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952643330 PECOS PAC ID: 4789824764 Enrollment ID: I20181203001041 |
| Provider Name | Ronald Dolor Gonzales |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1285693176 PECOS PAC ID: 2860597788 Enrollment ID: I20210219001704 |
| Provider Name | Mariko Caberto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427555630 PECOS PAC ID: 0648688408 Enrollment ID: I20210415000353 |
| Provider Name | James H Spain |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1174987762 PECOS PAC ID: 6204119787 Enrollment ID: I20230410001936 |
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