| Primary Care Specialists Of Orlando Llc | |
|
3615 S Orange Ave Orlando FL 32806-6216 | |
| (407) 855-2526 | |
| (407) 855-1503 |
| Full Name | Primary Care Specialists Of Orlando Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3615 S Orange Ave, Orlando, Florida |
| Authorized Official Name and Position | David F Cowan (PRESIDENT) |
| Authorized Official Contact | 4078552526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Specialists Of Orlando Llc 3615 S Orange Ave Orlando FL 32806-6216 Ph: (407) 855-2526 | Primary Care Specialists Of Orlando Llc 3615 S Orange Ave Orlando FL 32806-6216 Ph: (407) 855-2526 |
| NPI Number | 1740559939 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 07/30/2024 |
| Medicare PECOS PAC ID | 9830353317 |
|---|---|
| Medicare Enrollment ID | O20120613000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740559939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gerald J Kivett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205810421 PECOS PAC ID: 8921902719 Enrollment ID: I20040108000637 |
| Provider Name | David F Cowan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689658155 PECOS PAC ID: 8022917376 Enrollment ID: I20040114000637 |
| Provider Name | Douglas A Witter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437107257 PECOS PAC ID: 6709856222 Enrollment ID: I20040730000288 |
| Provider Name | Annapurna Pattisapu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972615599 PECOS PAC ID: 2769514215 Enrollment ID: I20100719000463 |
| Provider Name | Teri Lynn Stapleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790053726 PECOS PAC ID: 0547437311 Enrollment ID: I20121017000847 |
| Provider Name | Amy G Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316306756 PECOS PAC ID: 5092074179 Enrollment ID: I20190726000183 |
| Provider Name | Sohaib Al Obaidi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598347239 PECOS PAC ID: 0648672642 Enrollment ID: I20240924002036 |
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