| Spektrum Health | |
|
5205 S Orange Ave Ste 110 Orlando FL 32809-3067 | |
| (407) 454-1363 | |
| (321) 247-7391 |
| Full Name | Spektrum Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 5205 S Orange Ave Ste 110, Orlando, Florida |
| Authorized Official Name and Position | Joseph Anthony Knoll (CEO) |
| Authorized Official Contact | 4074541363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spektrum Health 5205 S Orange Ave Ste 110 Orlando FL 32809-3067 Ph: (407) 454-1363 | Spektrum Health 5205 S Orange Ave Ste 110 Orlando FL 32809-3067 Ph: (407) 454-1363 |
| NPI Number | 1467921767 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 01/26/2022 |
| Medicare PECOS PAC ID | 8426383258 |
|---|---|
| Medicare Enrollment ID | O20190716001033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467921767 | NPI | - | NPPES |
| 0WDSQ | Other | FL | FLORIDA BLUE |
| 015139500 | Medicaid | FL | |
| 1061098 | Other | FL | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Joseph Anthony Knoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023418126 PECOS PAC ID: 2860706942 Enrollment ID: I20150803001967 |
| Provider Name | Kimberly Keech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770190530 PECOS PAC ID: 3274946140 Enrollment ID: I20210114000162 |
| Provider Name | Nga Denise Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790329811 PECOS PAC ID: 0648679340 Enrollment ID: I20230227002787 |
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