| Nelson M Pichardo Md, Llc | |
|
2228 S Kirkman Rd Orlando FL 32811-2308 | |
| (407) 615-8180 | |
| (407) 615-8182 |
| Full Name | Nelson M Pichardo Md, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2228 S Kirkman Rd, Orlando, Florida |
| Authorized Official Name and Position | Nelson Miguel Pichardo (PRESIDENT) |
| Authorized Official Contact | 8634219447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nelson M Pichardo Md, Llc 10051 5th St N Ste 200 St Petersburg FL 33702-2211 Ph: (727) 824-0780 | Nelson M Pichardo Md, Llc 2228 S Kirkman Rd Orlando FL 32811-2308 Ph: (407) 615-8180 |
| NPI Number | 1437244738 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 03/12/2020 |
| Medicare PECOS PAC ID | 7810963519 |
|---|---|
| Medicare Enrollment ID | O20061010000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437244738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME-70866 (Florida) | Primary |
| Provider Name | Nelson M Pichardo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356321665 PECOS PAC ID: 6507832250 Enrollment ID: I20041116000841 |
| Provider Name | Juan Carlos Escandon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356567788 PECOS PAC ID: 7416084546 Enrollment ID: I20110923000534 |
| Provider Name | Betania Reyes Matos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629031679 PECOS PAC ID: 3779594932 Enrollment ID: I20150324000306 |
| Provider Name | Charlene E Dacosta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306802905 PECOS PAC ID: 6002828076 Enrollment ID: I20160718001032 |
| Provider Name | Patricia De Mello |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1942303995 PECOS PAC ID: 3072512011 Enrollment ID: I20180613002008 |
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