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12139 S Apopka Vineland Rd Orlando FL 32836-6802 | |
| (407) 730-9911 | |
| (407) 768-1479 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 12139 S Apopka Vineland Rd, Orlando, Florida |
| Authorized Official Name and Position | Cristina F Faria (CEO) |
| Authorized Official Contact | 4077309911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
12139 S Apopka Vineland Rd Orlando FL 32836-6802 Ph: (407) 730-9911 | 12139 S Apopka Vineland Rd Orlando FL 32836-6802 Ph: (407) 730-9911 |
| NPI Number | 1033502182 |
|---|---|
| Provider Enumeration Date | 03/13/2015 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 3678962008 |
|---|---|
| Medicare Enrollment ID | O20211105000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033502182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Joel Ramos-tirado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487963450 PECOS PAC ID: 3577872118 Enrollment ID: I20151021001246 |
| Provider Name | Daniel Kitner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619430790 PECOS PAC ID: 2062755572 Enrollment ID: I20220418001491 |
| Provider Name | Yuliet Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811515141 PECOS PAC ID: 6901269729 Enrollment ID: I20230828001185 |
| Provider Name | Julio Peraza Morejon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356060248 PECOS PAC ID: 0042756090 Enrollment ID: I20240725003577 |
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