| Woodland Lakes Family Practice Pa | |
|
13000 Avalon Lake Dr Suite 100 Orlando FL 32828-6434 | |
| (321) 235-0970 | |
| (321) 235-0971 |
| Full Name | Woodland Lakes Family Practice Pa |
|---|---|
| Speciality | General Practice |
| Location | 13000 Avalon Lake Dr, Orlando, Florida |
| Authorized Official Name and Position | George M Hudson (OWNER) |
| Authorized Official Contact | 3212350970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodland Lakes Family Practice Pa 13000 Avalon Lake Dr Suite 100 Orlando FL 32828-6434 Ph: (321) 235-0970 | Woodland Lakes Family Practice Pa 13000 Avalon Lake Dr Suite 100 Orlando FL 32828-6434 Ph: (321) 235-0970 |
| NPI Number | 1083806269 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 08/06/2009 |
| Medicare PECOS PAC ID | 3577659192 |
|---|---|
| Medicare Enrollment ID | O20071012000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083806269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0S5964 (Florida) | Primary |
| Provider Name | George M Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124008388 PECOS PAC ID: 7517068117 Enrollment ID: I20070726000587 |
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