| Omar Jose Vazquez Alicea, MD | |
|
225 N 1st St, Leesburg, FL 34748-5150 | |
| (407) 905-8827 | |
| (352) 360-2389 |
| Full Name | Omar Jose Vazquez Alicea |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 225 N 1st St, Leesburg, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811663131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 22439 (Puerto Rico) | Primary |
| Entity Name | Community Health Centers, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134258684 PECOS PAC ID: 4082515390 Enrollment ID: O20040120000172 |
| Entity Name | Premier Medical Associates All Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093829442 PECOS PAC ID: 2365418019 Enrollment ID: O20041026000956 |
| Entity Name | Premier Medical Associates Of Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366046179 PECOS PAC ID: 1557773413 Enrollment ID: O20201217000613 |
| Entity Name | Premier Medical Associates Of Florida Healthcare, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023612827 PECOS PAC ID: 6800200940 Enrollment ID: O20210201000388 |
| Mailing Address | Practice Location Address |
|---|---|
| Omar Jose Vazquez Alicea, MD 110 S Woodland St, Winter Garden, FL 34787-3546 Ph: (407) 905-8827 | Omar Jose Vazquez Alicea, MD 225 N 1st St, Leesburg, FL 34748-5150 Ph: (407) 905-8827 |
Dr. Jackeline Lopez, General Practice Medicare: Accepting Medicare Assignments Practice Location: 801 E Dixie Ave Ste 101, Leesburg, FL 34748 Phone: 352-326-4031 Fax: 352-360-0257 | |
Jose Llamas, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 601 E Dixie Ave Ste 102, Leesburg, FL 34748 Phone: 352-350-8888 Fax: 352-350-2014 | |
Blandine Pierre, MD General Practice Medicare: Medicare Enrolled Practice Location: 225 N 1st St, Leesburg, FL 34748 Phone: 407-905-8827 Fax: 352-360-2389 | |
Dr. Yamil Carlo Lopez, MD General Practice Medicare: Medicare Enrolled Practice Location: 941 N 14th St, Leesburg, FL 34748 Phone: 352-326-4031 Fax: 352-360-0257 | |
Dr. Hamidreza Ebneshahidi, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 601 E Dixie Ave Ste 102, Leesburg, FL 34748 Phone: 352-350-8888 Fax: 844-388-6186 | |
Dr. Yanira R. Feliciano Montalvo, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 601 E Dixie Ave Ste 102, Leesburg, FL 34748 Phone: 352-350-8888 Fax: 844-388-6186 |