| Axiomhealth Management Llc | |
|
1180 Spring Centre South Blvd Ste 225 Altamonte Springs FL 32714-1991 | |
| (407) 494-0644 | |
| (407) 494-0644 |
| Full Name | Axiomhealth Management Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1180 Spring Centre South Blvd Ste 225, Altamonte Springs, Florida |
| Authorized Official Name and Position | Dustin Patric Moura (REGISTERED AGENT) |
| Authorized Official Contact | 4073124613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Axiomhealth Management Llc 1180 Spring Centre South Blvd Ste 225 Altamonte Springs FL 32714-1991 Ph: (407) 495-1165 | Axiomhealth Management Llc 1180 Spring Centre South Blvd Ste 225 Altamonte Springs FL 32714-1991 Ph: (407) 494-0644 |
| NPI Number | 1912456799 |
|---|---|
| Provider Enumeration Date | 09/22/2016 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 3072897602 |
|---|---|
| Medicare Enrollment ID | O20170228000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912456799 | NPI | - | NPPES |
| 019968100 | Medicaid | FL | |
| 045208 | Other | FL | UNITED HEALTHCARE (OPTUM) |
| Provider Name | Randi C Bonner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013987338 PECOS PAC ID: 4284650789 Enrollment ID: I20051027000423 |
| Provider Name | Chy Ching Chuang |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609055953 PECOS PAC ID: 1759450448 Enrollment ID: I20080521000336 |
| Provider Name | Marcia Regina Roman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063774974 PECOS PAC ID: 5193976801 Enrollment ID: I20121106000192 |
| Provider Name | Deborah D Moura |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285779280 PECOS PAC ID: 9133342744 Enrollment ID: I20140529002167 |
| Provider Name | Hillary A Monsour |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003156738 PECOS PAC ID: 0941501779 Enrollment ID: I20151219000120 |
| Provider Name | Jigar D Vyas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073996310 PECOS PAC ID: 3779474218 Enrollment ID: I20160509002049 |
| Provider Name | Justine Alexis Nierras |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164870978 PECOS PAC ID: 8628321486 Enrollment ID: I20181024000430 |
| Provider Name | Elizabeth Seely |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821621657 PECOS PAC ID: 4880019637 Enrollment ID: I20200811000223 |
| Provider Name | Ariel A Aure |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700057973 PECOS PAC ID: 5092121178 Enrollment ID: I20210316000937 |
| Provider Name | Irene Lardizabal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295909018 PECOS PAC ID: 5991171696 Enrollment ID: I20221020003475 |
| Provider Name | Robert Matthew Sockol |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942613229 PECOS PAC ID: 1557692423 Enrollment ID: I20230323002857 |
| Provider Name | Briana Nicole Kidd |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629540059 PECOS PAC ID: 0547626517 Enrollment ID: I20230517000702 |
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