| Hope Centers Of Central Florida, Llc | |
|
101 E Miller St Orlando FL 32806-2123 | |
| (407) 246-6620 | |
| (407) 299-9141 |
| Full Name | Hope Centers Of Central Florida, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 E Miller St, Orlando, Florida |
| Authorized Official Name and Position | Stacey Wade (ADMINISTRATOR) |
| Authorized Official Contact | 4074459545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Centers Of Central Florida, Llc 1507 S Hiawassee Rd Suite 107 Orlando FL 32835-5718 Ph: (407) 445-9545 | Hope Centers Of Central Florida, Llc 101 E Miller St Orlando FL 32806-2123 Ph: (407) 246-6620 |
| NPI Number | 1053764985 |
|---|---|
| Provider Enumeration Date | 07/15/2016 |
| Last Update Date | 07/15/2016 |
| Medicare PECOS PAC ID | 8729334057 |
|---|---|
| Medicare Enrollment ID | O20180628002858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053764985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
| Provider Name | Raghu Ganjam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558304261 PECOS PAC ID: 7315840188 Enrollment ID: I20040129000355 |
| Provider Name | Pradeep K Vangala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306889050 PECOS PAC ID: 0244133015 Enrollment ID: I20080723000712 |
| Provider Name | Ravi P Akella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568405272 PECOS PAC ID: 6507769379 Enrollment ID: I20080723000742 |
| Provider Name | Aftab Qadir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972674349 PECOS PAC ID: 6002803053 Enrollment ID: I20090219000469 |
| Provider Name | Luis Allen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720035058 PECOS PAC ID: 2163574146 Enrollment ID: I20090722000670 |
| Provider Name | Karla D Tamakloe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235266651 PECOS PAC ID: 7517104805 Enrollment ID: I20130503000440 |
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