| Lifesmart Medical Center Inc | |
|
251 Maitland Ave Ste 215 Altamonte Springs FL 32701 | |
| (863) 256-9040 | |
| Not Available |
| Full Name | Lifesmart Medical Center Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 251 Maitland Ave Ste 215, Altamonte Springs, Florida |
| Authorized Official Name and Position | Yovany Baguet Vazquez (PRESIDENT) |
| Authorized Official Contact | 6896886730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesmart Medical Center Inc 251 Maitland Ave Ste 215 Altamonte Springs FL 32701 Ph: (863) 256-9040 | Lifesmart Medical Center Inc 251 Maitland Ave Ste 215 Altamonte Springs FL 32701 Ph: (863) 256-9040 |
| NPI Number | 1942972468 |
|---|---|
| Provider Enumeration Date | 10/03/2021 |
| Last Update Date | 10/03/2021 |
| Certification Date | 10/03/2021 |
| Medicare PECOS PAC ID | 9032585633 |
|---|---|
| Medicare Enrollment ID | O20221024001194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942972468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Joseph Secor-taddia |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1225591506 PECOS PAC ID: 9830571116 Enrollment ID: I20220803000771 |
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