| Mp Primary Care Services | |
|
2778 Us Highway 27 S Avon Park FL 33825-9755 | |
| (863) 358-0500 | |
| (863) 358-0508 |
| Full Name | Mp Primary Care Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 2778 Us Highway 27 S, Avon Park, Florida |
| Authorized Official Name and Position | Orland Mata (CEO) |
| Authorized Official Contact | 8638400639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mp Primary Care Services 2778 Us Highway 27 S Avon Park FL 33825-9755 Ph: (863) 358-0500 | Mp Primary Care Services 2778 Us Highway 27 S Avon Park FL 33825-9755 Ph: (863) 358-0500 |
| NPI Number | 1609512656 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 07/15/2024 |
| Certification Date | 07/15/2024 |
| Medicare PECOS PAC ID | 7618357880 |
|---|---|
| Medicare Enrollment ID | O20220706000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609512656 | NPI | - | NPPES |
| Provider Name | Orland Mata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235688441 PECOS PAC ID: 6204111776 Enrollment ID: I20170323002386 |
| Provider Name | Rebeca Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184113094 PECOS PAC ID: 9133548514 Enrollment ID: I20201005000889 |
| Provider Name | Jeila Stephanie Pujols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417563602 PECOS PAC ID: 9739593039 Enrollment ID: I20210128000029 |
| Provider Name | Arismendy E Perez Tavera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215441225 PECOS PAC ID: 9133526098 Enrollment ID: I20210921001067 |
| Provider Name | Ketsia Aurelien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598247314 PECOS PAC ID: 0446641443 Enrollment ID: I20211230001349 |
| Provider Name | Dasney Anosier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407584550 PECOS PAC ID: 1254717598 Enrollment ID: I20221010002836 |
| Provider Name | Evelyn Noel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710667829 PECOS PAC ID: 8729433230 Enrollment ID: I20231018000544 |
| Provider Name | Caryn Clementina Blair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922769389 PECOS PAC ID: 2961858204 Enrollment ID: I20231024000249 |
| Provider Name | Jessica M Hutchings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760263974 PECOS PAC ID: 8628428596 Enrollment ID: I20231219002878 |
| Provider Name | Christy Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649041823 PECOS PAC ID: 2264885441 Enrollment ID: I20240124004013 |
| Provider Name | Evelyn Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891422291 PECOS PAC ID: 1658713987 Enrollment ID: I20240531000971 |
| Provider Name | Jasmine Hutchings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649028283 PECOS PAC ID: 7315481835 Enrollment ID: I20240626000084 |
| Provider Name | Carola Gutierrez Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588871198 PECOS PAC ID: 4385178318 Enrollment ID: I20241113000851 |
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