| Mr Carlos Julio Moreno, | |
|
690 Dallas Hwy, Suite 101, Villa Rica, GA 30180-1264 | |
| (770) 459-0620 | |
| (770) 456-7604 |
| Full Name | Mr Carlos Julio Moreno |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 22 Years |
| Location | 690 Dallas Hwy, Villa Rica, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477615862 | NPI | - | NPPES |
| PA9102549 | Other | FL | PA LICENSE |
| 292140500 | Medicaid | FL | |
| 006320 | Other | GA | STATE LICENSE - PHYSICIAN ASSISTANT |
| PENDING | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9102549 (Florida) | Secondary |
| 363A00000X | Physician Assistant | 006320 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Center For Allergy And Asthma Of Georgia Pc | 2062460785 | 10 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Carlos Julio Moreno, 690 Dallas Hwy, Suite 101, Villa Rica, GA 30180-1264 Ph: (770) 459-0620 | Mr Carlos Julio Moreno, 690 Dallas Hwy, Suite 101, Villa Rica, GA 30180-1264 Ph: (770) 459-0620 |
Kortni Kilgore, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 403 Permian Way Ste D, Villa Rica, GA 30180 Phone: 770-627-7246 | |
Ms. Amanda Hope Descalzo, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 690 Dallas Hwy Ste 103, Villa Rica, GA 30180 Phone: 770-214-2800 Fax: 770-214-2803 | |
Mary Alexander-adams, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 705 Dallas Hwy Ste 101, Villa Rica, GA 30180 Phone: 770-459-4411 Fax: 770-459-1895 |