| Cfagi, LLC | |
|
740 South Concourse Parkway Suite 200 Maitland FL 32751 | |
| (407) 644-4014 | |
| Not Available |
| Full Name | Cfagi, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 740 South Concourse Parkway, Maitland, Florida |
| Authorized Official Name and Position | Carol Crump (PRESIDENT, BOARD OF MANAGERS) |
| Authorized Official Contact | 6157606588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cfagi, LLC 401 Commerce St Suite 600 Nashville TN 37219-2446 | Cfagi, LLC 740 South Concourse Parkway Suite 200 Maitland FL 32751 Ph: (407) 644-4014 |
| NPI Number | 1467901520 |
|---|---|
| Provider Enumeration Date | 09/29/2016 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 5496030579 |
|---|---|
| Medicare Enrollment ID | O20170403001253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467901520 | NPI | - | NPPES |
| 019722701 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
| Provider Name | Raouf E Hilal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427161793 PECOS PAC ID: 1153360904 Enrollment ID: I20050503000461 |
| Provider Name | Andria Michael Mushahwar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023110814 PECOS PAC ID: 3173500816 Enrollment ID: I20050929000370 |
| Provider Name | Joseph Quagliata |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750575395 PECOS PAC ID: 5799879672 Enrollment ID: I20070922000259 |
| Provider Name | Tina M Bruefach |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033221411 PECOS PAC ID: 2567518053 Enrollment ID: I20090924000660 |
| Provider Name | Paul S Panzarella |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275813057 PECOS PAC ID: 6305081365 Enrollment ID: I20170605000286 |
| Provider Name | Hannah Patterson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386107985 PECOS PAC ID: 2769892272 Enrollment ID: I20201111001492 |
| Provider Name | Demittre Sorenson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881264455 PECOS PAC ID: 8527463892 Enrollment ID: I20210825000434 |
| Provider Name | Yasmin D Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639951254 PECOS PAC ID: 1052761608 Enrollment ID: I20231222002295 |
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