| Dr Phillips Medical Wellness Center Llc | |
|
2915 Lakeview Dr Ste 1001 Fern Park FL 32730-2009 | |
| (407) 900-0613 | |
| (407) 335-6945 |
| Full Name | Dr Phillips Medical Wellness Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2915 Lakeview Dr Ste 1001, Fern Park, Florida |
| Authorized Official Name and Position | Maryam Phillips (OWNER) |
| Authorized Official Contact | 4079000613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Phillips Medical Wellness Center Llc 3300 S Fiske Blvd Rockledge FL 32955-4306 Ph: (407) 960-1465 | Dr Phillips Medical Wellness Center Llc 2915 Lakeview Dr Ste 1001 Fern Park FL 32730-2009 Ph: (407) 900-0613 |
| NPI Number | 1225549603 |
|---|---|
| Provider Enumeration Date | 10/12/2017 |
| Last Update Date | 03/25/2021 |
| Medicare PECOS PAC ID | 7810254109 |
|---|---|
| Medicare Enrollment ID | O20171121001809 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225549603 | NPI | - | NPPES |
| NH873 | Other | FL | FL MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dawn M Aycock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962772103 PECOS PAC ID: 6709046204 Enrollment ID: I20120320000839 |
| Provider Name | Maryam Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447578372 PECOS PAC ID: 4688817000 Enrollment ID: I20130903000657 |
| Provider Name | Sharon Yelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255730008 PECOS PAC ID: 8123339348 Enrollment ID: I20150615001825 |
| Provider Name | Santi R Chellu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437542750 PECOS PAC ID: 3375835291 Enrollment ID: I20160713000325 |
Health First Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2915 Lakeview Dr # 1001, Fern Park, FL 32730 Phone: 407-123-4567 |