| Gastroenterology And Nutrition Specialist Pa | |
|
2880 S Osceola Ave Orlando FL 32806-5431 | |
| (407) 843-0443 | |
| (407) 843-0442 |
| Full Name | Gastroenterology And Nutrition Specialist Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2880 S Osceola Ave, Orlando, Florida |
| Authorized Official Name and Position | Muhammad Asif Mohiuddin (PRESIDENT) |
| Authorized Official Contact | 4078430443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology And Nutrition Specialist Pa 2880 S Osceola Ave Orlando FL 32806-5431 Ph: (407) 843-0443 | Gastroenterology And Nutrition Specialist Pa 2880 S Osceola Ave Orlando FL 32806-5431 Ph: (407) 843-0443 |
| NPI Number | 1972658052 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 05/09/2014 |
| Medicare PECOS PAC ID | 2668464967 |
|---|---|
| Medicare Enrollment ID | O20040330000557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972658052 | NPI | - | NPPES |
| 262273400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME79526 (Florida) | Primary |
| Provider Name | Muhammad Asif Mohiuddin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265411185 PECOS PAC ID: 0547252850 Enrollment ID: I20110513000039 |
| Provider Name | Ashley L Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588171904 PECOS PAC ID: 8729322193 Enrollment ID: I20181212001260 |
| Provider Name | Iris N Bosse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073130688 PECOS PAC ID: 0941610026 Enrollment ID: I20201030000677 |
| Provider Name | Heather Marie Korkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922626647 PECOS PAC ID: 4385032549 Enrollment ID: I20211021001076 |
| Provider Name | Analaura Vallejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083326235 PECOS PAC ID: 9830560333 Enrollment ID: I20230119003135 |
| Provider Name | Yariminette Delgado Olivo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871875351 PECOS PAC ID: 7012226343 Enrollment ID: I20230503003384 |
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