| Jc Medical, Inc | |
|
1781 Park Center Drive Suite 120 Orlando FL 32835-6245 | |
| (407) 914-2325 | |
| (407) 826-1592 |
| Full Name | Jc Medical, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1781 Park Center Drive, Orlando, Florida |
| Authorized Official Name and Position | Gutteridge Jeancharles (PRESIDENT/CEO/MEDICAL DIRECTOR) |
| Authorized Official Contact | 4079142325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jc Medical, Inc P.o. Box 617440 Orlando FL 32861 Ph: (407) 914-2325 | Jc Medical, Inc 1781 Park Center Drive Suite 120 Orlando FL 32835-6245 Ph: (407) 914-2325 |
| NPI Number | 1558622068 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 03/29/2024 |
| Medicare PECOS PAC ID | 3678721909 |
|---|---|
| Medicare Enrollment ID | O20120912000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558622068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Gutteridge Jean-charles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598803470 PECOS PAC ID: 3577711803 Enrollment ID: I20120912000085 |
| Provider Name | Edward Patrick P Soriano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487848578 PECOS PAC ID: 6901996214 Enrollment ID: I20151215002635 |
| Provider Name | Lyse Briette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669922563 PECOS PAC ID: 0941570824 Enrollment ID: I20170726000362 |
| Provider Name | Eldere Germain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467019109 PECOS PAC ID: 5193057453 Enrollment ID: I20200504001629 |
| Provider Name | Dana L Santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770100828 PECOS PAC ID: 8022423375 Enrollment ID: I20210218000753 |
| Provider Name | Cassandra Louissaint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184268781 PECOS PAC ID: 1557745775 Enrollment ID: I20220907000850 |
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