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2151 Consulate Dr Ste 17 Orlando FL 32837-8808 | |
| (407) 630-6630 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2151 Consulate Dr Ste 17, Orlando, Florida |
| Authorized Official Name and Position | Rafaela Giunti Basso (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4076306630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2151 Consulate Dr Ste 17 Orlando FL 32837-8808 Ph: (407) 630-6630 | 2151 Consulate Dr Ste 17 Orlando FL 32837-8808 Ph: (407) 630-6630 |
| NPI Number | 1235996166 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 01/09/2025 |
| Medicare PECOS PAC ID | 4284073594 |
|---|---|
| Medicare Enrollment ID | O20240419001214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235996166 | NPI | - | NPPES |
| Provider Name | Rafaela Giunti Basso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699303107 PECOS PAC ID: 6002255312 Enrollment ID: I20240419001315 |
| Provider Name | George Yazigi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083155345 PECOS PAC ID: 9436599305 Enrollment ID: I20240425004148 |
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