| Kissimmee Medical Center Pa | |
|
1910 W Oak St Kissimmee FL 34741-4301 | |
| (407) 343-4338 | |
| (407) 343-4335 |
| Full Name | Kissimmee Medical Center Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1910 W Oak St, Kissimmee, Florida |
| Authorized Official Name and Position | Shanti Singh (PRESIDENT) |
| Authorized Official Contact | 4073434338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kissimmee Medical Center Pa 1910 W Oak St Kissimmee FL 34741-4301 Ph: (407) 343-4338 | Kissimmee Medical Center Pa 1910 W Oak St Kissimmee FL 34741-4301 Ph: (407) 343-4338 |
| NPI Number | 1558345173 |
|---|---|
| Provider Enumeration Date | 12/06/2005 |
| Last Update Date | 11/08/2011 |
| Medicare PECOS PAC ID | 6608040282 |
|---|---|
| Medicare Enrollment ID | O20111116000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558345173 | NPI | - | NPPES |
| 256014300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shanti Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144291980 PECOS PAC ID: 0042484628 Enrollment ID: I20111116000531 |
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