| Medical Associates Of Lake Nona, Llc | |
|
2428 Clearlake Rd Bldg K Cocoa FL 32922-5722 | |
| (321) 795-6380 | |
| (321) 208-8717 |
| Full Name | Medical Associates Of Lake Nona, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2428 Clearlake Rd Bldg K, Cocoa, Florida |
| Authorized Official Name and Position | Stephen B Dodson (OWNER) |
| Authorized Official Contact | 3217956380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Associates Of Lake Nona, Llc Po Box 560538 Rockledge FL 32956-0538 Ph: (321) 795-6380 | Medical Associates Of Lake Nona, Llc 2428 Clearlake Rd Bldg K Cocoa FL 32922-5722 Ph: (321) 795-6380 |
| NPI Number | 1801651328 |
|---|---|
| Provider Enumeration Date | 02/14/2024 |
| Last Update Date | 02/14/2024 |
| Medicare PECOS PAC ID | 0244670040 |
|---|---|
| Medicare Enrollment ID | O20240426001700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801651328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Stephen B Dodson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215324512 PECOS PAC ID: 5597011023 Enrollment ID: I20180712003482 |
Ana Conde Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Clearlake Rd Bldg K, Cocoa, FL 32922 Phone: 321-368-3862 | |
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