| Medical Home Alliance Llc | |
|
130 Ridge Center Dr Ste 104 Davenport FL 33837-6414 | |
| (863) 421-9447 | |
| (863) 421-1806 |
| Full Name | Medical Home Alliance Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 130 Ridge Center Dr Ste 104, Davenport, Florida |
| Authorized Official Name and Position | Zeneida Tavarez (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9174957496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Home Alliance Llc 2675 Winkler Ave Ste 200 Fort Myers FL 33901-9328 Ph: (877) 856-3774 | Medical Home Alliance Llc 130 Ridge Center Dr Ste 104 Davenport FL 33837-6414 Ph: (863) 421-9447 |
| NPI Number | 1740527811 |
|---|---|
| Provider Enumeration Date | 01/10/2013 |
| Last Update Date | 02/26/2026 |
| Medicare PECOS PAC ID | 6406096536 |
|---|---|
| Medicare Enrollment ID | O20130712000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740527811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael G Degnan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902802572 PECOS PAC ID: 5890744700 Enrollment ID: I20050118000949 |
| Provider Name | Sam M Korley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518962885 PECOS PAC ID: 5294837399 Enrollment ID: I20070220000557 |
| Provider Name | Luis C Favilli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013912625 PECOS PAC ID: 8820172406 Enrollment ID: I20080227000289 |
| Provider Name | Karol E Fortich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124284468 PECOS PAC ID: 6305033820 Enrollment ID: I20101209001168 |
| Provider Name | Juan Carlos Escandon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356567788 PECOS PAC ID: 7416084546 Enrollment ID: I20110923000534 |
| Provider Name | Ingrid T Fiallo Coronado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184992919 PECOS PAC ID: 7416192125 Enrollment ID: I20130401000132 |
| Provider Name | Zumilvette Ortiz Detres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861632200 PECOS PAC ID: 8123213253 Enrollment ID: I20130430000556 |
| Provider Name | Lysmar Carrion Dinguis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649572249 PECOS PAC ID: 0345400701 Enrollment ID: I20130529000571 |
| Provider Name | Maria Sanchez Avila |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1033133806 PECOS PAC ID: 1254327158 Enrollment ID: I20131024000747 |
| Provider Name | Keila Tosado De Leon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881843860 PECOS PAC ID: 9032380407 Enrollment ID: I20131029001792 |
| Provider Name | Ziolly Cortijo-cortes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952567216 PECOS PAC ID: 2860624822 Enrollment ID: I20140407001280 |
| Provider Name | Norali Hernandez-alonso |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770647190 PECOS PAC ID: 1355573312 Enrollment ID: I20140407001473 |
| Provider Name | Diego G Clavell Rivera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265672778 PECOS PAC ID: 7719027341 Enrollment ID: I20150306001257 |
| Provider Name | Betania Reyes Matos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629031679 PECOS PAC ID: 3779594932 Enrollment ID: I20150324000306 |
| Provider Name | Bianca R Trevino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235562042 PECOS PAC ID: 1355669904 Enrollment ID: I20150413000745 |
| Provider Name | Mariel Pinero |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1891795654 PECOS PAC ID: 3476872748 Enrollment ID: I20150507002441 |
| Provider Name | Tomas Ferrer Capiro |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548666183 PECOS PAC ID: 7911228432 Enrollment ID: I20150609000596 |
| Provider Name | Carlos F Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407113582 PECOS PAC ID: 2860704558 Enrollment ID: I20150709000876 |
| Provider Name | Tania Falcon Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497859722 PECOS PAC ID: 6406816362 Enrollment ID: I20150826001649 |
| Provider Name | Arelis Rodriguez Caban |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467566711 PECOS PAC ID: 1153326160 Enrollment ID: I20150827001429 |
| Provider Name | Sarim Idrees |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144617382 PECOS PAC ID: 5496056228 Enrollment ID: I20151219000155 |
| Provider Name | Emma M Herrera |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1376953836 PECOS PAC ID: 1456653476 Enrollment ID: I20160108000058 |
| Provider Name | Marisel Gutierrez Del Arroyo Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1942452628 PECOS PAC ID: 9638230139 Enrollment ID: I20160415000120 |
| Provider Name | Nildamarys Hernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497881577 PECOS PAC ID: 9830115351 Enrollment ID: I20160506001722 |
| Provider Name | Osvaldo Aviles Ribot |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1811054901 PECOS PAC ID: 2466677992 Enrollment ID: I20160511001051 |
| Provider Name | Carlos Del Rosario Mesa |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215314737 PECOS PAC ID: 8729378716 Enrollment ID: I20160603000079 |
| Provider Name | Hilda Ivonne Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952372807 PECOS PAC ID: 1456247634 Enrollment ID: I20160727001708 |
| Provider Name | Joel D Gonzalez-mendez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1811910060 PECOS PAC ID: 9436103108 Enrollment ID: I20160926001138 |
| Provider Name | Mayra M Casta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1821046285 PECOS PAC ID: 0547234999 Enrollment ID: I20161026002037 |
| Provider Name | Betzy Acevedo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184647778 PECOS PAC ID: 8426000126 Enrollment ID: I20161114001990 |
| Provider Name | Aixa Lajara |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518260454 PECOS PAC ID: 6103105697 Enrollment ID: I20161128002736 |
| Provider Name | Nancy Blas Velez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629134952 PECOS PAC ID: 6901980986 Enrollment ID: I20161213002496 |
| Provider Name | Agustin Caballero Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275761975 PECOS PAC ID: 9032306840 Enrollment ID: I20180214000126 |
| Provider Name | Candice Rivera Mendez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477799674 PECOS PAC ID: 9931415395 Enrollment ID: I20180314000307 |
| Provider Name | Javier Antonio Rosario |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568461945 PECOS PAC ID: 9032022017 Enrollment ID: I20180327002696 |
| Provider Name | Imarilys Zayas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780831131 PECOS PAC ID: 9638314149 Enrollment ID: I20180427000368 |
| Provider Name | Dilcia Hernandez Santana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1023209251 PECOS PAC ID: 4789835927 Enrollment ID: I20180525002168 |
| Provider Name | Patricia De Mello |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1942303995 PECOS PAC ID: 3072512011 Enrollment ID: I20180613002008 |
| Provider Name | Jorge Y Reyes Rosario |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1619051836 PECOS PAC ID: 3274591854 Enrollment ID: I20180821003625 |
| Provider Name | Brimarie Feliciano Ramos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275885998 PECOS PAC ID: 1557513744 Enrollment ID: I20180907001243 |
| Provider Name | Ismael Ruiz De La Rosa |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912130527 PECOS PAC ID: 1850435165 Enrollment ID: I20180914002739 |
| Provider Name | Sylma I Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306817101 PECOS PAC ID: 1557274693 Enrollment ID: I20180917001121 |
| Provider Name | Betsy Negron |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346499449 PECOS PAC ID: 8527109677 Enrollment ID: I20180918004400 |
| Provider Name | Miguelina Diroche Ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992120497 PECOS PAC ID: 6901029859 Enrollment ID: I20190114000483 |
| Provider Name | Melitza Lopez Valle |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427243021 PECOS PAC ID: 0143495598 Enrollment ID: I20190227002643 |
| Provider Name | Jose Salvador Santos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972694644 PECOS PAC ID: 9739270737 Enrollment ID: I20190620001114 |
| Provider Name | Marielis Pedroza Alicea |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1619133782 PECOS PAC ID: 3678632163 Enrollment ID: I20200311001147 |
| Provider Name | Gwendolyn Henson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700128832 PECOS PAC ID: 6709011083 Enrollment ID: I20210331001133 |
| Provider Name | Willma L Padro |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184935900 PECOS PAC ID: 1557779592 Enrollment ID: I20210413000299 |
| Provider Name | Natasha L Fenelon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003426883 PECOS PAC ID: 4688082464 Enrollment ID: I20210415001127 |
| Provider Name | Naicis Maura Chirino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417598954 PECOS PAC ID: 3577971159 Enrollment ID: I20210420001764 |
| Provider Name | Seidy Delgado Pons |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093827644 PECOS PAC ID: 3577562016 Enrollment ID: I20210506002802 |
| Provider Name | Agustin Vanoni |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1144561184 PECOS PAC ID: 4688933401 Enrollment ID: I20210514002457 |
| Provider Name | Barbara Np Pierre-louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053895375 PECOS PAC ID: 6608275805 Enrollment ID: I20210520000232 |
| Provider Name | Juan A Martin Lissabet |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649332792 PECOS PAC ID: 9931090636 Enrollment ID: I20211216001999 |
| Provider Name | Ricardo R Sanchez Maceira |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306873971 PECOS PAC ID: 3274627542 Enrollment ID: I20220112000968 |
| Provider Name | Justa Crespo Torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073659702 PECOS PAC ID: 5597717520 Enrollment ID: I20220606002875 |
| Provider Name | Hector John Marti Hernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851985642 PECOS PAC ID: 0042609489 Enrollment ID: I20220710000120 |
| Provider Name | Maria T Muriente Guzman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861658478 PECOS PAC ID: 9638368244 Enrollment ID: I20220810003941 |
| Provider Name | Harold Velaydez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1225612286 PECOS PAC ID: 2860875523 Enrollment ID: I20220814000020 |
| Provider Name | Uriel A. Pont Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437353703 PECOS PAC ID: 5698164622 Enrollment ID: I20220818002717 |
| Provider Name | Antonio E Garcia Arano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407594435 PECOS PAC ID: 2264809649 Enrollment ID: I20221028001157 |
| Provider Name | Toru Hashida |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952794901 PECOS PAC ID: 4183932965 Enrollment ID: I20221121001975 |
| Provider Name | Aida R Berdasco Paz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1801820543 PECOS PAC ID: 5496990152 Enrollment ID: I20230505000973 |
| Provider Name | Angel Rentas Leon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1407092877 PECOS PAC ID: 0042406647 Enrollment ID: I20230811000215 |
| Provider Name | Alexis Francisco Suarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821775537 PECOS PAC ID: 5395190961 Enrollment ID: I20231017002571 |
| Provider Name | Maritza Castillo Alfonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063285773 PECOS PAC ID: 6709236235 Enrollment ID: I20231227000267 |
| Provider Name | Milady Irizarry Vazquez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1528285954 PECOS PAC ID: 8820167265 Enrollment ID: I20240126002463 |
| Provider Name | Martha Maria Bonett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427827138 PECOS PAC ID: 8921441361 Enrollment ID: I20240213001447 |
| Provider Name | Aldo Alexis Goldsztein Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457703464 PECOS PAC ID: 4880902337 Enrollment ID: I20240312004237 |
| Provider Name | Ingrid Mercedes Abreu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1811099120 PECOS PAC ID: 5597157834 Enrollment ID: I20240417004219 |
| Provider Name | Crisbel Rosabal Pernas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730820051 PECOS PAC ID: 1355781444 Enrollment ID: I20240507001594 |
| Provider Name | Katerine Insuasti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780305615 PECOS PAC ID: 9638616121 Enrollment ID: I20240801002481 |
| Provider Name | Angel Manuel Cuenca Gongora |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962183665 PECOS PAC ID: 9032630330 Enrollment ID: I20250303002730 |
| Provider Name | Marisol Garcia Torna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265163984 PECOS PAC ID: 5799152492 Enrollment ID: I20250421002994 |
| Provider Name | Zolanye Rafelina Santana Betances |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1457162398 PECOS PAC ID: 5799203030 Enrollment ID: I20250520001397 |
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Surgeons Of Central Florida Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 755 Jay Bee Avenue, Davenport, FL 33897 Phone: 863-286-0607 | |
Adventist Health System/sunbelt, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 49513 Us Highway 27, Davenport, FL 33897 Phone: 863-588-4811 Fax: 863-588-4812 | |
Soni Family Practice, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 106 Park Place Blvd Ste C, Davenport, FL 33837 Phone: 863-588-4775 Fax: 863-422-7664 | |
Elon Health Primary Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 43378 Highway 27 Ste B, Davenport, FL 33837 Phone: 407-205-6996 Fax: 407-871-3599 | |
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