| None | |
|
1506 Village Oak Ln Kissimmee FL 34746-6558 | |
| (407) 931-1998 | |
| (407) 931-0522 |
| Full Name | None |
|---|---|
| Speciality | Clinic/Center |
| Location | 1506 Village Oak Ln, Kissimmee, Florida |
| Authorized Official Name and Position | Conrado Elyeran Talampas (OWNER) |
| Authorized Official Contact | 4079311998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| None 1506 Village Oak Ln Kissimmee FL 34746-6558 Ph: (407) 931-1998 | None 1506 Village Oak Ln Kissimmee FL 34746-6558 Ph: (407) 931-1998 |
| NPI Number | 1427204502 |
|---|---|
| Provider Enumeration Date | 08/08/2008 |
| Last Update Date | 10/30/2008 |
| Medicare PECOS PAC ID | 3577625870 |
|---|---|
| Medicare Enrollment ID | O20081220000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427204502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME84870 (Florida) | Primary |
| Provider Name | Conrado E Talampas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447204714 PECOS PAC ID: 3274635321 Enrollment ID: I20070221000191 |
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