| Premier Med Pa | |
|
2906 17th St. St Cloud FL 34769 | |
| (407) 543-6306 | |
| Not Available |
| Full Name | Premier Med Pa |
|---|---|
| Speciality | Hospitalist |
| Location | 2906 17th St., St Cloud, Florida |
| Authorized Official Name and Position | Jauvid Behram Ayadi (OWNER) |
| Authorized Official Contact | 4073522542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Med Pa 7512 Dr Phillips Blvd Ste 50-344 Orlando FL 32819-5420 Ph: (407) 543-6306 | Premier Med Pa 2906 17th St. St Cloud FL 34769 Ph: (407) 543-6306 |
| NPI Number | 1053877506 |
|---|---|
| Provider Enumeration Date | 02/20/2019 |
| Last Update Date | 10/18/2019 |
| Medicare PECOS PAC ID | 1557603370 |
|---|---|
| Medicare Enrollment ID | O20190614000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053877506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Jauvid B Ayadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619041332 PECOS PAC ID: 1557310828 Enrollment ID: I20050114000126 |
| Provider Name | Prakash P Kalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699849232 PECOS PAC ID: 5092764365 Enrollment ID: I20050114000169 |
| Provider Name | Matthew B Owen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902801863 PECOS PAC ID: 5193867125 Enrollment ID: I20100128000548 |
| Provider Name | Noman Subhani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427060243 PECOS PAC ID: 7012052558 Enrollment ID: I20100312000415 |
| Provider Name | Dennis Paray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013386069 PECOS PAC ID: 9032412309 Enrollment ID: I20160120000832 |
| Provider Name | Alejandro Berlin Dela Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770951519 PECOS PAC ID: 5890082440 Enrollment ID: I20160924000463 |
| Provider Name | Tiny Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013416478 PECOS PAC ID: 6103188214 Enrollment ID: I20180329000014 |
| Provider Name | Lalaine Dela Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427549799 PECOS PAC ID: 9537418256 Enrollment ID: I20180814000987 |
| Provider Name | Ali Mohammad Ahangari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992190888 PECOS PAC ID: 7416208244 Enrollment ID: I20180918003015 |
| Provider Name | Cora T Yoose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285065615 PECOS PAC ID: 9537485057 Enrollment ID: I20190516000802 |
| Provider Name | Liana Caban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841850823 PECOS PAC ID: 4183871296 Enrollment ID: I20190819003299 |
| Provider Name | Vahid Kazemi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093246845 PECOS PAC ID: 1951732023 Enrollment ID: I20200506001189 |
| Provider Name | Carmen Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265064406 PECOS PAC ID: 2466872569 Enrollment ID: I20201012000227 |
| Provider Name | Lilialis Collazo Yambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851971691 PECOS PAC ID: 5193134476 Enrollment ID: I20210518000953 |
| Provider Name | Brenalee Bagarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730672643 PECOS PAC ID: 6204236458 Enrollment ID: I20210610000675 |
| Provider Name | Caitlyn Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962284281 PECOS PAC ID: 7315397007 Enrollment ID: I20231220004071 |
| Provider Name | Ramez Adel Massoud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518594001 PECOS PAC ID: 2961846407 Enrollment ID: I20240222004106 |
| Provider Name | Michael Delzoppo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831725787 PECOS PAC ID: 3971943911 Enrollment ID: I20240424003327 |
Central Florida Infectious Disease Consultants Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 Budlinger Ave # A, St Cloud, FL 34769 Phone: 606-416-2476 Fax: 571-323-6777 | |
Universal Physicians Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1118 Pennsylvania Ave, St Cloud, FL 34769 Phone: 407-892-3313 Fax: 407-892-4428 |