| Telos Health Systems Fl Llc | |
|
615 Crescent Executive Ct Ste 100 Lake Mary FL 32746-2118 | |
| (201) 217-6777 | |
| Not Available |
| Full Name | Telos Health Systems Fl Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 615 Crescent Executive Ct Ste 100, Lake Mary, Florida |
| Authorized Official Name and Position | Jamie Lashley (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2012176777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telos Health Systems Fl Llc 980 Sylvan Ave Englewood Cliffs NJ 07632-3315 Ph: (201) 217-6777 | Telos Health Systems Fl Llc 615 Crescent Executive Ct Ste 100 Lake Mary FL 32746-2118 Ph: (201) 217-6777 |
| NPI Number | 1801624242 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 07/25/2024 |
| Medicare PECOS PAC ID | 6901329556 |
|---|---|
| Medicare Enrollment ID | O20250325001658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801624242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel J Guerra |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1285958124 PECOS PAC ID: 5597905398 Enrollment ID: I20130627000656 |
| Provider Name | Zahydie Lorell Burgos Ribot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154667491 PECOS PAC ID: 4183846058 Enrollment ID: I20141107001516 |
| Provider Name | Amarilis Colon Berrios |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982929287 PECOS PAC ID: 8022454826 Enrollment ID: I20240315000598 |
| Provider Name | Regina Watkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821515776 PECOS PAC ID: 9537509930 Enrollment ID: I20240502001651 |
| Provider Name | Terese Herring |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619368222 PECOS PAC ID: 4385164359 Enrollment ID: I20250220001751 |
| Provider Name | Kelly Susan Davis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1093143554 PECOS PAC ID: 7618499195 Enrollment ID: I20250313004076 |
| Provider Name | Mary Abigail Wagner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518050731 PECOS PAC ID: 7012434095 Enrollment ID: I20250505001210 |
| Provider Name | Ninette Montero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962867549 PECOS PAC ID: 1658890041 Enrollment ID: I20250529000871 |
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