| West Orange Family Medical Care,pa | |
|
1002 S Dillard St Suite 102 Winter Garden FL 34787 | |
| (407) 877-3577 | |
| Not Available |
| Full Name | West Orange Family Medical Care,pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1002 S Dillard St, Winter Garden, Florida |
| Authorized Official Name and Position | Michael G Mercado (OWNER) |
| Authorized Official Contact | 4078773577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Orange Family Medical Care,pa 1002 S Dillard St Suite 102 Winter Garden FL 34787 Ph: (407) 877-3577 | West Orange Family Medical Care,pa 1002 S Dillard St Suite 102 Winter Garden FL 34787 Ph: (407) 877-3577 |
| NPI Number | 1184710295 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 03/26/2014 |
| Medicare PECOS PAC ID | 9032183074 |
|---|---|
| Medicare Enrollment ID | O20040824001398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184710295 | NPI | - | NPPES |
| 37138700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael G Mercado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558404616 PECOS PAC ID: 5395719330 Enrollment ID: I20110118000046 |
| Provider Name | Jeffrey T Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295036697 PECOS PAC ID: 2668626268 Enrollment ID: I20130207000181 |
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