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NPI Code Detail

MEDICARE: WINTER PARK FAMILY HEALTH CENTER INC

MEDICARE: WINTER PARK FAMILY HEALTH CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
340471OTHERFLWINTER PARK MEDICARE GROUP NUMBER
647663YOTHERFLRONALD L. SHAW MD MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11316213507OTHERFLNPI FOR LINDSEY NEWMAN DEFRESNE, DO
21639373962OTHERMIDR. PRISKA'S NPI
448983ZOTHERFLRONALD STANISH MD
51922099555OTHERFLRONALD L SHAW MD NPI

General Provider Information

NPI Number : 1114901816
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINTER PARK FAMILY HEALTH CENTER INC
Provider Business Mailing Address
First Line : 2304 ALOMA AVE
Second Line : 100
City : WINTER PARK
State : FL
Zip : 32792-3330
Country : US
Telephone Number : 407-679-9222
Fax Number : 407-679-9061
Provider Business Practice Location Address
First Line : 2304 ALOMA AVE STE 100
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-3330
Country : US
Telephone Number : 407-679-9222
Fax Number : 407-679-9061
Authorized Official
Title or Position : PRESIDENT
Name : RONALD LORIN SHAW
Credential : MD
Telephone Number : 407-679-9222
Provider Enumeration Date : 12/06/2005
Last Update Date : 06/09/2015

Similar Medicare Providers

1922099555 — DR. RONALD LORIN SHAW MD
Practice Location Address:
2304 ALOMA AVE
WINTER PARK, FL
32792-3330
Practice Phone: 407-679-9222
Practice Fax: 407-679-9061
1174581888 — RONALD JOSEPH STANISH MD
Practice Location Address:
2304 ALOMA AVE
WINTER PARK, FL
32792-3330
Practice Phone: 407-679-9222
Practice Fax: 407-679-9061
1821019878 — SIGNATURE PHARMACY INC
Practice Location Address:
2304 ALOMA AVE
WINTER PARK, FL
32792-3330
Practice Phone: 407-673-2222
Practice Fax: 407-673-1234
1396808184 — GLENN RICHARD JOHNSTON M.D.
Practice Location Address:
2304 ALOMA AVE
WINTER PARK, FL
32792-3330
Practice Phone: 407-478-8840
Practice Fax: 407-478-8841
1639373962 — DR. RUDINA X. PRISKA MD
Practice Location Address:
2304 ALOMA AVE STE 100
WINTER PARK, FL
32792-3330
Practice Phone: 407-679-9222
Practice Fax: 407-679-9061
1497928865 — CHRISTOPHER W. CONAVAY, M.D., P.A.
Practice Location Address:
2304 ALOMA AVE , SUITE 201
WINTER PARK, FL
32792-3330
Practice Phone: 407-447-5370
Practice Fax: 407-447-4385

Directions to “WINTER PARK FAMILY HEALTH CENTER INC ” Practice Location

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