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Organization

MEDICAL ASSOCIATES OF CENTRAL FLORIDA

Active
Parent organization
MEDICAL ASSOCIATES OF CENTRAL FLORIDA
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDICAL ASSOCIATES OF CENTRAL FLORIDA
Authorized official
DR. MAHESH GANDHI ALLAM MD (PRESIDENT)
(863) 877-2411
Entity
Organization

Contact information

Practice address
1110 DRUID CIR, LAKE WALES, FL 33853-4307
(863) 877-2411
(863) 354-6617
Mailing address
1110 DRUID CIR, LAKE WALES, FL 33853-4307
(863) 877-2411
(863) 354-6617

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME64990
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23488
BCBS OF FL
FL
05
263360400
FL
01
45617
MEDICARE GROUP IDENTIFIER
FL
01
CH8733
MEDICARE RAILROAD
FL
Enumeration date
07/22/2006
Last updated
07/13/2015
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