Provider Demographics
NPI:1235857681
Name:CARECONNECTMD TENNESSEE PC
Entity Type:Organization
Organization Name:CARECONNECTMD TENNESSEE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:ACOSTA
Authorized Official - Last Name:COLLADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-789-9585
Mailing Address - Street 1:3090 BRISTOL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3061
Mailing Address - Country:US
Mailing Address - Phone:888-789-9585
Mailing Address - Fax:562-803-4500
Practice Address - Street 1:6000 POPLAR AVE STE 250
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3974
Practice Address - Country:US
Practice Address - Phone:888-789-9585
Practice Address - Fax:562-803-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty