Provider Demographics
NPI:1427020049
Name:ALEMAN PACHECO, JANICE M (MD)
Entity Type:Individual
Prefix:MISS
First Name:JANICE
Middle Name:M
Last Name:ALEMAN PACHECO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:896-698-3720
Mailing Address - Fax:
Practice Address - Street 1:595 OAK COMMONS BLVD STE A
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4211
Practice Address - Country:US
Practice Address - Phone:321-249-6954
Practice Address - Fax:407-483-7834
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14122174400000X
FLACN1139208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0023075Medicare ID - Type Unspecified
PRI28584Medicare UPIN