Provider Demographics
NPI:1427043439
Name:CENTRAL FLORIDA ENDOCRINE & DIABETES CONSULTANTS P A
Entity Type:Organization
Organization Name:CENTRAL FLORIDA ENDOCRINE & DIABETES CONSULTANTS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PACHOCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-629-4901
Mailing Address - Street 1:635 N MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4422
Mailing Address - Country:US
Mailing Address - Phone:407-629-4901
Mailing Address - Fax:407-629-0168
Practice Address - Street 1:635 N MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4422
Practice Address - Country:US
Practice Address - Phone:407-629-4901
Practice Address - Fax:407-629-0168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53974207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD95891Medicare UPIN
FL39857Medicare UPIN
FLE21437Medicare UPIN
FL7353530001Medicare NSC
FLF94553Medicare UPIN