Provider Demographics
NPI:1689875882
Name:MEDICAL OFFICE CONSULTANTS, INC.
Entity Type:Organization
Organization Name:MEDICAL OFFICE CONSULTANTS, INC.
Other - Org Name:PINE CASTLE WALK-IN CLINI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-850-0056
Mailing Address - Street 1:5636 HANSEL AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4216
Mailing Address - Country:US
Mailing Address - Phone:407-850-0056
Mailing Address - Fax:407-240-7693
Practice Address - Street 1:5636 HANSEL AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4216
Practice Address - Country:US
Practice Address - Phone:407-850-0056
Practice Address - Fax:407-240-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72450AMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER