NPI: 1164045753 · WINTER GARDEN, FL 34787 · Internal Medicine Physician · NPI assigned 05/18/2020
| Authorized Official | TAVERAS, DERRICK (CEO) |
| NPI Enumeration Date | 05/18/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 54 | $121.14 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99495 | 54 | 43 | $121.14 |