Healthcare Provider Details
I. General information
NPI: 1073556767
Provider Name (Legal Business Name): INPHYNET CONTRACTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2006
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5352 LINTON BLVD
DELRAY BEACH FL
33484-6514
US
IV. Provider business mailing address
PO BOX 634702
CINCINNATI OH
45263-4702
US
V. Phone/Fax
- Phone: 561-495-3115
- Fax: 561-495-3103
- Phone: 800-424-3672
- Fax: 954-377-3042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
D.
CORVINI
Title or Position: PRESIDENT
Credential: MD
Phone: 800-424-3672