Healthcare Provider Details

I. General information

NPI: 1154090173
Provider Name (Legal Business Name): FLORIDA HOSPITAL PHYSICIAN GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 SW 11TH ST
OCALA FL
34471-0967
US

IV. Provider business mailing address

900 HOPE WAY
ALTAMONTE SPRINGS FL
32714-1502
US

V. Phone/Fax

Practice location:
  • Phone: 352-354-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES C PRESSWOOD
Title or Position: VP/CFO
Credential:
Phone: 386-615-4237