Healthcare Provider Details

I. General information

NPI: 1376818500
Provider Name (Legal Business Name): FL-I MEDICAL SERVICES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1796 US HIGHWAY 441 N
OKEECHOBEE FL
34972-1918
US

IV. Provider business mailing address

PO BOX 37872
PHILADELPHIA PA
19101-0172
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-2151
  • Fax:
Mailing address:
  • Phone: 800-507-8874
  • Fax: 727-536-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRY R MEADOW
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 800-507-8874