Healthcare Provider Details

I. General information

NPI: 1801238035
Provider Name (Legal Business Name): FLORIDA EM-I MEDICAL SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 10/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 RED BUG LAKE ROAD
OVIEDO FL
32765
US

IV. Provider business mailing address

PO BOX 37743
PHILADELPHIA PA
19101-5043
US

V. Phone/Fax

Practice location:
  • Phone: 800-507-8874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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