Healthcare Provider Details

I. General information

NPI: 1619127263
Provider Name (Legal Business Name): CENTRAL FLORIDA INTERNISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 PROGRESS LANE
SAINT CLOUD FL
34769-6519
US

IV. Provider business mailing address

PO BOX 700577
SAINT CLOUD FL
34770-0577
US

V. Phone/Fax

Practice location:
  • Phone: 407-957-9911
  • Fax:
Mailing address:
  • Phone: 407-957-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. TABITHA RUBIN
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential:
Phone: 407-348-5175