Healthcare Provider Details

I. General information

NPI: 1184674673
Provider Name (Legal Business Name): FLORIDA EM-I MEDICAL SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SUN N LAKE BLVD
SEBRING FL
33872-1986
US

IV. Provider business mailing address

PO BOX 41816
PHILADELPHIA PA
19101-1816
US

V. Phone/Fax

Practice location:
  • Phone: 863-402-3372
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

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