Healthcare Provider Details

I. General information

NPI: 1548435704
Provider Name (Legal Business Name): FLORIDA EM-I MEDICAL SERVICES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 S HIGHLANDS AVE
SEBRING FL
33870-5416
US

IV. Provider business mailing address

PO BOX 37718
PHILADELPHIA PA
19101-5018
US

V. Phone/Fax

Practice location:
  • Phone: 863-385-6101
  • Fax:
Mailing address:
  • Phone: 800-355-3818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERRRY R. MEADOWS
Title or Position: VICE-PRESIDENT
Credential: MD
Phone: 800-507-3600