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General NPI Number Information
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NPI Number | 1144561234
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA MEDICAL & DIAGNOSTIC CLINIC, PA
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 3327 MEDICAL HILL RD
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City | SEBRING
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State | FL
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Zip | 33870-5531
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Country | US
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Telephone | 863-386-9122
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Fax | 863-386-0566
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Provider Business Mailing Address
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Address Line | 3327 MEDICAL HILL RD
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City | SEBRING
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State | FL
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Zip | 33870-5531
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Country | US
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Telephone | 863-386-9122
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Fax | 863-386-0566
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Authorized Official
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Title or Position | DIR
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Name | DR. GEORGE W IBRAHIM
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Credential | M.D.
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Telephone | 863-386-9122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME0031535
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License Number State | FL
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