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General NPI Number Information
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NPI Number | 1306198502
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Entity Type | Organization
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Legal Business Name | FLORIDA EM-I MEDICAL SERVICES, PA
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 21298 OLEAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6705
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Country | US
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Telephone | 941-627-6130
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Fax | 941-627-6146
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Provider Business Mailing Address
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Address Line | PO BOX 37902
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City | PHILADELPHIA
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State | PA
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Zip | 19101-0402
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Country | US
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Telephone | 800-355-0808
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Fax | 610-834-2862
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TERRY R MEADOWS
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Credential | M.D.
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Telephone | 800-507-8874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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