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General NPI Number Information
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NPI Number | 1316232200
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA ACCIDENT AND INJURY
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Dates
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Enumeration Date | 06/18/2011
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 17315 PAGONIA RD STE 103
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City | CLERMONT
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State | FL
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Zip | 34711-5956
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Country | US
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Telephone | 407-344-4878
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Fax | 407-344-7878
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Provider Business Mailing Address
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Address Line | 1611 N MAIN ST
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City | KISSIMMEE
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State | FL
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Zip | 34744-3304
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Country | US
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Telephone | 407-344-4878
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Fax | 407-344-7878
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. THOMAS PATRICK ENTWISTLE
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Credential | D.C.
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Telephone | 407-344-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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