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General NPI Number Information
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NPI Number | 1386894319
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Entity Type | Organization
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Legal Business Name | PLANT CITY INTERNAL MEDICINE SPECIALISTS, P.A.
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 1907 S ALEXANDER ST SUITE 1
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City | PLANT CITY
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State | FL
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Zip | 33563-8419
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Country | US
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Telephone | 813-754-3344
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Fax | 813-754-3574
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Provider Business Mailing Address
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Address Line | 1907 S ALEXANDER ST SUITE 1
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City | PLANT CITY
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State | FL
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Zip | 33563-8419
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Country | US
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Telephone | 813-754-3344
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Fax | 813-754-3574
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Authorized Official
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Title or Position | MANAGER
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Name | PEGGY YVONNE FYE
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Credential |
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Telephone | 813-754-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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