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General NPI Number Information
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NPI Number | 1467738682
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSOCIATES LLC
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Dates
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Enumeration Date | 11/02/2011
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 2572 W STATE ROAD 426 SUITE 1040
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City | OVIEDO
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State | FL
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Zip | 32765-8389
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Country | US
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Telephone | 407-366-9800
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Fax | 407-366-9283
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Provider Business Mailing Address
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Address Line | 235 N WESTMONTE DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DENNIS BUHRING
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Credential |
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Telephone | 407-262-5710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS5530
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License Number State | FL
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