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General NPI Number Information
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NPI Number | 1649228859
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA INPATIENT MEDICINE LLC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 525 TECHNOLOGY PARK STE 109
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City | LAKE MARY
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State | FL
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Zip | 32746-7107
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-5431
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Provider Business Mailing Address
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Address Line | PO BOX 102224
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City | ATLANTA
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State | GA
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Zip | 30368-7746
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-5431
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Authorized Official
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Title or Position | CEO
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Name | SHANNON ABBOTT
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Credential |
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Telephone | 407-647-2346
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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 | ME80505
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License Number State | FL
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