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General NPI Number Information
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NPI Number | 1881061083
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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 | 08/24/2015
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 719 RODEL CV SUITE 2001
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City | LAKE MARY
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State | FL
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Zip | 32746-5716
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Country | US
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Telephone | 407-302-3106
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Fax | 321-203-4602
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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/CHAIRMAN OF THE BOARD
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Name | DENNIS J. BUHRING
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Credential |
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Telephone | 407-649-7401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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