MEDICARE: PHYSICIAN ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013174135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	77 W UNDERWOOD ST FL 5
Second Line	:	MP 146
City	:	ORLANDO
State	:	FL
Zip	:	32806-1122
Country	:	US
Telephone Number	:	407-649-7400
Fax Number	:	407-649-7429

Provider Business Practice Location Address
First Line	:	7350 SANDLAKE COMMONS BLVD
Second Line	:	SUITE 1102
City	:	ORLANDO
State	:	FL
Zip	:	32819-8040
Country	:	US
Telephone Number	:	407-355-7478
Fax Number	:	407-354-2431

Authorized Official
Title or Position	:	CEO/MEMBER OF THE BOARD
Name	:	MR. DENNIS J. BUHRING
Credential	:
Telephone Number	:	407-649-7401

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	08/20/2015

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Directions to “PHYSICIAN ASSOCIATES LLC ” Practice Location

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