Basic Information
| Provider Information | |||||||||
| NPI: | 1952599375 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLORIDA INPATIENT MEDICINE ASSOCIATES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 96368 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731436368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009623303 | ||||||||
| FaxNumber: | 4056821586 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 CORAL HILLS DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330654108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543443000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2007 | ||||||||
| LastUpdateDate: | 09/17/2012 | ||||||||
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| AuthorizedOfficialLastName: | MCCORMICK | ||||||||
| AuthorizedOfficialFirstName: | TALBOT | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PREDSIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6784418500 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EAGLE HOSPITAL PHYSICIANS | ||||||||
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| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.