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TUI FAMILY MEDICINE PL NPI 1386940013


NPI Information

NPI: 1386940013
Provider Name: TUI FAMILY MEDICINE PL
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 10D2020717

Address:
4554 S CLYDE MORRIS BLVD
SUITE 2
PORT ORANGE, FL
ZIP 32129
Phone: (386) 304-2990
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TUI FAMILY MEDICINE PL is a clinic center in Port Orange, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). TUI FAMILY MEDICINE PL NPI is 1386940013. The provider is registered as an organization entity type.

The provider's business location address is:

4554 S CLYDE MORRIS BLVD
SUITE 2
PORT ORANGE, FL
ZIP 32129-403
Phone: (386) 304-2990

The provider's authorized official is Anunporn Srisawat .
The authorized official title is Managing Member and has the following contact phone number (386) 304-2990.

The CLIA number assigned to this NPI record is 10D2020717 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/27/2011 and was last updated on 10/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterME 95967FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.