INDEPENDENT MEDICAL GROUP LLC. NPI 1619568862

NPI Information

NPI: 1619568862
Provider Name: INDEPENDENT MEDICAL GROUP, LLC.
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 10D2172032

Address:
130 E MARKS ST
ORLANDO, FL
ZIP 32803
Phone: (407) 860-0283
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INDEPENDENT MEDICAL GROUP, LLC. is a health service clinic center in Orlando, FL. INDEPENDENT MEDICAL GROUP, LLC. NPI is 1619568862. The provider is registered as an organization entity type.

The provider's business location address is:

130 E MARKS ST
ORLANDO, FL
ZIP 32803-817
Phone: (407) 860-0283
Fax: (833) 258-4230

The provider's authorized official is Sonia N Torres .
The authorized official title is Clinical Operations Manager and has the following contact phone number (407) 860-0283.

The CLIA number assigned to this NPI record is 10D2172032 - other - community clinic for hiv/ with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2021 and was last updated on 9/28/2023.

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
1	261QH0100X	Clinic/Center	Health Service			Yes

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

NPI Synchronization or Removal

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