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PREMISE HEALTH OF FLORIDA MEDICAL P.A. NPI 1770257834


NPI Information

NPI: 1770257834
Provider Name: PREMISE HEALTH OF FLORIDA MEDICAL, P.A.

Doing Business As: MCCOY FEDERAL CREDIT UNION - ORLANDO

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 10D2150857

Address:
1111 LUCERNE TER
ORLANDO, FL
ZIP 32806
Phone: (407) 704-3403
Get Directions

PREMISE HEALTH OF FLORIDA MEDICAL, P.A. is a multi-specialty clinic center in Orlando, FL. PREMISE HEALTH OF FLORIDA MEDICAL, P.A. NPI is 1770257834. The provider is registered as an organization entity type.
The provider Is Doing Business As Mccoy Federal Credit Union - Orlando.

The provider's business location address is:

1111 LUCERNE TER
ORLANDO, FL
ZIP 32806-016
Phone: (407) 704-3403
Fax: (608) 665-4991

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 10D2150857 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/3/2021 and was last updated on 8/15/2022.


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
1261QM1300XClinic/CenterMulti-SpecialtyYes

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

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