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SOUTHEASTERN INTEGRATED MEDICAL PL NPI 1871573949


NPI Information

NPI: 1871573949
Provider Name: SOUTHEASTERN INTEGRATED MEDICAL PL
Classification: Neuromusculoskeletal Medicine & OMM - 204D00000X
Entity Type: Organization
Address:
4343 W NEWBERRY RD
GAINESVILLE, FL
ZIP 32607
Phone: (352) 224-2200
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SOUTHEASTERN INTEGRATED MEDICAL PL is a neuromusculoskeletal medicine omm in Gainesville, FL. The provider is the Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. SOUTHEASTERN INTEGRATED MEDICAL PL NPI is 1871573949. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4343 W NEWBERRY RD
GAINESVILLE, FL
ZIP 32607-817
Phone: (352) 224-2200
Fax: (352) 224-2484

The provider's authorized official is Daniel M Duncanson .
The authorized official title is Cheif Executive Officer and has the following contact phone number (352) 224-2200.

The enumeration date for this NPI number is 1/17/2006 and was last updated on 3/9/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207KA0200XAllergy & ImmunologyAllergyNo
2207KI0005XAllergy & ImmunologyClinical & Laboratory ImmunologyNo
3207NS0135XDermatologyProcedural DermatologyNo
4207Q00000XFamily MedicineNo
5207R00000XInternal MedicineNo
6207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyNo
7207RM1200XInternal MedicineMagnetic Resonance Imaging (MRI)No
8207RR0500XInternal MedicineRheumatologyNo
9207T00000XNeurological SurgeryNo
10207U00000XNuclear MedicineNo
11207V00000XObstetrics & GynecologyNo
12207VG0400XObstetrics & GynecologyGynecologyNo
13207X00000XOrthopaedic SurgeryNo
14207YS0123XOtolaryngologyFacial Plastic SurgeryNo
15204D00000XNeuromusculoskeletal Medicine & OMMYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1058586600MEDICAIDFLORIDA
297749MEDICARE PINFLORIDA

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: 4/28/2024

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