Provider Type Icon

SUPREME MEDICAL GROUP PLLC NPI 1073970810


NPI Information

NPI: 1073970810
Provider Name: SUPREME MEDICAL GROUP PLLC
Classification: Internal Medicine - 207RI0200X
Entity Type: Organization

Specialization: Infectious Disease

CLIA Number: 10D2174600

Address:
10967 LAKE UNDER HILL RD
UNIT 137
ORLANDO, FL
ZIP 32825
Phone: (407) 930-1030
Get Directions

SUPREME MEDICAL GROUP PLLC is an infectious disease internal medicine in Orlando, FL. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. SUPREME MEDICAL GROUP PLLC NPI is 1073970810. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10967 LAKE UNDER HILL RD
UNIT 137
ORLANDO, FL
ZIP 32825-455
Phone: (407) 930-1030
Fax: (407) 386-7277

The provider's authorized official is Sheena Mary Jose .
The authorized official title is Medical Director and has the following contact phone number (407) 930-1030.

The CLIA number assigned to this NPI record is 10D2174600 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2016 and was last updated on 12/23/2020.


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
1207RI0200XInternal MedicineInfectious DiseaseME109765FLORIDAYes

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

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.