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AVON PARK MEDICAL GROUP LLC. NPI 1225641954


NPI Information

NPI: 1225641954
Provider Name: AVON PARK MEDICAL GROUP, LLC.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 10D1040771

Address:
1023 US HIGHWAY 27 S
AVON PARK, FL
ZIP 33825
Phone: (813) 888-8215
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AVON PARK MEDICAL GROUP, LLC. is a clinic center in Avon Park, 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). AVON PARK MEDICAL GROUP, LLC. NPI is 1225641954. The provider is registered as an organization entity type.

The provider's business location address is:

1023 US HIGHWAY 27 S
AVON PARK, FL
ZIP 33825-107
Phone: (813) 888-8215

The provider's authorized official is Antonio Calvo .
The authorized official title is Coo and has the following contact phone number (813) 999-5309.

The CLIA number assigned to this NPI record is 10D1040771 - intermediate care facility/individuals with intellectual disability with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2020 and was last updated on 8/24/2020.


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
1261Q00000XClinic/CenterYes

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: 11/14/2023

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.