DOC PAM PA NPI 1295106334

NPI Information

NPI: 1295106334
Provider Name: DOC PAM, PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D2102843

Address:
201 N LAKEMONT AVE
SUITE 200
WINTER PARK, FL
ZIP 32792
Phone: (321) 203-4410
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DOC PAM, PA is a primary care clinic center in Winter Park, FL. DOC PAM, PA NPI is 1295106334. The provider is registered as an organization entity type.

The provider's business location address is:

201 N LAKEMONT AVE
SUITE 200
WINTER PARK, FL
ZIP 32792-228
Phone: (321) 203-4410
Fax: (321) 203-4409

The provider's authorized official is Pamela Christine Trout .
The authorized official title is President and has the following contact phone number (321) 662-2043.

The CLIA number assigned to this NPI record is 10D2102843 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/15/2015 and was last updated on 3/7/2023.

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	261QP2300X	Clinic/Center	Primary Care	ME94271	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	274282900	MEDICAID	FLORIDA
2	ME94271	OTHER	FLORIDA	FLORIDA STATE LICENSE

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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