ASCENSION INTERNAL MEDICINE OF FLORIDA LLC NPI 1811233505

NPI Information

NPI: 1811233505
Provider Name: ASCENSION INTERNAL MEDICINE OF FLORIDA, LLC
Classification:
Entity Type: Organization

CLIA Number: 10D2188219

Address:
1426 CANYON AVE NE STE C
LIVE OAK, FL
ZIP 32064
Phone: (386) 208-0537
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ASCENSION INTERNAL MEDICINE OF FLORIDA, LLC is a healthcare provider in Live Oak, FL. ASCENSION INTERNAL MEDICINE OF FLORIDA, LLC NPI is 1811233505. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1426 CANYON AVE NE STE C
LIVE OAK, FL
ZIP 32064-832
Phone: (386) 208-0537
Fax: (386) 208-0571

The provider's authorized official is Malik M Naqi .
The authorized official title is Director and has the following contact phone number (386) 208-0537.

The CLIA number assigned to this NPI record is 10D2188219 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2012 and was last updated on 12/10/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine				No

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	008086300	MEDICAID	FLORIDA

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

NPI Synchronization or Removal

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