SOUTHEASTERN INTEGRATED MEDICAL PL NPI 1912146853

NPI Information

  • NPI: 1912146853
  • Provider Name: SOUTHEASTERN INTEGRATED MEDICAL PL
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 10D0998279
  • Address: 3304 SW 34TH CIR
    OCALA, FL
    ZIP 34474
  • Phone: (352) 732-4438

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NPI Details

SOUTHEASTERN INTEGRATED MEDICAL PL is a diagnostic radiology radiology in Ocala, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SOUTHEASTERN INTEGRATED MEDICAL PL NPI is 1912146853. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3304 SW 34TH CIR
OCALA, FL
ZIP 34474-358
Phone: (352) 732-4438
Fax: (352) 291-0231

The provider's authorized official is Jesse C Brannen .
The authorized official title is Chief Operating Officer and has the following contact phone number (352) 224-2200.

The CLIA number assigned to this NPI record is 10D0998279 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2009 and was last updated on 2/17/2009.

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
12085R0202XRadiologyDiagnostic RadiologyFLORIDAYes

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
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: 11/21/2025

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