Provider Demographics
NPI:1285795641
Name:CENTRAL FLORIDA INTERNAL MEDICINE ASSOCIATES, P.L.
Entity type:Organization
Organization Name:CENTRAL FLORIDA INTERNAL MEDICINE ASSOCIATES, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SETTEMBRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-646-9663
Mailing Address - Street 1:4725 US HIGHWAY 98 S
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4334
Mailing Address - Country:US
Mailing Address - Phone:863-646-9663
Mailing Address - Fax:863-646-9664
Practice Address - Street 1:4725 US HIGHWAY 98 S
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4254
Practice Address - Country:US
Practice Address - Phone:863-646-9663
Practice Address - Fax:863-646-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1285795641OtherNPI
FL28191OtherBLUE CROSS BLUE SHIELD
FL379364800Medicaid
FL28191OtherBLUE CROSS BLUE SHIELD
FL379364800Medicaid