Provider Demographics
NPI:1316232200
Name:CENTRAL FLORIDA ACCIDENT AND INJURY
Entity type:Organization
Organization Name:CENTRAL FLORIDA ACCIDENT AND INJURY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ENTWISTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-344-4878
Mailing Address - Street 1:1611 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3304
Mailing Address - Country:US
Mailing Address - Phone:407-344-4878
Mailing Address - Fax:407-344-7878
Practice Address - Street 1:17315 PAGONIA RD STE 103
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5956
Practice Address - Country:US
Practice Address - Phone:407-344-4878
Practice Address - Fax:407-344-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-18
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center