Provider Demographics
NPI:1316989676
Name:FREDERICK R BEHRINGER JR MD PA
Entity type:Organization
Organization Name:FREDERICK R BEHRINGER JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEHRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-629-8881
Mailing Address - Street 1:2611 SE 17TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5587
Mailing Address - Country:US
Mailing Address - Phone:352-629-8881
Mailing Address - Fax:352-629-1220
Practice Address - Street 1:2611 SE 17TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5587
Practice Address - Country:US
Practice Address - Phone:352-629-8881
Practice Address - Fax:352-629-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036163174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070012734OtherRAILROAD MEDICARE
FL42142OtherBCBS OF FL ID NUMBER
FL500005345OtherRAILROAD MEDICARE
FL5596171OtherAETNA
FLK0658Medicare ID - Type UnspecifiedGROUP NUMBER
FL42142ZMedicare ID - Type UnspecifiedDR FREDERICK BEHRINGER
FL500005345OtherRAILROAD MEDICARE
FLE1642ZMedicare ID - Type UnspecifiedDAVID GOODMAN
FL5596171OtherAETNA