Provider Demographics
NPI:1386894319
Name:PLANT CITY INTERNAL MEDICINE SPECIALISTS, P.A.
Entity type:Organization
Organization Name:PLANT CITY INTERNAL MEDICINE SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:FYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-754-3344
Mailing Address - Street 1:1907 S ALEXANDER ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-8419
Mailing Address - Country:US
Mailing Address - Phone:813-754-3344
Mailing Address - Fax:813-754-3574
Practice Address - Street 1:1907 S ALEXANDER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-8419
Practice Address - Country:US
Practice Address - Phone:813-754-3344
Practice Address - Fax:813-754-3574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty