Provider Demographics
NPI:1427090802
Name:DRS PEELE & DEEB PA
Entity type:Organization
Organization Name:DRS PEELE & DEEB PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-877-7123
Mailing Address - Street 1:2416 E PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5301
Mailing Address - Country:US
Mailing Address - Phone:850-877-7123
Mailing Address - Fax:850-878-7036
Practice Address - Street 1:2416 E PLAZA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5301
Practice Address - Country:US
Practice Address - Phone:850-877-7123
Practice Address - Fax:850-878-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370103400Medicaid
FL45730OtherBSBC OF FL