Provider Demographics
NPI:1588093405
Name:PHYSICIANS CARE CENTERS OF KISSIMMEE LLC
Entity type:Organization
Organization Name:PHYSICIANS CARE CENTERS OF KISSIMMEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-385-0731
Mailing Address - Street 1:595 OAK COMMONS BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:561-385-0731
Mailing Address - Fax:
Practice Address - Street 1:595 OAK COMMONS BLVD
Practice Address - Street 2:STE A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4211
Practice Address - Country:US
Practice Address - Phone:561-385-0731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty