Provider Demographics
NPI:1912117797
Name:EMERGENCY AND ACUTE CARE MEDICAL COMPANY - SOUTHEAST, LLC
Entity type:Organization
Organization Name:EMERGENCY AND ACUTE CARE MEDICAL COMPANY - SOUTHEAST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRUEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-759-4765
Mailing Address - Street 1:PO BOX 227118
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-7118
Mailing Address - Country:US
Mailing Address - Phone:858-759-4765
Mailing Address - Fax:858-201-4987
Practice Address - Street 1:555 W STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5119
Practice Address - Country:US
Practice Address - Phone:407-767-5853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty