Provider Demographics
NPI:1992166284
Name:ACCESS IPC LLC
Entity type:Organization
Organization Name:ACCESS IPC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAVLIK
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:407-423-4761
Mailing Address - Street 1:2014 S. ORANGE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3069
Mailing Address - Country:US
Mailing Address - Phone:407-447-2273
Mailing Address - Fax:407-218-4621
Practice Address - Street 1:2014 S ORANGE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3069
Practice Address - Country:US
Practice Address - Phone:407-447-2273
Practice Address - Fax:407-218-4621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESS HEALTHCARE OF ORLANDO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-14
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty