Provider Demographics
NPI:1033390489
Name:INTERNAL MEDICINE OF CENTRAL FLORIDA PA
Entity Type:Organization
Organization Name:INTERNAL MEDICINE OF CENTRAL FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-504-0381
Mailing Address - Street 1:PO BOX 493110
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-3110
Mailing Address - Country:US
Mailing Address - Phone:352-504-0381
Mailing Address - Fax:352-315-1989
Practice Address - Street 1:708 PHYSICIANS CT
Practice Address - Street 2:SUITE 1
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7364
Practice Address - Country:US
Practice Address - Phone:352-504-0381
Practice Address - Fax:352-315-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI06324Medicare UPIN