Provider Demographics
NPI:1073556767
Name:INPHYNET CONTRACTING SERVICES LLC
Entity Type:Organization
Organization Name:INPHYNET CONTRACTING SERVICES LLC
Other - Org Name:INPHYNET CONTRACTING SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CORVINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-424-3672
Mailing Address - Street 1:PO BOX 634702
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4702
Mailing Address - Country:US
Mailing Address - Phone:800-424-3672
Mailing Address - Fax:954-377-3042
Practice Address - Street 1:5352 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6514
Practice Address - Country:US
Practice Address - Phone:561-495-3115
Practice Address - Fax:561-495-3103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060947100Medicaid
FL33458OtherBS FL
FL251538504Medicaid
FL063080200Medicaid
FLCA6878OtherMEDICARE TRAVELERS RR
FL055237201Medicaid
FL060967600Medicaid
FLCA7094OtherMEDICARE TRAVELERS RR - G
FL060947100Medicaid
FLCA6878OtherMEDICARE TRAVELERS RR
FLCA7094OtherMEDICARE TRAVELERS RR - G
FL21168CMedicare PIN