Provider Demographics
NPI:1114956935
Name:PARSONS MEDICAL CENTER
Entity Type:Organization
Organization Name:PARSONS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMARJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DHALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-689-9900
Mailing Address - Street 1:PO BOX 3550
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-3550
Mailing Address - Country:US
Mailing Address - Phone:813-689-9900
Mailing Address - Fax:813-653-9696
Practice Address - Street 1:1082 E BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5509
Practice Address - Country:US
Practice Address - Phone:813-689-9900
Practice Address - Fax:813-653-9696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARSONS MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-02
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98072207Q00000X
FLME59912207R00000X
FLME88758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21699Medicare PIN