Provider Demographics
NPI:1164689204
Name:PHYSICIAN ASSOCIATES LLC
Entity Type:Organization
Organization Name:PHYSICIAN ASSOCIATES LLC
Other - Org Name:ORTHOPEDIC INSTITUTE OF CENTRAL FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUHRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-262-5710
Mailing Address - Street 1:235 N WESTMONTE DR
Mailing Address - Street 2:PHYSICIAN ASSOCIATES LLC
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 RODEL CV
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4859
Practice Address - Country:US
Practice Address - Phone:407-977-4101
Practice Address - Fax:407-977-4139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062757709Medicaid
FL062757700Medicaid
FL062757700Medicaid
FL062757709Medicaid