Provider Demographics
NPI:1215359609
Name:CONSULTANT PHYSICIANS OF FLORIDA LLC
Entity Type:Organization
Organization Name:CONSULTANT PHYSICIANS OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-702-9342
Mailing Address - Street 1:460 RACCOON ST
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3802
Mailing Address - Country:US
Mailing Address - Phone:407-702-9342
Mailing Address - Fax:407-878-6548
Practice Address - Street 1:460 RACCOON ST
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3802
Practice Address - Country:US
Practice Address - Phone:407-702-9342
Practice Address - Fax:407-878-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty