Provider Demographics
NPI:1346229101
Name:INFECTIOUS DISEASE OF CENTRAL FL
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE OF CENTRAL FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-246-1946
Mailing Address - Street 1:22 WEST LAKE BEAUTY DR.
Mailing Address - Street 2:STE 104
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2945
Mailing Address - Country:US
Mailing Address - Phone:407-246-1946
Mailing Address - Fax:407-246-1411
Practice Address - Street 1:22 LAKE BEAUTY DR
Practice Address - Street 2:STE 104
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2037
Practice Address - Country:US
Practice Address - Phone:407-246-1946
Practice Address - Fax:407-246-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040887500Medicaid
FL040887500Medicaid
FLD62558Medicare UPIN