Provider Demographics
NPI:1417351743
Name:PHYSICIAN ASSOCIATES LLC
Entity Type:Organization
Organization Name:PHYSICIAN ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUHRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-262-5715
Mailing Address - Street 1:235 N WESTMONTE DR
Mailing Address - Street 2:
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 1:9679 LAKE NONA VILLAGE PLACE
Practice Address - Street 2:SUITE 101, 103, AND 104
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-9999
Practice Address - Country:US
Practice Address - Phone:407-245-1437
Practice Address - Fax:407-275-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty