Provider Demographics
NPI:1497196240
Name:ADVANCED CARE PHYSICIANS GROUP , PA
Entity Type:Organization
Organization Name:ADVANCED CARE PHYSICIANS GROUP , PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KINGSLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASARE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-729-9000
Mailing Address - Street 1:9555 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-2562
Mailing Address - Country:US
Mailing Address - Phone:727-729-9000
Mailing Address - Fax:
Practice Address - Street 1:9555 SEMINOLE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-2562
Practice Address - Country:US
Practice Address - Phone:727-729-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 10525207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty