Provider Demographics
NPI:1508017005
Name:THRESHOLD HEALTH SYSTEMS
Entity Type:Organization
Organization Name:THRESHOLD HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:ESQUIRE
Authorized Official - Phone:407-671-7060
Mailing Address - Street 1:3550 N GOLDENROD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8823
Mailing Address - Country:US
Mailing Address - Phone:321-527-2064
Mailing Address - Fax:321-527-2065
Practice Address - Street 1:3550 N GOLDENROD RD STE 1
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8823
Practice Address - Country:US
Practice Address - Phone:321-527-2064
Practice Address - Fax:321-527-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP331552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty