Provider Demographics
NPI:1518100775
Name:INTERNALCARE PLLC
Entity Type:Organization
Organization Name:INTERNALCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-831-1140
Mailing Address - Street 1:12207 HIGHWAY 49
Mailing Address - Street 2:SUITE 40
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-2955
Mailing Address - Country:US
Mailing Address - Phone:228-831-1140
Mailing Address - Fax:228-831-1104
Practice Address - Street 1:12207 HIGHWAY 49
Practice Address - Street 2:SUITE 40
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-2955
Practice Address - Country:US
Practice Address - Phone:228-831-1140
Practice Address - Fax:228-831-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20037207R00000X
MSR858126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty