Provider Demographics
NPI:1609059666
Name:CENTRAL FLORIDA PRIMARY CARE P L C
Entity Type:Organization
Organization Name:CENTRAL FLORIDA PRIMARY CARE P L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-248-8862
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-0884
Mailing Address - Country:US
Mailing Address - Phone:407-248-8862
Mailing Address - Fax:407-248-8863
Practice Address - Street 1:7345 W SAND LAKE RD
Practice Address - Street 2:SUITE 222
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5284
Practice Address - Country:US
Practice Address - Phone:407-248-8862
Practice Address - Fax:407-248-8863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94731207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AI004Medicare PIN