Provider Demographics
NPI:1629515325
Name:EFFINGER HEALTH, PA
Entity Type:Organization
Organization Name:EFFINGER HEALTH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LANTZ
Authorized Official - Last Name:EFFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:888-698-2714
Mailing Address - Street 1:1891 CAPITAL CIR NE STE 9
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4486
Mailing Address - Country:US
Mailing Address - Phone:888-698-2714
Mailing Address - Fax:888-698-2714
Practice Address - Street 1:1891 CAPITAL CIR NE STE 9
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4486
Practice Address - Country:US
Practice Address - Phone:888-698-2714
Practice Address - Fax:888-698-2714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003429700Medicaid
FL003429700Medicaid