Provider Demographics
NPI:1760080212
Name:SUMMIT HEALTH MULTI SPECIALTY OF FLORIDA LLC
Entity Type:Organization
Organization Name:SUMMIT HEALTH MULTI SPECIALTY OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-473-0973
Mailing Address - Street 1:3247 Q ST NW STE 152
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-3047
Mailing Address - Country:US
Mailing Address - Phone:240-469-2181
Mailing Address - Fax:
Practice Address - Street 1:1881 W KENNEDY BLVD STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1611
Practice Address - Country:US
Practice Address - Phone:240-469-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty