Provider Demographics
NPI:1821305863
Name:INVERNESS FAMILY PRACTICE P A
Entity Type:Organization
Organization Name:INVERNESS FAMILY PRACTICE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-860-0633
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34451-0909
Mailing Address - Country:US
Mailing Address - Phone:352-860-0633
Mailing Address - Fax:352-344-8218
Practice Address - Street 1:2222 HIGHWAY 44 W
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3860
Practice Address - Country:US
Practice Address - Phone:352-860-0633
Practice Address - Fax:352-344-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62708261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF47727Medicare UPIN