Provider Demographics
NPI:1851442651
Name:PHYSICIANS INJURY CARE CENTER
Entity Type:Organization
Organization Name:PHYSICIANS INJURY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:COLVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-295-1441
Mailing Address - Street 1:5287 ALHAMBRA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-7203
Mailing Address - Country:US
Mailing Address - Phone:407-295-1441
Mailing Address - Fax:407-292-2331
Practice Address - Street 1:5287 ALHAMBRA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7203
Practice Address - Country:US
Practice Address - Phone:407-295-1441
Practice Address - Fax:407-292-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation