Provider Demographics
NPI:1992844351
Name:POINTE MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:POINTE MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-276-5700
Mailing Address - Street 1:1996 KINGSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4442
Mailing Address - Country:US
Mailing Address - Phone:904-276-5700
Mailing Address - Fax:904-272-1474
Practice Address - Street 1:1996 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4442
Practice Address - Country:US
Practice Address - Phone:904-276-5700
Practice Address - Fax:904-272-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069445305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ52252Medicare UPIN
FLK1868Medicare ID - Type UnspecifiedGROUP NUMBER
FLG36901Medicare UPIN
FLY5793ZMedicare ID - Type UnspecifiedMICHAEL DAILY PT
FL28509BMedicare ID - Type UnspecifiedDR BERNARD'S MC