Provider Demographics
NPI:1336153709
Name:FLORIDA MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:FLORIDA MEDICAL ASSOCIATES LLC
Other - Org Name:VIPCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP - OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:SRIRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDARAMOORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-622-7000
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5735
Mailing Address - Country:US
Mailing Address - Phone:352-509-9900
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:13940 N US HIGHWAY 441 STE 102
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8909
Practice Address - Country:US
Practice Address - Phone:352-751-9900
Practice Address - Fax:844-388-6186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty