Provider Demographics
NPI:1700273000
Name:HOME PHYSICIANS GROUP P.A.
Entity Type:Organization
Organization Name:HOME PHYSICIANS GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NURIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-590-6399
Mailing Address - Street 1:1834 N ALAFAYA TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4743
Mailing Address - Country:US
Mailing Address - Phone:321-235-0692
Mailing Address - Fax:321-235-0694
Practice Address - Street 1:1834 N ALAFAYA TRL
Practice Address - Street 2:STE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4743
Practice Address - Country:US
Practice Address - Phone:321-235-0694
Practice Address - Fax:321-235-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7691207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty