Provider Demographics
NPI:1982758561
Name:NORTH SEMINOLE FAMILY PRACTICE ASSOC P A
Entity Type:Organization
Organization Name:NORTH SEMINOLE FAMILY PRACTICE ASSOC P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-321-4230
Mailing Address - Street 1:2209 S FRENCH AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-4245
Mailing Address - Country:US
Mailing Address - Phone:407-321-4230
Mailing Address - Fax:407-324-7642
Practice Address - Street 1:2209 S FRENCH AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-4245
Practice Address - Country:US
Practice Address - Phone:407-321-4230
Practice Address - Fax:407-324-7642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0368680001Medicare NSC
FL97601Medicare ID - Type UnspecifiedGROUP ID NUMBER