Institute Of Internal Medicine P A

LBN: Institute Of Internal Medicine P A
Institute Of Internal Medicine P A is an health care organization with primary practice located at 1301 Plantation Island Dr S Ste 402B, St Augustine FL 32080-3108. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Institute Of Internal Medicine P A can be contacted via phone (904) 460-0707, or through Vivero, Carmen C via phone (904) 460-0707.

Contact Information

Primary practice address
1301 Plantation Island Dr S Ste 402B St Augustine FL 32080-3108
Phone: (904) 460-0707
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Vivero, Carmen C Doctor of Medicine (MD)
Phone: (904) 460-0707

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME76599 Florida
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X ME76599 Florida

Profile Details

NPI number 1457523003
LBN Legal business name Institute Of Internal Medicine P A
DBA Doing business as
Authorized official Vivero, Carmen C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 24th, 2008
Last updated Sep 15th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457523003 NPPES
Florida Other DN9360 RR MEDICARE
Florida Other 44784 RR MEDICARE
Florida MEDICAID 003271700 RR MEDICARE

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