Southeastern Integrated Medical Pl

LBN: Southeastern Integrated Medical Pl
Southeastern Integrated Medical Pl is an health care organization with primary practice located at 4881 Nw 8Th Ave Suite 2, Gainesville FL 32605-4582. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Southeastern Integrated Medical Pl can be contacted via phone (352) 224-2486, or through Brannen, Jesse C via phone (352) 224-2200.

Contact Information

Primary practice address
4881 Nw 8Th Ave Suite 2 Gainesville FL 32605-4582
Phone: (352) 224-2486
Fax: (352) 331-6550
Website:
Map and Directions
Authorized official contact:
Name: Brannen, Jesse C
Phone: (352) 224-2200

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X PY6591 Florida

Profile Details

NPI number 1093970162
LBN Legal business name Southeastern Integrated Medical Pl
DBA Doing business as
Authorized official Brannen, Jesse C
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 28th, 2008
Last updated Jul 28th, 2008 - about 18 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 1093970162 NPPES
Florida MEDICAID 058586600

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