Indian River Medical Office Pa

LBN: Indian River Medical Office Pa
Indian River Medical Office Pa is an health care organization with primary practice located at 3300 Dairy Rd , Titusville FL 32796-1512. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Indian River Medical Office Pa can be contacted via phone (321) 269-6530, or through Whittamore, Jill D via phone (321) 267-6687.

Contact Information

Primary practice address
3300 Dairy Rd Titusville FL 32796-1512
Phone: (321) 269-6530
Fax: (321) 269-2334
Website:
Map and Directions
Authorized official contact:
Name: Whittamore, Jill D CMM CPC
Phone: (321) 267-6687

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1245220557
LBN Legal business name Indian River Medical Office Pa
DBA Doing business as
Authorized official Whittamore, Jill D CMM CPC
Entity Organization
Organization subpart 1 No
Enumeration date Oct 27th, 2005
Last updated Mar 3rd, 2011 - about 14 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 1245220557 NPPES
Florida MEDICAID 250742100
Florida Other 40745

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