Southeastern Integrated Medical Pl

LBN: Southeastern Integrated Medical Pl
Southeastern Integrated Medical Pl is an health care organization with primary practice located at 1315 Nw 21St Ave Suite 2, Chiefland FL 32626-1977. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty. Southeastern Integrated Medical Pl can be contacted via phone (352) 493-1741, or through Libnick, Jesse A via phone (352) 493-1741.

Contact Information

Primary practice address
1315 Nw 21St Ave Suite 2 Chiefland FL 32626-1977
Phone: (352) 493-1741
Fax: (352) 490-8641
Website:
Map and Directions
Authorized official contact:
Name: Libnick, Jesse A Doctor of Medicine (MD)
Phone: (352) 493-1741

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X ME68806 Florida

Profile Details

NPI number 1720419484
LBN Legal business name Southeastern Integrated Medical Pl
DBA Doing business as
Authorized official Libnick, Jesse A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 6th, 2013
Last updated Dec 6th, 2013 - about 12 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 1720419484 NPPES
Florida MEDICAID 058586600

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