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Organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Active
Organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Active
Parent organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN INTEGRATED MEDICAL PL
Authorized official
AMY E CLUNN M.D. (PHYSICIAN)
(352) 732-4438
Entity
Organization
Contact information
Practice address
3305 SW 34TH CIR, SUITE 101, OCALA, FL 34474-6616
(352) 732-4438
(352) 732-0028
Mailing address
3305 SW 34TH CIR, SUITE 101, OCALA, FL 34474-6616
(352) 732-4438
(352) 732-0028
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
ME86226
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058586600
—
FL
Enumeration date
12/06/2013
Last updated
12/06/2013
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