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Organization
PHYSICIAN ASSOCIATES LLC
Active
Organization
PHYSICIAN ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STUBEE (AVP)
(407) 481-7156
Entity
Organization
Contact information
Practice address
77 W UNDERWOOD ST, ORLANDO, FL 32806-1122
(407) 481-7139
Mailing address
3090 CARUSO CT STE 50, ORLANDO, FL 32806-8510
(407) 481-7139
(407) 481-7190
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062757700
—
FL
05
—
062757710
—
FL
Enumeration date
10/13/2005
Last updated
10/04/2019
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