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Organization
HAINES CITY INTERNAL MEDICINE PA
Active
Organization
HAINES CITY INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY C STINE JR. MD (PART OWNER)
(863) 422-9562
Entity
Organization
Contact information
Practice address
608 INGRAHAM AVE, HAINES CITY, FL 33844-4330
(863) 422-9562
(863) 421-3246
Mailing address
608 INGRAHAM AVENUE, HAINES CITY, FL 33844-5619
(863) 422-9562
(863) 421-3246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0050219
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259269000
—
FL
Enumeration date
01/25/2007
Last updated
04/24/2020
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