# FLORIDA INTERNAL MEDICINE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831136274
- **Authorized official:** DR. GLEN F DAVIS MD (PRESIDENT)
- **Authorized official phone:** (407) 333-2503

## Contact information

- **Practice address:** 4106 W LAKE MARY BLVD, SUITE 301, LAKE MARY, FL 32746-3315
- **Practice address phone:** (407) 333-2503
- **Practice address fax:** (407) 333-0962
- **Mailing address:** 4106 W LAKE MARY BLVD, SUITE 301, LAKE MARY, FL 32746-3315
- **Mailing address phone:** (407) 333-2503
- **Mailing address fax:** (407) 333-0962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/02/2006
- **Last updated:** 08/23/2007