Individual
SEGUNDO IMBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540 CITRUS MEDICAL, OCOEE, FL 34761
(407) 896-8097
(407) 898-8328
Mailing address
1540 CITRUS MEDICAL, OCOEE, FL 34761
(407) 896-8097
(407) 898-8328
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME65235
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME65235
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25179
BCBS
FL
01
—
260051877
RAILROAD MEDICARE
—
05
—
375824900
—
FL
Enumeration date
05/20/2006
Last updated
10/24/2019
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