Organization
PHOENIX INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT POWERS D.O. (PRESIDENT)
(407) 906-5092
Entity
Organization
Contact information
Practice address
5579 S ORANGE AVE, EDGEWOOD, FL 32809-3493
(407) 906-5092
(407) 641-8133
Mailing address
127 W FAIRBANKS AVE # 374, WINTER PARK, FL 32789-4326
(407) 906-5092
(407) 641-8133
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003812400
—
FL
Enumeration date
04/01/2019
Last updated
10/09/2020
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