Organization
PHYSICIAN ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS J BUHRING (CEO)
(407) 262-5757
Entity
Organization
Contact information
Practice address
2107 DAIRY RD, MELBOURNE, FL 32904-5209
(321) 259-1054
(321) 989-0246
Mailing address
235 N WESTMONTE DR, ALTAMONTE SPRINGS, FL 32714-3345
(407) 262-5710
(407) 262-5796
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME77004
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
ME77004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062757700
—
FL
01
—
97037
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/24/2010
Last updated
03/24/2010
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