Organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Active
Parent organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN INTEGRATED MEDICAL PL
Authorized official
DANIEL M DUNCANSON M.D.,C.P.E. (CHEIF EXECUTIVE OFFICER)
(352) 224-2200
Entity
Organization
Contact information
Practice address
4343 W NEWBERRY RD, GAINESVILLE, FL 32607-2817
(352) 224-2200
(352) 224-2484
Mailing address
4881 NW 8TH AVE, SUITE 2, GAINESVILLE, FL 32605-4582
(352) 547-2373
(352) 416-1813
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
207KA0200X
Allergy Physician
—
—
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207U00000X
Nuclear Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VG0400X
Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058586600
—
FL
Enumeration date
01/17/2006
Last updated
03/09/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us