Organization
FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY SIBISKI (EXECUTIVE VICE PRESIDENT)
(352) 265-8017
Entity
Organization
Contact information
Practice address
13611 NW 1ST LN, STE 200, NEWBERRY, FL 32669-2664
(352) 265-8670
(352) 265-8671
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
(352) 265-8670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/21/2012
Last updated
10/27/2016
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