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
1600 SW ARCHER RD, # 100294, GAINESVILLE, FL 32610-0294
(352) 273-7562
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
(352) 265-8017
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053482002
—
FL
Enumeration date
06/22/2007
Last updated
07/19/2016
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