NPIMap

Organization Active NPI

Physician Business Alliance Inc

  • Non-Pharmacy Dispensing Site
  • Clermont, FL
National Provider Identifier
1003439498
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
PHYSICIAN BUSINESS ALLIANCE INC
Practice address
2020 Oakley Seaver Dr Ste 3
Clermont, FL 34711-1902
Phone
(352) 242-0404
NPI assigned
May 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David H Lucas, MDNPI 1336131069
Title
Treasurer
Phone
(352) 242-0404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

2020 Oakley Seaver Dr Ste 3
Clermont, FL 34711-1902

Mailing address

2020 Oakley Seaver Dr Ste 3
Clermont, FL 34711-1902
Phone (352) 242-0404

Other names 1

  • Physician Business Alliance DBA Sports Medicine Institute Doing business as

National Provider Directory

National Provider Directory

Locations

2020 Oakley Seaver Dr
Ste 3
Clermont, FL 34711
Phone (352) 242-0404

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1003439498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 OAKLEY SEAVER DR STE 3",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111902",
            "telephone_number": "352-242-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 OAKLEY SEAVER DR STE 3",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111902",
            "telephone_number": "352-242-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN BUSINESS ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "352-242-0404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physician Business Alliance DBA Sports Medicine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.