NPIMap

Organization Active NPI

Southeastern Clinical Services,Inc.

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1033162011
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
SOUTHEASTERN CLINICAL SERVICES,INC.
Practice address
4215 Edgewater
Orlando, FL 32804
Phone
(407) 539-2000
Fax
(407) 398-0050
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
John F Byrnes Jr., PACNPI 1639163629
Title
President
Phone
(407) 539-2000

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
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

4215 Edgewater
Orlando, FL 32804

Mailing address

4215 Edgewater
Orlando, FL 32804
Phone (407) 539-2000

Other identifiers 1

IdentifierTypeStateIssuer
290643100MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1033162011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 EDGEWATER",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-539-2000",
            "fax_number": "407-398-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 EDGEWATER",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-539-2000",
            "fax_number": "407-398-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN CLINICAL SERVICES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "BYRNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-539-2000",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290643100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.