Central Florida Medical & Diagnostic Clinic, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME0031535 Issued in FL

Legal business name

CENTRAL FLORIDA MEDICAL & DIAGNOSTIC CLINIC, PA

Practice address

3327 Medical Hill Rd
Sebring, FL 33870-5531

Phone

(863) 386-9122

Fax

(863) 386-0566

NPI assigned

Mar 14, 2013

Last updated

Jul 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George W Ibrahim, M.D.

Title

Dir

Phone

(863) 386-9122

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1144561234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 MEDICAL HILL RD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338705531",
            "telephone_number": "863-386-9122",
            "fax_number": "863-386-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 MEDICAL HILL RD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338705531",
            "telephone_number": "863-386-9122",
            "fax_number": "863-386-0566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6721 US Highway 27 S",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "338765737",
            "country_code": "US",
            "telephone_number": "863-386-9122",
            "fax_number": "863-386-0566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL FLORIDA MEDICAL & DIAGNOSTIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2021-07-07",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIR",
        "authorized_official_telephone_number": "863-386-9122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0031535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.