NPIMap

Organization Active NPI

P-3 Medical Inc

  • Family Medicine Physician
  • Mount Dora, FL
National Provider Identifier
1235457219
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME30738 Issued in FL
Legal business name
P-3 MEDICAL INC
Practice address
7004 Norne LN
Mount Dora, FL 32757-7076
Phone
(407) 361-7565
NPI assigned
May 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Mrs. Patty L Polley, LPNNPI 1184856262
Title
President
Phone
(407) 361-7565

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME30738 FL Primary

Addresses

Primary practice location

7004 Norne LN
Mount Dora, FL 32757-7076

Mailing address

PO Box 1910
Mount Dora, FL 32756-1910
Phone (407) 361-7565

National Provider Directory

National Provider Directory

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": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1235457219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1910",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327561910",
            "telephone_number": "407-361-7565",
            "fax_number": "352-383-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7004 NORNE LN",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327577076",
            "telephone_number": "407-361-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P-3 MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "POLLEY",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-361-7565",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME30738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.