Irvin C. Bembry, M.D.P.a.
Organization Active NPI Family Medicine Physician · Jasper, FL
NPI 1306174396 · NPPES record last updated Dec 2, 2009
Key facts
- NPI
- 1306174396
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 22041 (FL)
- Legal business name
- IRVIN C. BEMBRY, M.D.P.A.
- Practice address
- 413 5TH Ave NW
Jasper, FL 32052-7801 - Phone
- (386) 792-2985
- Fax
- (386) 792-0833
- NPI assigned
- Dec 2, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Irvin C Bembry, M.D.
- Title
- President
- Phone
- (386) 792-2985
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 22041 | FL | Yes |
Addresses
Primary practice location
413 5TH Ave NW
Jasper, FL 32052-7801
Mailing address
PO Box 1028
Jasper, FL 32052-1028
Phone (386) 792-2985
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055712900 | Medicaid | FL | |
| 18882 | Other | FL | BLUE CROSS AND BLUE SHIELD OF FL. |
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- Jasper FL Opco LLC
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All providers in Jasper, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.