Internal Medicine Group of Winter Haven,P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE GROUP OF WINTER HAVEN,P.A.

Practice address

400 Avenue K SE
Suite 11
Winter Haven, FL 33880-4146

Phone

(863) 294-4404

Fax

(863) 294-1059

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Brenda D Allen

Title

Office Manager

Phone

(863) 294-4404

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1306879721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 AVENUE K SE",
            "address_2": "SUITE 11",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804146",
            "telephone_number": "863-294-4404",
            "fax_number": "863-294-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVENUE K SE",
            "address_2": "SUITE 11",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804146",
            "telephone_number": "863-294-4404",
            "fax_number": "863-294-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE GROUP OF WINTER HAVEN,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "863-294-4404"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253257300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Susan Iskowitz, LCSW
• Esaam El-Dean Ismail, O.D.
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• J. Agustin Lacson M.D. Inc
• J&Y Assisted Living for the Ages

• Internal Medicine Physician in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.