Interventional Medical Associates LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME82864 Issued in FL

Legal business name

INTERVENTIONAL MEDICAL ASSOCIATES LLC

Practice address

6821 NW 11TH PL
Gainesville, FL 32605-4216

Phone

(352) 331-3353

Fax

(352) 333-9035

NPI assigned

Dec 5, 2005

Organization subpart

No

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

Authorized official

Name

Robyn Gann

Title

Practice Manager

Phone

(352) 331-3353

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1487638219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6821 NW 11TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054216",
            "telephone_number": "352-331-3353",
            "fax_number": "352-333-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6821 NW 11TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054216",
            "telephone_number": "352-331-3353",
            "fax_number": "352-333-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "GANN",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "352-331-3353"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME82864",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME76862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.