Park Lake Physical Medicine, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PARK LAKE PHYSICAL MEDICINE, LLC

Doing business as

Integrative Physical Medicine

Practice address

2206 E Colonial Dr
Orlando, FL 32803-4912

Phone

(407) 839-1045

Fax

(407) 839-1044

NPI assigned

Nov 23, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Shelby Anne Reid

Title

Manager

Phone

(407) 839-1045

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Integrative Physical Medicine Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bret G Scheuplein, BS DC

  • Chiropractor
  • Orlando, FL
  • NPI 1548390552
  NPD (past)

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1669749396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034912",
            "telephone_number": "407-839-1045",
            "fax_number": "407-839-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034912",
            "telephone_number": "407-839-1045",
            "fax_number": "407-839-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK LAKE PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-839-1045",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "6694190001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrative Physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Ana Oliva Parinas
• Wendel Ivey Parish, PHARMOCIST
• Erin Craig Parisi, LMHC, MCAP, QS
• Janecya Parisien
• Park Chiropractic LLC
• Park Place Medical, LLC
• Eunice Park, PHARM.D
• Jiin Park, DC
• Kwang Jin Park, NP
• Rebecca Park, MS, CCC-SLP

• Physical Medicine & Rehabilitation Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.