Inverness Surgical Association P a

Primary specialty

SpecialistTaxonomy code 174400000X

License

80110207817 Issued in FL

Legal business name

INVERNESS SURGICAL ASSOCIATION P A

Practice address

403 W Highland Blvd
Inverness, FL 34452-4717

Phone

(352) 726-3646

Fax

(352) 726-0079

NPI assigned

Mar 7, 2006

Last updated

Jan 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marc E Fernandez, M.D.

Title

Officer/Secretary

Phone

(352) 726-3646

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1790752863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524717",
            "telephone_number": "352-726-3646",
            "fax_number": "352-726-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524717",
            "telephone_number": "352-726-3646",
            "fax_number": "352-726-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INVERNESS SURGICAL ASSOCIATION P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICER/SECRETARY",
        "authorized_official_telephone_number": "352-726-3646",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "80110207817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258062400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "38905",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrated Regional Laboratories Pathology Services, LLC
• Inverness Family Care High Risk PLLC
• Inverness Family Practice P a
• Inverness Health
• Inverness Medical Imaging LLC
• Inverness Tinnitus Center
• Inverness VA Clinic
• Shajetha Thivakaran Iyathurai, MD
• Amber Jackson
• Michael R Jacoby, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.