SOUTHEASTERN CLINICAL SERVICES,INC. (NPI# 1033162011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033162011 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN CLINICAL SERVICES,INC. |
| Practice Address |
4215 Edgewater Orlando FL 32804 |
| Practice Telephone | 4075392000 |
| Practice Fax Number | 4073980050 |
| Mailing Telephone | 4075392000 |
| Mailing Fax Number | 4073980050 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-02-22 |
| Authorized Official Name | JOHN F BYRNES JR. (PRESIDENT) |
| Authorized Official Telephone | 4075392000 |
| Authorized Official Credential | PAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 290643100 | 05 |
| Street Address |
4215 EDGEWATER |
| City | ORLANDO |
| State | FL |
| Zip Code | 32804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881252716 | Alyssa Bass | Counselor | 3130 Edgewater Dr, Orlando, FL 32804 | 2019-06-05 |
| 1841856366 | Debora Cheryl Ramirez | Technician/Technologist | 1231 North Orange Ave, Orlando, FL 32804 | 2019-05-10 |
| 1679074009 | Jessica Dobbs | Counselor | 3801 Grant Blvd, Orlando, FL 32804 | 2018-02-21 |
| 1881109031 | Pedro Mendez Jr. | Counselor | 1800 W. Colonial Drive, Orlando, FL 32804 | 2017-12-11 |
| 1902259310 | Michael Lo | Nurse Practitioner | 2400 N Orange Ave Ste 302, Orlando, FL 32804 | 2016-07-20 |
| 1083093595 | Michael Gregg | Student in an Organized Health Care Education/Training Program | 2415 North Orange Avenue, Suite 400, Orlando, FL 32804 | 2015-05-29 |
| 1922485473 | Lindsay Rae Piet | Physician Assistant | 1910 N. Orange Ave., Orlando, FL 32804 | 2015-05-05 |
| 1093106189 | College Park Community Acupuncture & Herbal Medicine | Acupuncturist | 710 W. Princeton Street., Suite A, Orlando, FL 32804 | 2015-02-10 |
| 1164822359 | Orlando Sleep Solutions, LLC | Durable Medical Equipment & Medical Supplies | 2921 N. Orange Ave, Orlando, FL 32804 | 2014-08-26 |
| 1780926741 | Joseph Arturo Reza | Student in an Organized Health Care Education/Training Program | 2415 N Orange Ave #400, Orlando, FL 32804 | 2013-03-17 |
| Find all providers in zip 32804 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| 1750843405 | Heather Louise Anderson | Physician Assistant | 5422 Lewiston St, Orlando, FL 32812 | 2019-04-02 |
| 1649600891 | Raul F Velez | Physician Assistant | 14139 Budworth Cir, Orlando, FL 32832-6123 | 2013-11-24 |
| 1255630075 | Joleen Chapman | Physician Assistant | 122 Annie St, Orlando, FL 32806-1214 | 2011-03-18 |
| 1124354600 | Tiffany M Murray | Physician Assistant | 83 W Copeland Dr, Orlando, FL 32806-2002 | 2009-10-19 |
| 1225277825 | M Catherine Broderick | Physician Assistant | 1720 S Cook Avenue, Orlando, FL 32808 | 2009-02-05 |
| 1033360938 | Monica M Rivera | Physician Assistant | 2591 Carrickton Cir, Orlando, FL 32824-4217 | 2008-10-09 |
| 1316104383 | Michele D Young | Physician Assistant | 3802 Oakwater Cir Ste 3, Orlando, FL 32806-6200 | 2008-05-19 |
| 1386696631 | Kevin P Kingsley | Physician Assistant | 2501 N Orange Ave Ste 411, Orlando, FL 32804-4644 | 2006-05-16 |
| 1619928355 | Leslie Lauren Mackey | Physician Assistant | 601 E Rollins Ave, Orlando, FL 32803-1248 | 2006-05-15 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.