1114731239 NPI number — FLORIDA HOSPITAL MEDICAL GROUP INC

Table of content: MRS. MEGAN JANE DALSING RD, LD (NPI 1184065153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114731239 NPI number — FLORIDA HOSPITAL MEDICAL GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLORIDA HOSPITAL MEDICAL GROUP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114731239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 935933
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31193-5933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-737-5654
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7975 LAKE UNDERHILL RD STE 330
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32822-8210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-407-4070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2025

Additional Information

Authorized Official

Authorized Official Last Name:
MCLARREN
Authorized Official First Name:
VANCE
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
407-200-2700

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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