| |
15016 Us Highway 441, Eustis, FL 32726-6589 | |
(352) 742-9577 | |
(352) 742-3584 |
Full Name | |
---|---|
Type | Facility |
Speciality | Pain Medicine - Pain Medicine |
Location | 15016 Us Highway 441, Eustis, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770521296 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH7897 (Florida) | Primary |
207R00000X | Internal Medicine | ME77919 (Florida) | Primary |
208VP0000X | Pain Medicine - Pain Medicine | ME77919 (Florida) | Primary |
Mailing Address | Practice Location Address |
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15016 Us Highway 441, Eustis, FL 32726-6589 Ph: (352) 742-9577 | 15016 Us Highway 441, Eustis, FL 32726-6589 Ph: (352) 742-9577 |