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19228 Nw Us Highway 441 High Springs FL 32643-8783 | |
| (386) 454-1156 | |
| (386) 454-1158 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 19228 Nw Us Highway 441, High Springs, Florida |
| Authorized Official Name and Position | Nasir Ahmed (PHYSICAN) |
| Authorized Official Contact | 3864541156 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
19228 Nw Us Highway 441 High Springs FL 32643-8783 Ph: (386) 454-1156 | 19228 Nw Us Highway 441 High Springs FL 32643-8783 Ph: (386) 454-1156 |
| NPI Number | 1710438015 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 10/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710438015 | NPI | - | NPPES |
| 007470000 | Medicaid | FL | |
| 003432700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | ME97945 (Florida) | Primary |
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