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1120 Citrus Tower Blvd Suite # 300 Clermont FL 34711-1909 | |
| (352) 243-0206 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1120 Citrus Tower Blvd, Clermont, Florida |
| Authorized Official Name and Position | Pateesha Bruten (BILLING MANGER) |
| Authorized Official Contact | 9546568855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2929 N University Dr Suite # 110 Coral Springs FL 33065-5081 Ph: (954) 656-8855 | 1120 Citrus Tower Blvd Suite # 300 Clermont FL 34711-1909 Ph: (352) 243-0206 |
| NPI Number | 1205062163 |
|---|---|
| Provider Enumeration Date | 06/05/2009 |
| Last Update Date | 11/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205062163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME103291 (Florida) | Primary |
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