Dynamic Health Centers | |
163 Sw Stonegate Ter Ste 109 Lake City FL 32024-3459 | |
(386) 438-8391 | |
Not Available |
Full Name | Dynamic Health Centers |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 163 Sw Stonegate Ter Ste 109, Lake City, Florida |
Authorized Official Name and Position | Melissa Distefano (PRESIDENT) |
Authorized Official Contact | 3522625625 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Dynamic Health Centers 163 Sw Stonegate Ter Ste 109 Lake City FL 32024-3459 Ph: (386) 438-8391 | Dynamic Health Centers 163 Sw Stonegate Ter Ste 109 Lake City FL 32024-3459 Ph: (386) 438-8391 |
NPI Number | 1508181272 |
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Provider Enumeration Date | 04/06/2010 |
Last Update Date | 07/29/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508181272 | NPI | - | NPPES |
006309100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | HCC8936 (Florida) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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