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704 Doctors Ct Leesburg FL 34748-7314 | |
| (352) 326-7850 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 704 Doctors Ct, Leesburg, Florida |
| Authorized Official Name and Position | Regina Ingram (ADMINISTRATOR) |
| Authorized Official Contact | 3527286808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
511 Medical Plaza Dr Leesburg FL 34748-7326 Ph: (352) 728-6808 | 704 Doctors Ct Leesburg FL 34748-7314 Ph: (352) 326-7850 |
| NPI Number | 1154453074 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154453074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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