| Mid-florida Primary Care Pa | |
|
17809 Se 109th Ave Mid-florida Primary Care Pa Summerfield FL 34491-8912 | |
| (352) 307-4200 | |
| (352) 307-2520 |
| Full Name | Mid-florida Primary Care Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 17809 Se 109th Ave, Summerfield, Florida |
| Authorized Official Name and Position | Ravi P Gupta (PRESIDENT) |
| Authorized Official Contact | 3527284242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-florida Primary Care Pa 401 North Blvd W Leesburg FL 34748-5044 Ph: (352) 728-4242 | Mid-florida Primary Care Pa 17809 Se 109th Ave Mid-florida Primary Care Pa Summerfield FL 34491-8912 Ph: (352) 307-4200 |
| NPI Number | 1235328592 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235328592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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