The Village Physician Llc | |
10435 Se 170th Pl Summerfield FL 34491-8998 | |
(352) 347-7332 | |
(347) 352-4478 |
Full Name | The Village Physician Llc |
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Speciality | Internal Medicine |
Location | 10435 Se 170th Pl, Summerfield, Florida |
Authorized Official Name and Position | Anis A Shahmiri (OWNER) |
Authorized Official Contact | 3522065688 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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The Village Physician Llc Po Box 7 Belleview FL 34421-0007 Ph: (352) 347-7332 | The Village Physician Llc 10435 Se 170th Pl Summerfield FL 34491-8998 Ph: (352) 347-7332 |
NPI Number | 1972856516 |
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Provider Enumeration Date | 10/19/2012 |
Last Update Date | 03/28/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972856516 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME0075362 (Florida) | Primary |
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