Tricounty Medical Group, Llc | |
1906 Wingfield Dr Longwood FL 32779-7007 | |
(407) 637-2898 | |
Not Available |
Full Name | Tricounty Medical Group, Llc |
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Speciality | Internal Medicine |
Location | 1906 Wingfield Dr, Longwood, Florida |
Authorized Official Name and Position | Shahid Sharif (OWNER) |
Authorized Official Contact | 4076372898 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tricounty Medical Group, Llc 1906 Wingfield Dr Longwood FL 32779-7007 Ph: (407) 637-2898 | Tricounty Medical Group, Llc 1906 Wingfield Dr Longwood FL 32779-7007 Ph: (407) 637-2898 |
NPI Number | 1821496597 |
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Provider Enumeration Date | 12/12/2014 |
Last Update Date | 02/04/2015 |
Medicare PECOS PAC ID | 8729305073 |
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Medicare Enrollment ID | O20150325000586 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821496597 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME92280 (Florida) | Primary |
Provider Name | Shahid Sharif |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1578579272 PECOS PAC ID: 7012814882 Enrollment ID: I20050331000415 |
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