Vqol Primary Care Physician | |
8550 Ne 138th Ln Ste 102 Lady Lake FL 32159-6816 | |
(352) 314-2922 | |
Not Available |
Full Name | Vqol Primary Care Physician |
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Speciality | Clinic/Center |
Location | 8550 Ne 138th Ln Ste 102, Lady Lake, Florida |
Authorized Official Name and Position | Claude Danois (PRESIDENT) |
Authorized Official Contact | 3523142922 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vqol Primary Care Physician Po Box 490625 Leesburg FL 34749-0625 Ph: (352) 314-2922 | Vqol Primary Care Physician 8550 Ne 138th Ln Ste 102 Lady Lake FL 32159-6816 Ph: (352) 314-2922 |
NPI Number | 1083045918 |
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Provider Enumeration Date | 12/03/2013 |
Last Update Date | 04/02/2019 |
Medicare PECOS PAC ID | 8921237660 |
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Medicare Enrollment ID | O20140129001387 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083045918 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | ME106117 (Florida) | Primary |
Provider Name | Claude Danois |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1205870938 PECOS PAC ID: 9931114055 Enrollment ID: I20110928000735 |
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