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PROMISE MEDICAL GROUP PLLC NPI 1043560832


NPI Information

NPI: 1043560832
Provider Name: PROMISE MEDICAL GROUP, PLLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
2351 CLEARWATER RUN
THE VILLAGES, FL
ZIP 32162
Phone: (352) 812-0579
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PROMISE MEDICAL GROUP, PLLC is an internal medicine in The Villages, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PROMISE MEDICAL GROUP, PLLC NPI is 1043560832. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2351 CLEARWATER RUN
THE VILLAGES, FL
ZIP 32162
Phone: (352) 812-0579

The provider's authorized official is David Wayne Stephenson .
The authorized official title is President and has the following contact phone number (352) 812-0579.

The enumeration date for this NPI number is 9/19/2012 and was last updated on 10/23/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineME106525FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1FD876ZOTHERFLORIDAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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