MOUNT DORA FAMILY PRACTICE PA NPI 1073639969

NPI Information

NPI: 1073639969
Provider Name: MOUNT DORA FAMILY PRACTICE PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
18540 US HIGHWAY 441
MOUNT DORA, FL
ZIP 32757
Phone: (352) 383-7743
Get Directions

MOUNT DORA FAMILY PRACTICE PA is a family medicine in Mount Dora, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MOUNT DORA FAMILY PRACTICE PA NPI is 1073639969. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

18540 US HIGHWAY 441
MOUNT DORA, FL
ZIP 32757-725
Phone: (352) 383-7743
Fax: (352) 383-9226

The provider's authorized official is Robert Dale Lynch .
The authorized official title is Owner and has the following contact phone number (352) 383-7743.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 1/8/2008.

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
1	207Q00000X	Family Medicine		ME55532	FLORIDA	Yes

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
1	274649200	MEDICAID	FLORIDA
2	DA2650	OTHER	FLORIDA	RR MEDICARE
3	G19132	MEDICARE UPIN	FLORIDA
4	27928V	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA

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

NPI Synchronization or Removal

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