TOMMY L LOUISVILLE MD PA NPI 1508012477

NPI Information

TOMMY L LOUISVILLE MD PA is an urgent care clinic center in Avon Park, FL. TOMMY L LOUISVILLE MD PA NPI is 1508012477. The provider is registered as an organization entity type.

The provider's business location address is:

1598 US 27 N
AVON PARK, FL
ZIP 33825-151
Phone: (863) 452-1980
Fax: (407) 386-3342

The provider's authorized official is Tommy L Louisville .
The authorized official title is Ceo and has the following contact phone number (863) 452-1980.

The enumeration date for this NPI number is 8/12/2008 and was last updated on 8/12/2008.

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:

Other Identifiers

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

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