Professional Family Practice

NPI 1275962680 - Clinic/Center - 261QP2300X

NPI Details
NPI 1275962680
Enumeration Date 11/06/2013
Last Updated 02/26/2014
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name PURNAMA D PURNAMA
Position OWNER
Phone (352) 404-7707
Fax (888) 488-0722
Practice Location
725 ALMOND ST
CLERMONT FL, 34711-3120, US
Phone (352) 404-7707
Fax (888) 488-0722
Business Location
2105 HARTWOOD MARSH RD
CLERMONT FL, 34711-5389, US
Phone (352) 404-7707
Fax (888) 488-0722
Toxanomy
Taxonomy Code 261QP2300X
License State Florida
License Number ME85427
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According to our database, Professional Family Practice NPI is 1275962680, taxonomy code is 261QP2300X and license number is ME85427, license state is located at Florida. Professional Family Practice physically located at 725 Almond St, Clermont FL, 34711-3120. NPI Number 1033115704 has the healthcare provider type.

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1275962680 NPI number is provided on an as is basis without warranty of any kind. 1275962680 is maintained by the National Plan & Provider Enumeration System. The contents of Professional Family Practice are for informational purposes only.