Healthcare Provider Details

I. General information

NPI: 1235142209
Provider Name (Legal Business Name): TOTAL HEALTH CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 SW 4TH PL
GAINESVILLE FL
32607-3112
US

IV. Provider business mailing address

2728 SW 4TH PL
GAINESVILLE FL
32607-3112
US

V. Phone/Fax

Practice location:
  • Phone: 352-378-5852
  • Fax: 352-367-1009
Mailing address:
  • Phone: 352-378-5852
  • Fax: 352-367-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME72454
License Number StateFL

VIII. Authorized Official

Name: SABINE IRENE MCREYNOLDS
Title or Position: OWNER
Credential: MD
Phone: 352-378-5852