Healthcare Provider Details

I. General information

NPI: 1194372920
Provider Name (Legal Business Name): SPRING HILL PRIMARY CARE - VHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5485 FIRETHORN PT
SPRING HILL FL
34609-9512
US

IV. Provider business mailing address

PO BOX 15722
BROOKSVILLE FL
34604-0123
US

V. Phone/Fax

Practice location:
  • Phone: 267-393-5265
  • Fax:
Mailing address:
  • Phone: 267-393-5265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SALMAN MUDDASSIR
Title or Position: OWNER
Credential: MD
Phone: 267-393-5265