Healthcare Provider Details

I. General information

NPI: 1861370165
Provider Name (Legal Business Name): CIM MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 OLD CAMP RD STE 162
THE VILLAGES FL
32162-5609
US

IV. Provider business mailing address

609 W BIDWELL ST
FRUITLAND PARK FL
34731-4314
US

V. Phone/Fax

Practice location:
  • Phone: 352-430-2720
  • Fax:
Mailing address:
  • Phone: 352-446-6174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER CHESHIRE
Title or Position: OWNER
Credential:
Phone: 352-430-2720