Healthcare Provider Details

I. General information

NPI: 1013336908
Provider Name (Legal Business Name): VILLAGES TRI-COUNTY MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 11/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N US HIGHWAY 441 SUITE 1830
THE VILLAGES FL
32159-8999
US

IV. Provider business mailing address

1501 N US HIGHWAY 441 SUITE 1830
THE VILLAGES FL
32159-8999
US

V. Phone/Fax

Practice location:
  • Phone: 352-751-8828
  • Fax:
Mailing address:
  • Phone: 352-751-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIANE HARDEN
Title or Position: CFO
Credential:
Phone: 352-323-5762