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General NPI Number Information
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NPI Number | 1023440260
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Entity Type | Individual
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Provider Name | MILDRED VERONICA FARMER M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 16176 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34601-8910
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Country | US
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Telephone | 352-597-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 N SHORE DR NE
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City | ST PETERSBURG
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State | FL
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Zip | 33704-4836
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Country | US
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Telephone | 727-560-2323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME0048792
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License Number State | FL
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