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General NPI Number Information
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NPI Number | 1053771493
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Entity Type | Organization
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Legal Business Name | MDL HEALTH, PLLC
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Dates
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Enumeration Date | 02/27/2016
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Last Update Date | 02/27/2016
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Provider Practice Location Address
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Address Line | 1802 GLENCOE DR
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City | LYNN HAVEN
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State | FL
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Zip | 32444-4077
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Country | US
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Telephone | 703-625-1430
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 GLENCOE DR
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City | LYNN HAVEN
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State | FL
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Zip | 32444-4077
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HASHANI M PERKINS
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Credential | M.D.
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Telephone | 703-625-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME123818
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License Number State | FL
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