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General NPI Number Information
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NPI Number | 1104493659
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Entity Type | Organization
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Legal Business Name | RED MOUNTAIN EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 4600 SW 46TH CT
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City | OCALA
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State | FL
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Zip | 34474-5708
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Country | US
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Telephone | 352-291-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1A BURTON HILLS BLVD
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City | NASHVILLE
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State | TN
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Zip | 37215-6187
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Country | US
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Telephone | 973-251-1132
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KATHY KONDAS
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Credential |
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Telephone | 973-251-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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