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General NPI Number Information
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NPI Number | 1265631519
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Entity Type | Organization
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Legal Business Name | MEDICAL VENTURES OF AMERICA
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 910 OLD CAMP RD PROF BLDG 114
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City | THE VILLAGES
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State | FL
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Zip | 32162-5604
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Country | US
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Telephone | 352-259-4322
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Fax | 352-259-3882
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Provider Business Mailing Address
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Address Line | 910 OLD CAMP RD PROF BUILDING 114
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City | THE VILLAGES
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State | FL
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Zip | 32162
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Country | US
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Telephone | 352-315-8881
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Fax | 352-315-8883
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | MRS. DAWN E WALKER
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Credential |
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Telephone | 352-315-1651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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