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General NPI Number Information
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NPI Number | 1306262514
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Entity Type | Organization
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Legal Business Name | VINELAND MEDICAL CARE LLC
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 1319 E VINE ST
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City | KISSIMMEE
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State | FL
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Zip | 34744-3642
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Country | US
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Telephone | 813-410-2914
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Fax |
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Provider Business Mailing Address
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Address Line | 1319 E VINE ST
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City | KISSIMMEE
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State | FL
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Zip | 34744-3642
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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 | OWNER
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Name | MR. HARRY HINDI
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Credential | PA
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Telephone | 813-410-2914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9100810
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License Number State | FL
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