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General NPI Number Information
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NPI Number | 1457086654
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Entity Type | Organization
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Legal Business Name | EXTREME INFUSED MEDICAL PLUS
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 11871 ILLINOIS ST
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City | DUNNELLON
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State | FL
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Zip | 34431-6503
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Country | US
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Telephone | 352-220-3873
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Fax | 352-517-7088
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Provider Business Mailing Address
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Address Line | 11871 ILLINOIS ST
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City | DUNNELLON
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State | FL
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Zip | 34431-6503
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Country | US
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Telephone | 352-220-3873
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Fax | 352-517-7088
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Authorized Official
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Title or Position | OWNER PROVIDER
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Name | NIKALINA LELIEA DUNDAS
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Credential | APRN FNP C
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Telephone | 352-220-3873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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