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General NPI Number Information
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NPI Number | 1518793397
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Entity Type | Organization
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Legal Business Name | HERNANDO PRIMARY HEALTH LLC
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 4169 LAMSON AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-3707
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Country | US
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Telephone | 352-667-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 4169 LAMSON AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-3707
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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 | BILLING MANAGER
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Name | KIMBERLY LE
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Credential |
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Telephone | 352-688-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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