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General NPI Number Information
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NPI Number | 1538192075
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH ENTERPRISES INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 607 HIGHWAY 466
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City | LADY LAKE
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State | FL
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Zip | 32159-3792
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Country | US
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Telephone | 352-259-7994
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Fax | 352-259-7992
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Provider Business Mailing Address
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Address Line | PO BOX 1777
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City | LADY LAKE
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State | FL
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Zip | 32158-1777
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Country | US
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Telephone | 352-259-7994
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Fax | 352-259-7992
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN D BURRESS
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Credential | DO
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Telephone | 352-259-7994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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