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General NPI Number Information
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NPI Number | 1568726057
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Entity Type | Organization
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Legal Business Name | VILLAGES TRI-COUNTY MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 1451 EL CAMINO REAL
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City | THE VILLAGES
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State | FL
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Zip | 32159-0041
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Country | US
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Telephone | 352-751-8863
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Fax | 352-751-8904
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Provider Business Mailing Address
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Address Line | 1451 EL CAMINO REAL
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City | THE VILLAGES
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State | FL
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Zip | 32159-0041
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Country | US
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Telephone | 352-751-8863
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Fax | 352-751-8904
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Authorized Official
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Title or Position | SVP/CFO
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Name | MS. DIANE HARDEN
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Credential |
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Telephone | 352-323-5002
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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 | 4464
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License Number State | FL
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