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General NPI Number Information
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NPI Number | 1679704878
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY INFECTIOUS DISEASE
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 910 OLD CAMP RD SUITE 130
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City | THE VILLAGES
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State | FL
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Zip | 32162-5609
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Country | US
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Telephone | 352-633-0215
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Fax | 352-633-0219
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Provider Business Mailing Address
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Address Line | 1576 BELLA CRUZ DRIVE SUITE 336
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City | THE VILLAGES
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State | FL
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Zip | 32159-8969
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Country | US
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Telephone | 352-633-0215
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Fax | 352-633-0219
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | DR. SHEILA GILLIKIN
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Credential | MD
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Telephone | 352-633-0215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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