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General NPI Number Information
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NPI Number | 1700336914
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Entity Type | Organization
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Legal Business Name | FURSANKIM GROUP LLC
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 13940 N US HIGHWAY 441 OAKLAND HILL PROFESSIONAL CENTER, STE 905
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City | LADY LAKE
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State | FL
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Zip | 32159-8908
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Country | US
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Telephone | 651-343-0262
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Fax |
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Provider Business Mailing Address
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Address Line | 22 REDWOOD TRACK TER
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City | OCALA
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State | FL
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Zip | 34472-6074
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Country | US
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Telephone | 651-343-0262
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SARANTUYA SANGI
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Credential | LAC
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Telephone | 651-343-0262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | AP3710
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License Number State | FL
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