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General NPI Number Information
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NPI Number | 1780839720
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Entity Type | Organization
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Legal Business Name | MID FLORIDA MEDICAL
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 2756 B ENTERPRISE ROAD
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City | ORANGE CITY
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State | FL
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Zip | 32763
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Country | US
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Telephone | 386-774-1390
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Fax | 386-774-2346
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Provider Business Mailing Address
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Address Line | 2756 ENTERPRISE RD STE B
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City | ORANGE CITY
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State | FL
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Zip | 32763-8330
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Country | US
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Telephone | 386-774-1390
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Fax | 386-774-2346
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Authorized Official
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Title or Position | OWNER
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Name | MR. GARY N KNIGHT
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Credential |
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Telephone | 800-422-2612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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