MEDICARE: RAYMOND J MIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	DO00442	RI
2	207RG0100X	Gastroenterology Physician	DO15999	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023014735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND J MIS

Provider Business Mailing Address
First Line	:	1020 LAKE SUMTER LNDG
Second Line	:
City	:	THE VILLAGES
State	:	FL
Zip	:	32162-2699
Country	:	US
Telephone Number	:	352-674-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 N US HIGHWAY 441 STE 810
Second Line	:
City	:	THE VILLAGES
State	:	FL
Zip	:	32159-8987
Country	:	US
Telephone Number	:	352-674-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	08/18/2025

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Directions to “ RAYMOND J MIS ” Practice Location

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