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NPI Code Detail

MEDICARE: MEDICAL VENTURES OF AMERICA

MEDICARE: MEDICAL VENTURES OF AMERICA
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
1173000000XLegal MedicineME77919FL

Other Identifiers

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

General Provider Information

NPI Number : 1053869487
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL VENTURES OF AMERICA
Provider Business Mailing Address
First Line : 16890 US HIGHWAY 441
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-6705
Country : US
Telephone Number : 352-315-1651
Fax Number : 352-315-1703
Provider Business Practice Location Address
First Line : 16890 US HIGHWAY 441
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-6705
Country : US
Telephone Number : 352-315-1651
Fax Number : 352-315-1703
Authorized Official
Title or Position : BILLING MANAGER
Name : GLENDA MARTI
Credential :
Telephone Number : 352-315-1651
Provider Enumeration Date : 09/14/2016
Last Update Date : 10/11/2016

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Directions to “MEDICAL VENTURES OF AMERICA ” Practice Location

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