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NPI Code Detail

MEDICARE: VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLC

MEDICARE: VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLC
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
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician

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 : 1154056117
Entity Type Code : Organization
Provider Name (Legal Business Name) : VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLC
Provider Business Mailing Address
First Line : 4650 WESTWAY PARK BLVD STE 206
Second Line :
City : HOUSTON
State : TX
Zip : 77041-2006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13911 NINE EAGLES DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-3004
Country : US
Telephone Number : 407-798-8800
Fax Number :
Authorized Official
Title or Position : DIRECTOR REVENUE CYCLE
Name : REBECCA RAGER
Credential :
Telephone Number : 844-969-0686
Provider Enumeration Date : 07/22/2022
Last Update Date : 01/14/2025

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