MEDICARE: NEIGHBORMD OF LONGWOOD LLC

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	207R00000X	Internal Medicine Physician

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	:	1285232108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORMD OF LONGWOOD LLC

Provider Business Mailing Address
First Line	:	280 WEKIVA SPRINGS RD STE 1000
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6098
Country	:	US
Telephone Number	:	407-788-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 WEKIVA SPRINGS RD STE 1000
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6098
Country	:	US
Telephone Number	:	407-788-2273
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DAVID ROMANELLO
Credential	:
Telephone Number	:	352-459-3661

Provider Enumeration Date	:	10/13/2020
Last Update Date	:	08/19/2021

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Directions to “NEIGHBORMD OF LONGWOOD LLC ” Practice Location

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