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NPI Code Detail

MEDICARE: INFUSION CENTERS OF AMERICA

MEDICARE: INFUSION CENTERS 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
1261QI0500XInfusion Therapy Clinic/CenterFL

General Provider Information

NPI Number : 1528461316
Entity Type Code : Organization
Provider Name (Legal Business Name) : INFUSION CENTERS 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 : OWNER
Name : DR. RAYMOND DOMINICK
Credential : MD
Telephone Number : 325-315-1651
Provider Enumeration Date : 10/07/2014
Last Update Date : 10/07/2014

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Directions to “INFUSION CENTERS OF AMERICA ” Practice Location

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