MEDICARE: THE BILTMORE GROUP 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	208D00000X	General Practice Physician	ME25156	FL

General Provider Information

NPI Number	:	1992022560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BILTMORE GROUP LLC

Provider Business Mailing Address
First Line	:	445 W OAK ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-6627
Country	:	US
Telephone Number	:	407-518-1041
Fax Number	:	407-518-1042

Provider Business Practice Location Address
First Line	:	445 W OAK ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-6627
Country	:	US
Telephone Number	:	407-518-1041
Fax Number	:	407-518-1042

Authorized Official
Title or Position	:	OWNER / MEDICAL DIRECTOR
Name	:	DR. JOHN THADDEUS LEGOWIK
Credential	:	M.D.
Telephone Number	:	407-518-1041

Provider Enumeration Date	:	04/22/2010
Last Update Date	:	04/28/2010

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Directions to “THE BILTMORE GROUP LLC ” Practice Location

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