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Organization
GOOD SHEPHERD MEDICAL CLINIC PA
Active
Organization
GOOD SHEPHERD MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER B LEE MD (PRESIDENT)
(352) 666-1011
Entity
Organization
Contact information
Practice address
8425 NORTHCLIFFE BLVD, SUITE 104, SPRING HILL, FL 34606-1107
(352) 688-6346
(352) 688-9103
Mailing address
8425 NORTHCLIFFE BLVD, SUITE 104, SPRING HILL, FL 34606-1107
(352) 688-6346
(352) 688-9103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME76767
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7176
MEDICARE RAILROAD
FL
Enumeration date
06/04/2008
Last updated
08/19/2008
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