# FAMILY MEDICAL CARE OF MOUNT DORA INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265844757
- **Authorized official:** JOHN N BOUCHER (CEO)
- **Authorized official phone:** (407) 834-7800

## Contact information

- **Practice address:** 17580 US HIGHWAY 441, MOUNT DORA, FL 32757-6711
- **Practice address phone:** (352) 383-8200
- **Mailing address:** PO BOX 1844, MOUNT DORA, FL 32756-1844
- **Mailing address phone:** (352) 383-8200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | HCC10266 | FL | Yes |

## Other

- **Enumeration date:** 06/02/2014
- **Last updated:** 01/30/2015