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Organization
WILCO CIVIL, D.O. PLLC
Active
Organization
WILCO CIVIL, D.O. PLLC
Active
Other names
Civil Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILCO CIVIL DO (EMPLOYEE)
(813) 403-9096
Entity
Organization
Contact information
Practice address
18598 MILTON KEYNES CT, LAND O LAKES, FL 34638-2202
(813) 403-9096
Mailing address
5230 LAND O LAKES BLVD, #2873, LAND O LAKES, FL 34639
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
315D00000X
Inpatient Hospice
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS16855
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
09/07/2020
Last updated
11/04/2020
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