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Organization
MEDEK PROVIDER NETWORK LLC
Active
Organization
MEDEK PROVIDER NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE MAHFOOD (DIRECTOR OF OPERATIONS)
(954) 892-3940
Entity
Organization
Contact information
Practice address
131 WATERMAN AVE, MOUNT DORA, FL 32757-9541
(352) 385-1803
Mailing address
131 WATERMAN AVE, MOUNT DORA, FL 32757-9541
(352) 385-1803
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/06/2021
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