# WEST FLORIDA MEDICAL ASSOCIATES, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WEST FLORIDA MEDICAL ASSOCIATES, PA
- **Other names:** Deven Medical Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437755345
- **Legal business name:** WEST FLORIDA MEDICAL ASSOCIATES, PA
- **Authorized official:** ULHAS T DEVEN MD (PRESIDENT)
- **Authorized official phone:** (352) 464-0762

## Contact information

- **Practice address:** 41 N INGLIS AVE STE B, INGLIS, FL 34449-9463
- **Practice address phone:** (352) 447-2122
- **Practice address fax:** (352) 465-7576
- **Mailing address:** 3920 N GRAYHAWK LOOP, LECANTO, FL 34461-8471
- **Mailing address phone:** (352) 464-0762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/07/2020
- **Last updated:** 12/07/2020