# TRICOUNTY SPECIALISTS LLC

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

## Provider details

- **NPI number:** 1528308095
- **Authorized official:** WILLIAM S MAXFIELD MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (352) 240-1146

## Contact information

- **Practice address:** 510 CR 466, SUITE 207, LADY LAKE, FL 32159
- **Practice address phone:** (352) 240-1146
- **Mailing address:** 510 CR 466, SUITE 207, LADY LAKE, FL 32159
- **Mailing address phone:** (352) 240-1146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | ME15266 | FL | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | ME52212 | FL | — |

## Other

- **Enumeration date:** 02/21/2013
- **Last updated:** 04/26/2013