# AC MEDICAL PROVIDER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TREASURE COAST MEDICAL ASSOICATES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578928396
- **Legal business name:** TREASURE COAST MEDICAL ASSOICATES
- **Authorized official:** COLLEEN B PARKHURST (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (772) 692-8082

## Contact information

- **Practice address:** 4340 W NEWBERRY RD, GAINESVILLE, FL 32607-2586
- **Practice address phone:** (772) 692-8082
- **Mailing address:** 3405 NW FEDERAL HWY, JENSEN BEACH, FL 34957
- **Mailing address phone:** (772) 692-8082
- **Mailing address fax:** (772) 232-9383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME74643 | FL | Yes |

## Other

- **Enumeration date:** 12/21/2015
- **Last updated:** 12/21/2015