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Organization
TOTAL MEDICAL HEALTHCARE PC
Active
Organization
TOTAL MEDICAL HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMOS KANAKOUDAS M.D. (PRESIDENT)
(646) 824-1380
Entity
Organization
Contact information
Practice address
550 E MAIN ST STE 100, RIVERHEAD, NY 11901-2672
(631) 591-3093
(631) 317-1010
Mailing address
665 TREEHOUSE CIR, ST AUGUSTINE, FL 32095-6837
(904) 654-2410
(904) 417-7177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60 257261
NY
363LF0000X
Family Nurse Practitioner
33 337755
NY
Other
Enumeration date
08/29/2014
Last updated
05/14/2019
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