# MICHAEL PENNACHIO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MICHAEL PENNACHIO, LLC
- **Other names:** Michael Pennachio, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730689530
- **Legal business name:** MICHAEL PENNACHIO, LLC
- **Authorized official:** MICHAEL PENNACHIO MD (OWNER)
- **Authorized official phone:** (352) 227-1999

## Contact information

- **Practice address:** 1100 S GROVE ST, EUSTIS, FL 32726-5524
- **Practice address phone:** (352) 227-1999
- **Mailing address:** 14244 SR 50, CLERMONT, FL 34711-8003
- **Mailing address phone:** (352) 227-1999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME45426 | FL | Yes |

## Other

- **Enumeration date:** 02/19/2018
- **Last updated:** 02/19/2018