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Organization

VILLAGES INTERNAL MEDICINE AND SENIOR CLINIC PA

Active
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Organization

VILLAGES INTERNAL MEDICINE AND SENIOR CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WINSTON EVALLE M.D. (PRESIDENT)
(352) 259-0364
Entity
Organization

Contact information

Practice address
3351 WEDGEWOOD LN, THE VILLAGES, FL 32162-7181
(352) 259-0634
(352) 259-2174
Mailing address
3351 WEDGEWOOD LN, THE VILLAGES, FL 32162-7181
(352) 259-0634
(352) 259-2174

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME80483
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
ME80483
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58634
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/15/2007
Last updated
11/29/2010
About Stedi
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