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Organization
FERNHILL FAMILY MEDICINE LLC
Active
Organization
FERNHILL FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KUMARAN KONDATH MOHAN MD (DIRECT OWNER)
(352) 589-9090
Entity
Organization
Contact information
Practice address
4601 N HIGHWAY 19A, MOUNT DORA, FL 32757-2039
(352) 589-9090
(352) 589-1433
Mailing address
4601 N HIGHWAY 19A, MOUNT DORA, FL 32757-2039
(352) 589-9090
(352) 589-1433
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 83819
FL
Other
Enumeration date
01/08/2007
Last updated
10/26/2010
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