Organization
CHIEFLAND MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L CONNOLE II (EXEC DIRECTOR)
(352) 493-9500
Entity
Organization
Contact information
Practice address
1113 NW 23RD AVE, CHIEFLAND, FL 32626-1911
(352) 493-9500
(352) 493-7070
Mailing address
1113 NW 23RD AVE, CHIEFLAND, FL 32626-1911
(352) 493-9500
(352) 493-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
HCC4256
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21419
BCBS
FL
Enumeration date
05/11/2006
Last updated
09/20/2007
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