Organization
PROFESSIONAL FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PURNAMA D MADRAY (OWNER)
(352) 404-7707
Entity
Organization
Contact information
Practice address
725 ALMOND ST, CLERMONT, FL 34711-3120
(352) 404-7707
(888) 488-0722
Mailing address
2105 HARTWOOD MARSH RD, CLERMONT, FL 34711-5389
(352) 404-7707
(888) 488-0722
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME85427
FL
Other
Enumeration date
11/06/2013
Last updated
02/26/2014
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