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Organization

ANTONIOU FAMILY MEDICINE, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NIKOLAS ANTONIOU M.D. (PRESIDENT)
(630) 240-5779
Entity
Organization

Contact information

Practice address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(352) 376-1611
Mailing address
1601 SW ARCHER ROAD, GAINESVILLE, FL 32608
(352) 376-1611

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036098315
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1487683793
INDIVIDUAL NPI THAT NEEDS THE ADDRESS UPDATED TO GAINESVILLE FL. THANK YOU
IL
Enumeration date
07/13/2009
Last updated
07/06/2010
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