Organization
FLORIDA HEART & VASCULAR MULTI SPECIALTY GROUP, PA
Active
Other names
Leesburg Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA INGRAM (ADMINISTRATIVE ASSISTANT)
(352) 728-6808
Entity
Organization
Contact information
Practice address
802 E DIXIE AVE, LEESBURG, FL 34748-6014
(352) 787-1324
(352) 360-0668
Mailing address
802 E DIXIE AVE, LEESBURG, FL 34748-6014
(352) 728-6808
(352) 728-1751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
03/09/2007
Last updated
10/03/2007
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