Organization
HEALTHVINE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA D DOHERTY M.D (PRESIDENT)
(352) 569-9990
Entity
Organization
Contact information
Practice address
725 BENTON AVE, BROOKSVILLE, FL 34601-3213
(352) 796-1492
Mailing address
725 BENTON AVE, BROOKSVILLE, FL 34601-3213
(352) 796-1492
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
FL
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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