Organization
TRI-COUNTY ORTHOPAEDIC CENTER,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY MANDUME KERINA M.D. (PRESIDENT)
(352) 326-8115
Entity
Organization
Contact information
Practice address
701 MEDICAL PLAZA DR, LEESBURG, FL 34748-7313
(352) 326-8115
(352) 326-5282
Mailing address
701 MEDICAL PLAZA DR, LEESBURG, FL 34748-7313
(352) 326-8115
(352) 326-5282
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74632
BLUE CROSS OF FL
FL
Enumeration date
08/30/2006
Last updated
01/22/2010
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