Organization
HOMETOWN PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MENICHINO (CEO OF MANAGING COMPANY)
(352) 674-8905
Entity
Organization
Contact information
Practice address
1400 N US HIGHWAY 441, SUITE 522, THE VILLAGES, FL 32159-8975
(352) 674-8905
(352) 674-8919
Mailing address
1020 LAKE SUMTER LNDG, THE VILLAGES, FL 32162-2699
(352) 674-8905
(352) 674-8919
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME128166
FL
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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