Organization
MICHAEL PENNACHIO, LLC
Active
Parent organization
MICHAEL PENNACHIO, LLC
Other names
Michael Pennachio, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL PENNACHIO, LLC
Authorized official
MICHAEL PENNACHIO MD (OWNER)
(352) 227-1999
Entity
Organization
Contact information
Practice address
1100 S GROVE ST, EUSTIS, FL 32726-5524
(352) 227-1999
Mailing address
14244 SR 50, CLERMONT, FL 34711-8003
(352) 227-1999
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME45426
FL
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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