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Organization

EMMANUEL CHRISTIAN HEALTH CENTER PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIVIAN J WOODARD M.D. (OWNER OPERATOR)
(352) 259-1991
Entity
Organization

Contact information

Practice address
918 ROLLING ACRES RD, SUITE 1, LADY LAKE, FL 32159-5027
(352) 259-1991
Mailing address
918 ROLLING ACRES RD, SUITE 1, LADY LAKE, FL 32159-5027
(352) 259-1991

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 53291
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
257686400
FL
Enumeration date
08/28/2006
Last updated
01/27/2011
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