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Organization

ALINA COMMUNITY CENTER AT MOUNT DORA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRAVIL JOSEPH APRN (MGR)
(352) 602-7924
Entity
Organization

Contact information

Practice address
4601 N HIGHWAY 19A, MOUNT DORA, FL 32757-2039
(352) 602-7924
(352) 602-4952
Mailing address
4601 N HIGHWAY 19A, MOUNT DORA, FL 32757-2039
(352) 602-7924
(352) 602-4952

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
04/19/2019
Last updated
01/02/2025
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