| Emc 360, LLC | |
|
1008 Juliette Blvd Mount Dora FL 32757-6500 | |
| (407) 450-6991 | |
| Not Available |
| Full Name | Emc 360, LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1008 Juliette Blvd, Mount Dora, Florida |
| Authorized Official Name and Position | William Frederick Von Bargen (PRESIDENT) |
| Authorized Official Contact | 4074506991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emc 360, LLC 1008 Juliette Blvd Mount Dora FL 32757-6500 Ph: (407) 450-6991 | Emc 360, LLC 1008 Juliette Blvd Mount Dora FL 32757-6500 Ph: (407) 450-6991 |
| NPI Number | 1790398246 |
|---|---|
| Provider Enumeration Date | 08/25/2020 |
| Last Update Date | 08/25/2020 |
| Certification Date | 08/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790398246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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