| Medek Provider Network LLC | |
|
131 Waterman Ave Mount Dora FL 32757-9541 | |
| (352) 385-1803 | |
| Not Available |
| Full Name | Medek Provider Network LLC |
|---|---|
| Speciality | General Practice |
| Location | 131 Waterman Ave, Mount Dora, Florida |
| Authorized Official Name and Position | Eugene Mahfood (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9548923940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medek Provider Network LLC 131 Waterman Ave Mount Dora FL 32757-9541 Ph: (352) 385-1803 | Medek Provider Network LLC 131 Waterman Ave Mount Dora FL 32757-9541 Ph: (352) 385-1803 |
| NPI Number | 1356959779 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 07/06/2021 |
| Certification Date | 06/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356959779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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