| Organization Name: | LEGACY PHYSICIANS GROUP FLORIDA LLC |
| NPI Number: | 1013242783 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VIVEK S SASTRY (PRESIDENT) |
| Mailing Address: | 7460 Warren Parkway Suite 160 Frisco |
| State: | TX US |
| Postal Code: | 750344170 |
| Phone Number: | 9726685400 |
| Fax Number: | 9726685401 |
| NPI Enumeration Date: | 10/13/2009 |
| NPI Last Update Date: | 08/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | ME105041 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |