Organization Name: | LEHIGH HMA PHYSICIAN MANAGEMENT, LLC |
NPI Number: | 1316244775 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL L GINGRAS (VICE PRESIDENT) |
Mailing Address: | 1530 Lee Blvd Suite 2300 Lehigh Acres |
State: | FL US |
Postal Code: | 339364893 |
Phone Number: | 2395731505 |
Fax Number: | 2395731744 |
NPI Enumeration Date: | 02/22/2011 |
NPI Last Update Date: | 11/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |