Northern Medical Center INC

NPI #1134567613 in North Port, Florida

Provider Information

NPI Number: 1134567613
Entity Type: Organization
Organization Name: Northern Medical Center INC
Primary Specialty: General Practice
Enumeration Date: Jun 6, 2013
Last Updated: Oct 10, 2013

Practice Location

Address: 12450 TAMIAMI TRL S
Address 2: SUITE E
City: North Port
State: Florida
ZIP Code: 34287-1473
Phone: (941) 257-4763

Authorized Official

Name: DANIIL SUPISHCHEV
Title: OWNER
Phone: (941) 257-4763

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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