Emc 360, LLC

NPI #1790398246 in Mount Dora, Florida

Provider Information

NPI Number: 1790398246
Entity Type: Organization
Organization Name: Emc 360, LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Aug 25, 2020
Last Updated: Aug 25, 2020

Practice Location

Address: 1008 JULIETTE BLVD
City: Mount Dora
State: Florida
ZIP Code: 32757-6500
Phone: (407) 450-6991

Authorized Official

Name: DR. WILLIAM FREDERICK VON BARGEN JR., DO
Title: PRESIDENT
Phone: (407) 450-6991

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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