Medisupport LLC

NPI #1922612233 in Summerfield, Florida

Provider Information

NPI Number: 1922612233
Entity Type: Organization
Organization Name: Medisupport LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Sep 3, 2020
Last Updated: Sep 3, 2020

Practice Location

Address: 15151 S US HIGHWAY 441
City: Summerfield
State: Florida
ZIP Code: 34491-4482
Phone: (954) 444-2879

Authorized Official

Name: DR. CHERIE L HANSEN, DO
Title: OWNER
Phone: (954) 444-2879

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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