Provider Demographics
NPI:1285128496
Name:SIMEDHEALTH, L.L.C.
Entity type:Organization
Organization Name:SIMEDHEALTH, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:DUNCANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-224-2302
Mailing Address - Street 1:PO BOX 357010
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-7010
Mailing Address - Country:US
Mailing Address - Phone:352-224-2200
Mailing Address - Fax:352-224-2484
Practice Address - Street 1:4343 W. NEWBERRY ROAD
Practice Address - Street 2:SUITE 10
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2817
Practice Address - Country:US
Practice Address - Phone:352-373-2340
Practice Address - Fax:352-373-3140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMEDHEALTH, L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72829207Q00000X
FLME080634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty