My Virtual MD, LLC
Clinic/Center, Health Services in Ponte Vedra Beach, FL. Organization (NPI-2).
NPI number1043836620
StatusActive
Last updated in NPPESSep 29, 2020
Details
- NPI
- 1043836620
- Entity type
- Organization (NPI-2)
- Legal business name
- My Virtual MD, LLC
- Organization subpart
- No
- Enumeration date
- Jun 19, 2020
- Certification date
- Sep 29, 2020
- Last updated
- Sep 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | – | – | Yes |
Practice location
100 Ironwood Dr Unit 135Ponte Vedra Beach, FL 32082-2288
Phone 904-402-0472
Mailing address
100 Ironwood Dr Unit 135Ponte Vedra Beach, FL 32082-2288
Phone 904-402-0472
Authorized official
James Joyner
Owner
9044020472
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