Provider Demographics
NPI:1083045918
Name:VQOL PRIMARY CARE PHYSICIAN
Entity Type:Organization
Organization Name:VQOL PRIMARY CARE PHYSICIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-314-2922
Mailing Address - Street 1:PO BOX 490625
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-0625
Mailing Address - Country:US
Mailing Address - Phone:352-314-2922
Mailing Address - Fax:
Practice Address - Street 1:8550 NE 138TH LN STE 102
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-6816
Practice Address - Country:US
Practice Address - Phone:352-314-2922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106117261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care