Provider Demographics
NPI:1114525300
Name:PANZER CONCIERGE MEDICINE LLC
Entity Type:Organization
Organization Name:PANZER CONCIERGE MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PANZER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-425-4774
Mailing Address - Street 1:101 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1132
Mailing Address - Country:US
Mailing Address - Phone:352-565-5256
Mailing Address - Fax:352-565-5227
Practice Address - Street 1:101 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1132
Practice Address - Country:US
Practice Address - Phone:352-565-5256
Practice Address - Fax:352-565-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty