Provider Demographics
NPI:1144416165
Name:COREMEDY LLC
Entity Type:Organization
Organization Name:COREMEDY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BEINHAUER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-666-8089
Mailing Address - Street 1:11120 LIBBY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2454
Mailing Address - Country:US
Mailing Address - Phone:352-666-8089
Mailing Address - Fax:352-666-6645
Practice Address - Street 1:11120 LIBBY RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2454
Practice Address - Country:US
Practice Address - Phone:352-666-8089
Practice Address - Fax:352-666-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty