Provider Demographics
NPI:1194007310
Name:FLOYD S DILLARD MD PA
Entity Type:Organization
Organization Name:FLOYD S DILLARD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:S
Authorized Official - Last Name:DILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-357-6500
Mailing Address - Street 1:826 N BAY ST
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-2942
Mailing Address - Country:US
Mailing Address - Phone:352-357-6500
Mailing Address - Fax:352-357-9136
Practice Address - Street 1:826 N BAY ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-2942
Practice Address - Country:US
Practice Address - Phone:352-357-6500
Practice Address - Fax:352-357-9136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty