Provider Demographics
NPI:1235142209
Name:TOTAL HEALTH CARE PLLC
Entity Type:Organization
Organization Name:TOTAL HEALTH CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:MCREYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-378-5852
Mailing Address - Street 1:2728 SW 4TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3112
Mailing Address - Country:US
Mailing Address - Phone:352-378-5852
Mailing Address - Fax:352-367-1009
Practice Address - Street 1:2728 SW 4TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-3112
Practice Address - Country:US
Practice Address - Phone:352-378-5852
Practice Address - Fax:352-367-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDE5214OtherRAILROAD MEDICARE
FLK9351Medicare PIN