Provider Demographics
NPI:1336453141
Name:SPRING HILL PRIMARY CARE LLC
Entity Type:Organization
Organization Name:SPRING HILL PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAJYALAKSHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-835-7155
Mailing Address - Street 1:10500 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5046
Mailing Address - Country:US
Mailing Address - Phone:352-835-7155
Mailing Address - Fax:352-835-7199
Practice Address - Street 1:10500 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5046
Practice Address - Country:US
Practice Address - Phone:352-835-7155
Practice Address - Fax:352-835-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106816261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care