Graduated: 2002
NPI: 1508972373
Practice Locations (3)
17410 E HWY 50, SUITE 110
CLERMONT, FL 34711
17410 E HWY 50 110, VIDA CARE MEDICAL GROUP
CLERMONT, FL 34711
3527174800
6307 SWANSON ST
WINDERMERE, FL 347864118
Source: CMS National Downloadable File, September 2026.