MULBERRY MEDICAL GROUP PA
Ambulatory Health in Lady Lake, FL

License number
Florida ME80865
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. GUILLERMO B AVECILLA MD
Title: PRESIDENT
Phone: (352) 259-7900
Address
Address 2
8489 Mulberry Ln, Lady Lake, FL 32162
PO Box 587, Oxford, FL 34484
National Provider ID: 1417132465
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about MULBERRY MEDICAL GROUP PA at bizstanding.com

MULBERRY MEDICAL GROUP, PA

Lady Lake, FL  -  Oxford, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
Voluntary Dissolution
Registration:
Nov 1, 2002
Inactive since:
Aug 17, 2011
Phone:
(352) 259-7900 (Phone)
Addresses:
8489 SE 165 Mulberry Ln, The Villages, FL 32162 (Physical)
Oxford, FL 34484 (Mailing)
8489 SE 165 Ln, Lady Lake, FL 32162
PO Box 587, Oxford, FL 34484
State ID:
P02000117421
Business type:
Florida Profit Corporation
Principal, Internal Medicine, Presidents:
Joe Avecilla (Finance Manager),Josephine M Avecilla President, inactive, 8489 SE 165 Mulberry Ln, The Villages, FL 32162 (Physical),Guillermo B. Avecilla Principal, Internal Medicine, President, inactive
Agent:
Josephine Avecilla,8489 SE 165 Mulberry Ln, The Villages, FL 32162 (Physical)
EIN:
45-0490879

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