Provider Demographics
NPI:1366804270
Name:VALUE IN PREVENTION OF GEORGIA, LLC
Entity type:Organization
Organization Name:VALUE IN PREVENTION OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-982-4300
Mailing Address - Street 1:4950 COMMUNICATION AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-3307
Mailing Address - Country:US
Mailing Address - Phone:561-982-4300
Mailing Address - Fax:561-953-6617
Practice Address - Street 1:790 CHURCH ST NE STE 500
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8957
Practice Address - Country:US
Practice Address - Phone:770-874-9739
Practice Address - Fax:770-427-0180
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MDVIP MEDICAL GROUP HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-22
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty