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IDLEWOOD MEDICAL CLINIC INC
NPI 1316249246
Family Medicine - Adult Medicine in Tucker, GA

Active since November 29, 2010
2157 IDLEWOOD RD, STE B, TUCKER, GA 30084(305) 388-4383(305) 388-4380 Get Directions Write a Review

NPPES record last updated: December 17, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Idlewood Medical Clinic Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDLEWOOD MEDICAL CLINIC INC (NPI 1316249246) is a healthcare organization registered as an adult medicine in Tucker, Georgia and active in the NPI registry since November 2010. The organization lists Aida Rosa De La Vega, Ceo, as its authorized official.

NPPES Registry Identity

NPI1316249246
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameIDLEWOOD MEDICAL CLINIC INC
Location Address2157 IDLEWOOD RD, STE BTucker, GA 30084-4832
Mailing Address2157 Idlewood Rd, Ste BTucker, GA 30084-4832 · (305) 388-4383 · Fax (305) 388-4380
Phone(305) 388-4383
Fax(305) 388-4380
Organization SubpartNo
Authorized OfficialAida Rosa De La VegaCeo · (305) 388-4383
Enumeration DateNovember 29, 2010
Last NPPES UpdateDecember 17, 2010
✔ NPI 1316249246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
2157 IDLEWOOD RD, Tucker, GA 30084
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idlewood Medical Clinic Inc's NPI number?

The NPI number for Idlewood Medical Clinic Inc is 1316249246. It was assigned to this organization in the NPPES registry on November 29, 2010.

Where is Idlewood Medical Clinic Inc located?

Idlewood Medical Clinic Inc is located at 2157 Idlewood Rd Ste B, Tucker, GA 30084. The listed phone number is (305) 388-4383.

What is Idlewood Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Idlewood Medical Clinic Inc was last updated on December 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.