MEDICARE: FAMILY LIFE TODAY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW0003338	FL

General Provider Information

NPI Number	:	1134335458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY LIFE TODAY, INC

Provider Business Mailing Address
First Line	:	1000 BELCHER RD S
Second Line	:	SUITE 7
City	:	LARGO
State	:	FL
Zip	:	33771-3321
Country	:	US
Telephone Number	:	727-532-8220
Fax Number	:	727-524-8608

Provider Business Practice Location Address
First Line	:	1000 BELCHER RD S
Second Line	:	SUITE 7
City	:	LARGO
State	:	FL
Zip	:	33771-3321
Country	:	US
Telephone Number	:	727-532-8220
Fax Number	:	727-524-8608

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. JOAN MARILYN VAN WINGERDEN
Credential	:	LCSW
Telephone Number	:	727-532-8220

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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Directions to “FAMILY LIFE TODAY, INC ” Practice Location

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