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NPI Code Detail

MEDICARE: FAMILY PRACTICE CENTER OF SANFORD PA

MEDICARE: FAMILY PRACTICE CENTER OF SANFORD PA
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
199331OTHERFLBCB GRP BILL PROVIDER NUM

General Provider Information

NPI Number : 1609993666
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY PRACTICE CENTER OF SANFORD PA
Provider Business Mailing Address
First Line : 712 W 25TH ST
Second Line :
City : SANFORD
State : FL
Zip : 32771-4232
Country : US
Telephone Number : 407-322-6341
Fax Number :
Provider Business Practice Location Address
First Line : 712 W 25TH ST
Second Line :
City : SANFORD
State : FL
Zip : 32771-4232
Country : US
Telephone Number : 407-322-6341
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. LYNN H CLEARY
Credential :
Telephone Number : 407-322-6341
Provider Enumeration Date : 03/23/2007
Last Update Date : 08/22/2020

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Directions to “FAMILY PRACTICE CENTER OF SANFORD PA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.