MEDICARE: FLORIDA INSTITUTE OF FAMILY MEDICINE, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363LF0000X	Family Nurse Practitioner
3	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639285141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA INSTITUTE OF FAMILY MEDICINE, PA

Provider Business Mailing Address
First Line	:	1100 62ND AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-5620
Country	:	US
Telephone Number	:	727-866-3166
Fax Number	:	727-864-4043

Provider Business Practice Location Address
First Line	:	1100 62ND AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-5620
Country	:	US
Telephone Number	:	727-866-3166
Fax Number	:	727-864-4043

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK B NORSTEIN
Credential	:	MD
Telephone Number	:	727-866-3166

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	02/18/2011

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