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NPI Code Detail

MEDICARE: F R FRUEHAN FAMILY PRACTICE INC

MEDICARE: F R FRUEHAN FAMILY PRACTICE 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
1207Q00000XFamily Medicine PhysicianOS5359FL

General Provider Information

NPI Number : 1841316312
Entity Type Code : Organization
Provider Name (Legal Business Name) : F R FRUEHAN FAMILY PRACTICE INC
Provider Business Mailing Address
First Line : 9 PINECONE DR
Second Line : STE 102
City : PALM COAST
State : FL
Zip : 32137
Country : US
Telephone Number : 386-445-6191
Fax Number : 386-445-3916
Provider Business Practice Location Address
First Line : 9 PINE CONE DR STE 102
Second Line :
City : PALM COAST
State : FL
Zip : 32137-8683
Country : US
Telephone Number : 386-445-6191
Fax Number : 386-445-3916
Authorized Official
Title or Position : OFFICE MANAGER CREDENTIAL DEPT
Name : CINDY K VANZUUK
Credential :
Telephone Number : 386-445-6191
Provider Enumeration Date : 03/22/2007
Last Update Date : 06/11/2008

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Directions to “F R FRUEHAN FAMILY PRACTICE INC ” Practice Location

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