Healthcare Provider Details

I. General information

NPI: 1659826881
Provider Name (Legal Business Name): ALL CARE FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BARKLEY CIR SUITE 3
FORT MYERS FL
33907-4518
US

IV. Provider business mailing address

4259 10TH AVE N
LAKE WORTH FL
33461-2323
US

V. Phone/Fax

Practice location:
  • Phone: 238-226-0910
  • Fax: 239-226-0912
Mailing address:
  • Phone: 561-218-4951
  • Fax: 561-218-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberPMC1465
License Number StateFL

VIII. Authorized Official

Name: KRISTEN J TOUHEY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 239-226-0910