Healthcare Provider Details

I. General information

NPI: 1245289206
Provider Name (Legal Business Name): ALLIANCE FAMILY PHYSICIANS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 NW 56TH TER STE C
GAINESVILLE FL
32605-6401
US

IV. Provider business mailing address

817 NW 56TH TER STE C
GAINESVILLE FL
32605-6401
US

V. Phone/Fax

Practice location:
  • Phone: 352-234-3050
  • Fax:
Mailing address:
  • Phone: 352-234-3050
  • Fax: 352-553-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS0007386
License Number StateFL

VIII. Authorized Official

Name: STEFAN MANN
Title or Position: PRESIDENT
Credential: MD
Phone: 352-234-3050