Healthcare Provider Details

I. General information

NPI: 1861315285
Provider Name (Legal Business Name): AFIC GROUP OF COA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1422 W TRAMMELL ST
LANTANA FL
33462-4241
US

IV. Provider business mailing address

1422 W TRAMMELL ST
LANTANA FL
33462-4241
US

V. Phone/Fax

Practice location:
  • Phone: 579-400-1124
  • Fax:
Mailing address:
  • Phone: 579-400-1124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JORDAN BELL
Title or Position: PRESIDENT
Credential:
Phone: 579-400-1124