Healthcare Provider Details

I. General information

NPI: 1346271368
Provider Name (Legal Business Name): FAMILY CARE PHYSICANS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 VENTURE DR SUITE A
SOUTH DAYTONA FL
32119-3478
US

IV. Provider business mailing address

401 VENTURE DR SUITE A
SOUTH DAYTONA FL
32119-3478
US

V. Phone/Fax

Practice location:
  • Phone: 386-761-8888
  • Fax: 386-760-8798
Mailing address:
  • Phone: 386-761-8888
  • Fax: 386-760-8798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY FRIEDMAN
Title or Position: MANAGING PARTNER
Credential: DO
Phone: 386-761-8888