Healthcare Provider Details
I. General information
NPI: 1326386293
Provider Name (Legal Business Name): FLORIDA MEDICAL PRACTICE PLAN INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2013
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2911 ROBERTS AVE
TALLAHASSEE FL
32310-5007
US
IV. Provider business mailing address
2911 ROBERTS AVE
TALLAHASSEE FL
32310-5007
US
V. Phone/Fax
- Phone: 850-644-1543
- Fax: 855-230-7421
- Phone: 850-644-1542
- Fax: 855-230-7421
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name:
ALMA
B
LITTLES
Title or Position: DEAN
Credential: MD
Phone: 850-644-5024