Healthcare Provider Details

I. General information

NPI: 1366388795
Provider Name (Legal Business Name): MY FAMILY DOC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 RIVIERA CT
WESTON FL
33332-3419
US

IV. Provider business mailing address

2680 RIVIERA CT
WESTON FL
33332-3419
US

V. Phone/Fax

Practice location:
  • Phone: 954-591-2654
  • Fax: 954-691-3017
Mailing address:
  • Phone: 954-591-2654
  • Fax: 954-691-3017

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: VANDHANA KISWANI-BARLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 954-591-2654