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General NPI Number Information
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NPI Number | 1417559147
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Entity Type | Organization
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Legal Business Name | FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1215 DUNN AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6330
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Country | US
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Telephone | 904-757-1998
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Fax | 904-696-7462
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 904-745-3618
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Fax | 904-722-4271
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Authorized Official
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Title or Position | SECRETARY
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Name | DAVID BROWN
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Credential |
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Telephone | 833-702-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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