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General NPI Number Information
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NPI Number | 1487321493
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Entity Type | Organization
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Legal Business Name | UCFA PHYSICIANS NETWORK GROUP OF FLORIDA
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 1334 TIMBERLANE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32312-1766
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Country | US
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Telephone | 423-271-9911
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Fax |
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Provider Business Mailing Address
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Address Line | 8930 CROSS PARK DR STE 3
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City | KNOXVILLE
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State | TN
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Zip | 37923-4713
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Country | US
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Telephone | 423-271-9911
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Fax |
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Authorized Official
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Title or Position | ACTING CHIEF PMG
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Name | THEO STEPHENS
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Credential |
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Telephone | 423-271-9911
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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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