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General NPI Number Information
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NPI Number | 1487913133
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Entity Type | Organization
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Legal Business Name | FAMILY CARE INC
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 12/21/2012
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Provider Practice Location Address
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Address Line | 6078 14TH ST W
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City | BRADENTON
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State | FL
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Zip | 34207-4104
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Country | US
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Telephone | 941-752-1400
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Fax | 941-752-0192
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Provider Business Mailing Address
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Address Line | 6078 14TH ST W
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City | BRADENTON
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State | FL
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Zip | 34207
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Country | US
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Telephone | 941-752-1400
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Fax | 941-752-0192
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Authorized Official
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Title or Position | MEDICAL DOCTOR/OWNER
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Name | DR. ASAD MOIZ ALI
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Credential | M.D.
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Telephone | 941-752-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME0071369
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License Number State | FL
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