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General NPI Number Information
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NPI Number | 1578777504
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE & REHAB INC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 7685 103RD STREET SUITE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32210
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Country | US
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Telephone | 904-771-1116
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Fax | 904-771-0515
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Provider Business Mailing Address
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Address Line | 7685 103RD STREET SUITE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32210
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Country | US
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Telephone | 904-771-1116
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Fax | 904-771-0515
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Authorized Official
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Title or Position | CEO
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Name | SYED S HUSSAIN
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Credential | MD
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Telephone | 904-771-1116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME74307
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License Number State | FL
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