MEDICARE: FRIENDS AND FAMILY MEDICAL ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1144540121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDS AND FAMILY MEDICAL ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	3037 LANDOVER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-7260
Country	:	US
Telephone Number	:	352-584-3455
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 LANDOVER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-7260
Country	:	US
Telephone Number	:	352-584-3455
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RUTH ANN HOOCK
Credential	:
Telephone Number	:	352-584-3455

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	06/01/2010

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