MEDICARE: FAMILY MEDICINE AND HEALTHCARE, P.A.

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	251B00000X	Case Management Agency	OS7919	FL
2	261Q00000X	Clinic/Center	OS7919	FL
3	261QH0100X	Health Service Clinic/Center	OS7919	FL
4	261QP2300X	Primary Care Clinic/Center	OS7919	FL
5	207Q00000X	Family Medicine Physician	OS7919	FL

General Provider Information

NPI Number	:	1326232174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICINE AND HEALTHCARE, P.A.

Provider Business Mailing Address
First Line	:	1990 N FEDERAL HWY
Second Line	:	SUITE C
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-1032
Country	:	US
Telephone Number	:	954-788-9399
Fax Number	:	954-905-4990

Provider Business Practice Location Address
First Line	:	1990 N FEDERAL HWY
Second Line	:	SUITE C
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-1032
Country	:	US
Telephone Number	:	954-788-9399
Fax Number	:	954-905-4990

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. WILLIAM W. CHEATHAM
Credential	:	D.O.
Telephone Number	:	954-788-9399

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	09/04/2007

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Directions to “FAMILY MEDICINE AND HEALTHCARE, P.A. ” Practice Location

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