MEDICARE: FAMCARE MEDICAL CENTER 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1326991159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMCARE MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	1817 S UNIVERSITY DR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-5805
Country	:	US
Telephone Number	:	954-274-4285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 S UNIVERSITY DR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-5805
Country	:	US
Telephone Number	:	954-274-4285
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	YVENA C FEVRY
Credential	:
Telephone Number	:	954-274-4285

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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