MEDICARE: FAMILY MEDICAL CENTER

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	207Q00000X	Family Medicine Physician	ME0023239	FL
2	207Q00000X	Family Medicine Physician	ME0026499	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386673168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	5323 GRAND BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4014
Country	:	US
Telephone Number	:	727-848-4878
Fax Number	:	727-846-7269

Provider Business Practice Location Address
First Line	:	5323 GRAND BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4014
Country	:	US
Telephone Number	:	727-848-4878
Fax Number	:	727-846-7269

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALAN SICHELMAN
Credential	:	M.D.
Telephone Number	:	727-848-4878

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	06/20/2008

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Directions to “FAMILY MEDICAL CENTER ” Practice Location

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