MEDICARE: FLORIDA FAMILY MEDICINE 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	207Q00000X	Family Medicine Physician	ME27211	FL

General Provider Information

NPI Number	:	1477609766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA FAMILY MEDICINE LLC

Provider Business Mailing Address
First Line	:	7500 4TH ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-5410
Country	:	US
Telephone Number	:	727-526-4122
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 4TH ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-5410
Country	:	US
Telephone Number	:	727-526-4122
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. JEREMY AMBROSE ABINALES
Credential	:
Telephone Number	:	727-526-4122

Provider Enumeration Date	:	01/27/2007
Last Update Date	:	08/22/2020

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Directions to “FLORIDA FAMILY MEDICINE LLC ” Practice Location

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