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NPI Code Detail

MEDICARE: FIRST PRIMARY CARE AND FAMILY MEDICINE, INC.

MEDICARE: FIRST PRIMARY CARE AND FAMILY MEDICINE, INC.
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
1261QR0208XMobile Radiology Clinic/Center
2335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HCC7670OTHERFLAHCA HCC

General Provider Information

NPI Number : 1528290350
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRST PRIMARY CARE AND FAMILY MEDICINE, INC.
Provider Business Mailing Address
First Line : 1681 EAGLE HARBOR PKWY
Second Line : SUITE A
City : FLEMING ISLAND
State : FL
Zip : 32003-4819
Country : US
Telephone Number : 904-264-2006
Fax Number : 904-264-2766
Provider Business Practice Location Address
First Line : 1681 EAGLE HARBOR PKWY
Second Line : SUITE A
City : FLEMING ISLAND
State : FL
Zip : 32003-4819
Country : US
Telephone Number : 904-264-2006
Fax Number : 904-264-2766
Authorized Official
Title or Position : OWNER
Name : HUI TANG
Credential : MD
Telephone Number : 904-264-2006
Provider Enumeration Date : 08/12/2009
Last Update Date : 08/12/2009

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Directions to “FIRST PRIMARY CARE AND FAMILY MEDICINE, INC. ” Practice Location

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