MEDICARE: ALL FAMILY CLINIC OF DAYTONA BEACH, 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
1	174400000X	Specialist	ME31437	FL

General Provider Information

NPI Number	:	1750472122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL FAMILY CLINIC OF DAYTONA BEACH, INC

Provider Business Mailing Address
First Line	:	1051 TOWN CENTER DRIVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763
Country	:	US
Telephone Number	:	386-774-8444
Fax Number	:	386-774-8735

Provider Business Practice Location Address
First Line	:	1051 TOWN CENTER DRIVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763
Country	:	US
Telephone Number	:	386-774-8444
Fax Number	:	386-774-8735

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. FRANK SEVERIANO ALVAREZ, JR. X
Credential	:	M.D.
Telephone Number	:	386-248-0107

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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