MEDICARE: FAMILY CARE MEDICAL GROUP

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

General Provider Information

NPI Number	:	1750499026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE MEDICAL GROUP

Provider Business Mailing Address
First Line	:	10244 E COLONIAL DR
Second Line	:	STE 101
City	:	ORLANDO
State	:	FL
Zip	:	32817-4374
Country	:	US
Telephone Number	:	407-737-9989
Fax Number	:	407-380-3228

Provider Business Practice Location Address
First Line	:	10244 E COLONIAL DR
Second Line	:	STE 101
City	:	ORLANDO
State	:	FL
Zip	:	32817-4374
Country	:	US
Telephone Number	:	407-737-9989
Fax Number	:	407-380-3228

Authorized Official
Title or Position	:	DOO
Name	:	EDNA TORRES
Credential	:
Telephone Number	:	407-737-9989

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	03/04/2008

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Directions to “FAMILY CARE MEDICAL GROUP ” Practice Location

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