MEDICARE: TOTAL FAMILY HEALTH CARE, 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	207Q00000X	Family Medicine Physician

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	:	1861401226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL FAMILY HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 120550
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34712-0550
Country	:	US
Telephone Number	:	352-394-4237
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 CITRUS TOWER BLVD
Second Line	:	SUITE A
City	:	CLERMONT
State	:	FL
Zip	:	34711-6880
Country	:	US
Telephone Number	:	352-394-4237
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARA JAKOB
Credential	:	MD
Telephone Number	:	352-394-4237

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	10/20/2010

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