MEDICARE: FAMILY PLUS PRIMARY CARE,RPA,PC

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	261QH0100X	Health Service Clinic/Center	23-1330	NY

General Provider Information

NPI Number	:	1912930371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PLUS PRIMARY CARE,RPA,PC

Provider Business Mailing Address
First Line	:	PO BOX 491811
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34749-1811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8566 N MAIN ST
Second Line	:
City	:	EDEN
State	:	NY
Zip	:	14057-1229
Country	:	US
Telephone Number	:	716-992-2512
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES MARTIN
Credential	:
Telephone Number	:	716-984-9309

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/22/2020

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