| Family Care Physician Group | |
|
45669 Highway 27 Davenport FL 33897-4546 | |
| (863) 866-2551 | |
| (863) 866-2552 |
| Full Name | Family Care Physician Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 45669 Highway 27, Davenport, Florida |
| Authorized Official Name and Position | Lira Lama (DIRECTOR) |
| Authorized Official Contact | 4079681755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Physician Group 45669 Highway 27 Davenport FL 33897-4546 Ph: (863) 866-2551 | Family Care Physician Group 45669 Highway 27 Davenport FL 33897-4546 Ph: (863) 866-2551 |
| NPI Number | 1578016820 |
|---|---|
| Provider Enumeration Date | 08/03/2016 |
| Last Update Date | 04/23/2020 |
| Medicare PECOS PAC ID | 8921368580 |
|---|---|
| Medicare Enrollment ID | O20180131000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578016820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Nelson A Nieves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841327236 PECOS PAC ID: 5395808190 Enrollment ID: I20090105000516 |
| Provider Name | Luis Miguel Nunez Arroyo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205307188 PECOS PAC ID: 2264867258 Enrollment ID: I20200623001690 |
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