FAMILY PRACTICE CENTER OF BRANDON LLC NPI 1487962619

NPI Information

FAMILY PRACTICE CENTER OF BRANDON LLC is a family medicine in Brandon, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAMILY PRACTICE CENTER OF BRANDON LLC NPI is 1487962619. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

205 S MOON AVE
SUITE 105
BRANDON, FL
ZIP 33511-716
Phone: (813) 681-6064
Fax: (813) 653-4132

The provider's authorized official is Miguel Mazariegos .
The authorized official title is Physician and has the following contact phone number (813) 681-6064.

The CLIA number assigned to this NPI record is 10D0948166 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2010 and was last updated on 9/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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