Provider Demographics
NPI:1154825677
Name:ZEPHYRHILLS FAMILY PRACTICE AND GERIATRIC CARE, LLC
Entity Type:Organization
Organization Name:ZEPHYRHILLS FAMILY PRACTICE AND GERIATRIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-355-4914
Mailing Address - Street 1:PO BOX 3268
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33539-3268
Mailing Address - Country:US
Mailing Address - Phone:813-355-4914
Mailing Address - Fax:855-547-5415
Practice Address - Street 1:7213 GREEN SLOPE DR
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-1306
Practice Address - Country:US
Practice Address - Phone:813-355-4917
Practice Address - Fax:855-547-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty