Provider Demographics
NPI:1326232174
Name:FAMILY MEDICINE AND HEALTHCARE, P.A.
Entity Type:Organization
Organization Name:FAMILY MEDICINE AND HEALTHCARE, P.A.
Other - Org Name:DR. WILLIAM W. CHEATHAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHEATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-788-9399
Mailing Address - Street 1:1990 N FEDERAL HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1032
Mailing Address - Country:US
Mailing Address - Phone:954-788-9399
Mailing Address - Fax:954-905-4990
Practice Address - Street 1:1990 N FEDERAL HWY
Practice Address - Street 2:SUITE C
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1032
Practice Address - Country:US
Practice Address - Phone:954-788-9399
Practice Address - Fax:954-905-4990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7919207Q00000X, 251B00000X, 261Q00000X, 261QH0100X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty