Provider Demographics
NPI:1346425659
Name:THE FAMILY CLINIC LLC
Entity Type:Organization
Organization Name:THE FAMILY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYMBERLY
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:RITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:850-265-3606
Mailing Address - Street 1:621 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-1737
Mailing Address - Country:US
Mailing Address - Phone:850-265-3606
Mailing Address - Fax:850-271-0400
Practice Address - Street 1:621 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-1737
Practice Address - Country:US
Practice Address - Phone:850-265-3606
Practice Address - Fax:850-271-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7653207P00000X
FLOS10197207Q00000X
FLOS10001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty