Provider Demographics
NPI:1407020837
Name:ALILIN FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:ALILIN FAMILY MEDICINE LLC
Other - Org Name:AFM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-657-2111
Mailing Address - Street 1:7221 ALOMA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-7119
Mailing Address - Country:US
Mailing Address - Phone:407-657-2111
Mailing Address - Fax:866-725-4812
Practice Address - Street 1:1410 W BROADWAY ST STE 104
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6537
Practice Address - Country:US
Practice Address - Phone:407-657-2111
Practice Address - Fax:866-725-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAS339Medicare PIN