Provider Demographics
NPI:1629746243
Name:A & C FAMILY CARE CLINIC
Entity Type:Organization
Organization Name:A & C FAMILY CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:POMBO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:786-424-1300
Mailing Address - Street 1:3100 NW 97TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-2255
Mailing Address - Country:US
Mailing Address - Phone:786-424-1300
Mailing Address - Fax:305-402-0372
Practice Address - Street 1:3100 NW 97TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-2255
Practice Address - Country:US
Practice Address - Phone:786-424-1300
Practice Address - Fax:305-402-0372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty