Provider Demographics
NPI:1710239694
Name:YOUR FAMILY DOCTOR, LLC
Entity Type:Organization
Organization Name:YOUR FAMILY DOCTOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAURAV
Authorized Official - Middle Name:V
Authorized Official - Last Name:MALHOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-584-8524
Mailing Address - Street 1:11077 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5000
Mailing Address - Country:US
Mailing Address - Phone:352-684-3300
Mailing Address - Fax:352-684-3222
Practice Address - Street 1:13028 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6421
Practice Address - Country:US
Practice Address - Phone:727-862-3591
Practice Address - Fax:727-863-7034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty