Provider Demographics
NPI:1740206127
Name:CFCF, INC
Entity Type:Organization
Organization Name:CFCF, INC
Other - Org Name:CARE FIRST FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LLARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:352-742-0025
Mailing Address - Street 1:1936 SALK AVE
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4310
Mailing Address - Country:US
Mailing Address - Phone:352-742-0025
Mailing Address - Fax:352-742-8167
Practice Address - Street 1:1936 SALK AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4310
Practice Address - Country:US
Practice Address - Phone:352-742-0025
Practice Address - Fax:352-742-8167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 5726207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80260XMedicare ID - Type UnspecifiedINDIVIDUAL
FLC65171Medicare UPIN
FLK9612Medicare ID - Type UnspecifiedGROUP#