Provider Demographics
NPI:1811031925
Name:FAMILY MEDICAL CENTER PC
Entity Type:Organization
Organization Name:FAMILY MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REMEDIOS
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-361-2930
Mailing Address - Street 1:8638 CENTREVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5264
Mailing Address - Country:US
Mailing Address - Phone:703-361-2930
Mailing Address - Fax:703-361-0910
Practice Address - Street 1:8638 CENTREVILLE RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5264
Practice Address - Country:US
Practice Address - Phone:703-361-2930
Practice Address - Fax:703-361-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty