Provider Demographics
NPI:1871684670
Name:FRANCE AVENUE FAMILY PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:FRANCE AVENUE FAMILY PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-253-0676
Mailing Address - Street 1:7600 FRANCE AVE S # 4100
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5924
Mailing Address - Country:US
Mailing Address - Phone:952-831-1551
Mailing Address - Fax:952-831-0725
Practice Address - Street 1:7600 FRANCE AVE S # 4100
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-831-1551
Practice Address - Fax:952-831-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1382261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC02845Medicare ID - Type Unspecified