Provider Demographics
NPI:1134535891
Name:INDEPENDENT FAMILY PRACTICE CORPORATION
Entity type:Organization
Organization Name:INDEPENDENT FAMILY PRACTICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMPELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-813-0007
Mailing Address - Street 1:17500 NE 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2123
Mailing Address - Country:US
Mailing Address - Phone:518-813-0007
Mailing Address - Fax:425-871-0007
Practice Address - Street 1:17500 NE 9TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2123
Practice Address - Country:US
Practice Address - Phone:518-813-0007
Practice Address - Fax:425-871-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251B00000XAgenciesCase Management
No305S00000XManaged Care OrganizationsPoint of Service