Provider Demographics
NPI:1700281821
Name:ALL FAMILY CLINIC OF DAYTONA BEACH, INC
Entity Type:Organization
Organization Name:ALL FAMILY CLINIC OF DAYTONA BEACH, INC
Other - Org Name:FLORIDA MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:SEVERINO
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:386-248-0107
Mailing Address - Street 1:1040 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4612
Mailing Address - Country:US
Mailing Address - Phone:386-248-0107
Mailing Address - Fax:386-248-0109
Practice Address - Street 1:697 MAITLAND AVE
Practice Address - Street 2:SUITE 1002
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6821
Practice Address - Country:US
Practice Address - Phone:407-539-2111
Practice Address - Fax:407-539-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty