Provider Demographics
NPI:1740512631
Name:FLORIDA FAMILY PHYSICIANS LLC
Entity type:Organization
Organization Name:FLORIDA FAMILY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HARMINDER
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:NANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-921-2074
Mailing Address - Street 1:PO BOX 951659
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-1659
Mailing Address - Country:US
Mailing Address - Phone:407-921-2074
Mailing Address - Fax:321-363-1735
Practice Address - Street 1:2045 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3307
Practice Address - Country:US
Practice Address - Phone:407-921-2074
Practice Address - Fax:321-363-1735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care