Provider Demographics
NPI:1821358607
Name:STORY FAMILY MEDICINE
Entity type:Organization
Organization Name:STORY FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-766-1900
Mailing Address - Street 1:9048 FALCON CT
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-7631
Mailing Address - Country:US
Mailing Address - Phone:941-766-1900
Mailing Address - Fax:941-766-1902
Practice Address - Street 1:17912 TOLEDO BLADE BLVD
Practice Address - Street 2:STE A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1042
Practice Address - Country:US
Practice Address - Phone:941-766-1001
Practice Address - Fax:941-766-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty