1659826881 NPI number — ALL CARE FAMILY HEALTH LLC

Table of content: (NPI 1659826881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659826881 NPI number — ALL CARE FAMILY HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL CARE FAMILY HEALTH LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659826881
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4259 10TH AVE N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE WORTH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33461-2323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-218-4951
Provider Business Mailing Address Fax Number:
561-218-4961

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 BARKLEY CIR
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33907-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
238-226-0910
Provider Business Practice Location Address Fax Number:
239-226-0912
Provider Enumeration Date:
08/17/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOUHEY
Authorized Official First Name:
KRISTEN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
239-226-0910

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X , with the licence number:  PMC1465 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)