Families First Medical Group Llc | |
11555 Central Pkwy Ste 402 Jacksonville FL 32224-2695 | |
(904) 747-3800 | |
Not Available |
Full Name | Families First Medical Group Llc |
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Speciality | Family Medicine |
Location | 11555 Central Pkwy Ste 402, Jacksonville, Florida |
Authorized Official Name and Position | Tracee Holzendorf (ADMINISTRATOR) |
Authorized Official Contact | 9046080095 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Families First Medical Group Llc 8246 Riding Club Rd E Jacksonville FL 32256-7266 Ph: (904) 707-6042 | Families First Medical Group Llc 11555 Central Pkwy Ste 402 Jacksonville FL 32224-2695 Ph: (904) 747-3800 |
NPI Number | 1154942563 |
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Provider Enumeration Date | 04/27/2020 |
Last Update Date | 12/17/2021 |
Medicare PECOS PAC ID | 5698167351 |
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Medicare Enrollment ID | O20220110001661 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154942563 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kia Mitchell |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184602583 PECOS PAC ID: 1052346657 Enrollment ID: I20051003000506 |
Provider Name | Robin Tighe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013661214 PECOS PAC ID: 0446630586 Enrollment ID: I20220706003237 |
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