| Family Care Of Land O Lakes Pa | |
|
1942 Highland Oaks Blvd Suite A Lutz FL 33559-7410 | |
| (813) 948-3838 | |
| (813) 949-0629 |
| Full Name | Family Care Of Land O Lakes Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1942 Highland Oaks Blvd, Lutz, Florida |
| Authorized Official Name and Position | Robert Bruce Rosequist (OWNER) |
| Authorized Official Contact | 8139483838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Of Land O Lakes Pa 1942 Highland Oaks Blvd Suite A Lutz FL 33559-7410 Ph: (813) 948-3838 | Family Care Of Land O Lakes Pa 1942 Highland Oaks Blvd Suite A Lutz FL 33559-7410 Ph: (813) 948-3838 |
| NPI Number | 1073735833 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 05/04/2011 |
| Medicare PECOS PAC ID | 3678663713 |
|---|---|
| Medicare Enrollment ID | O20071213000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073735833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0048283 (Florida) | Secondary |
| 207Q00000X | Family Medicine | 0040424 (Florida) | Primary |
| 207Q00000X | Family Medicine | ME20601 (Florida) | Secondary |
| Provider Name | Robert B Rosequist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699771071 PECOS PAC ID: 7618058892 Enrollment ID: I20090127000574 |
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