| Family Medicine Clinic | |
|
8515 S Us Highway 1 Suite 3 Port Saint Lucie FL 34952-3346 | |
| (772) 380-4042 | |
| (772) 380-4043 |
| Full Name | Family Medicine Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 8515 S Us Highway 1, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Imran M Malik (MANAGING MEMBER) |
| Authorized Official Contact | 7723804042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Clinic 8515 S Us Highway 1 Suite 3 Port Saint Lucie FL 34952-3346 Ph: (772) 380-4042 | Family Medicine Clinic 8515 S Us Highway 1 Suite 3 Port Saint Lucie FL 34952-3346 Ph: (772) 380-4042 |
| NPI Number | 1649553793 |
|---|---|
| Provider Enumeration Date | 09/26/2011 |
| Last Update Date | 11/15/2011 |
| Medicare PECOS PAC ID | 3678746708 |
|---|---|
| Medicare Enrollment ID | O20111104000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649553793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME107296 (Florida) | Primary |
| Provider Name | Imran M Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760651285 PECOS PAC ID: 1355530775 Enrollment ID: I20110114000722 |
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