| Family Practice Associates Pa | |
|
4410 W Newberry Rd Ste B Gainesville FL 32607-2290 | |
| (352) 372-7800 | |
| (352) 372-7879 |
| Full Name | Family Practice Associates Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4410 W Newberry Rd Ste B, Gainesville, Florida |
| Authorized Official Name and Position | Rene Lee Pack (PRESIDENT) |
| Authorized Official Contact | 3523727800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Associates Pa 4410 W Newberry Rd Ste B Gainesville FL 32607-2290 Ph: (352) 372-7800 | Family Practice Associates Pa 4410 W Newberry Rd Ste B Gainesville FL 32607-2290 Ph: (352) 372-7800 |
| NPI Number | 1134151871 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7416919352 |
|---|---|
| Medicare Enrollment ID | O20041102000777 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134151871 | NPI | - | NPPES |
| 45751 | Other | FL | BCBS GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
| Provider Name | Deena L Otoole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770528861 PECOS PAC ID: 5193771145 Enrollment ID: I20050323000790 |
| Provider Name | Brandon K Bodlak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144251810 PECOS PAC ID: 0840207080 Enrollment ID: I20060314000353 |
| Provider Name | Michael A Horseman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245297993 PECOS PAC ID: 0941262885 Enrollment ID: I20101012001286 |
| Provider Name | Rene A Lee Pack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851358766 PECOS PAC ID: 3678535515 Enrollment ID: I20101013000922 |
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