| Fort Pierce Family Care, Inc. | |
|
3851 Virginia Avenue Fort Pierce FL 34981 | |
| (954) 661-8151 | |
| Not Available |
| Full Name | Fort Pierce Family Care, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3851 Virginia Avenue, Fort Pierce, Florida |
| Authorized Official Name and Position | Jerry Jacobson (PHYSICIAN) |
| Authorized Official Contact | 9546618151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Pierce Family Care, Inc. 3709 Oak Ridge Ln Weston FL 33331-3706 Ph: (954) 661-8151 | Fort Pierce Family Care, Inc. 3851 Virginia Avenue Fort Pierce FL 34981 Ph: (954) 661-8151 |
| NPI Number | 1710271333 |
|---|---|
| Provider Enumeration Date | 05/31/2011 |
| Last Update Date | 05/31/2011 |
| Medicare PECOS PAC ID | 1153597851 |
|---|---|
| Medicare Enrollment ID | O20111230000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710271333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME0059609 (Florida) | Primary |
| Provider Name | Jerome Jacobson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770590168 PECOS PAC ID: 9032026976 Enrollment ID: I20041115000184 |
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