| Your Family Dr Llc | |
|
11961 N Florida Ave Ste A Tampa FL 33612-5213 | |
| (813) 931-0333 | |
| (813) 644-6919 |
| Full Name | Your Family Dr Llc |
|---|---|
| Speciality | General Practice |
| Location | 11961 N Florida Ave Ste A, Tampa, Florida |
| Authorized Official Name and Position | Elaine Guimbarda (PRESIDENT) |
| Authorized Official Contact | 7868794216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Family Dr Llc 11961 N Florida Ave Ste A Tampa FL 33612-5213 Ph: (813) 931-0333 | Your Family Dr Llc 11961 N Florida Ave Ste A Tampa FL 33612-5213 Ph: (813) 931-0333 |
| NPI Number | 1417666538 |
|---|---|
| Provider Enumeration Date | 11/17/2022 |
| Last Update Date | 11/08/2023 |
| Medicare PECOS PAC ID | 4486019700 |
|---|---|
| Medicare Enrollment ID | O20230420001094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417666538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Elaine J Guimbarda Cuellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396136768 PECOS PAC ID: 8527423854 Enrollment ID: I20230420001448 |
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