| Organization Name: | FLORIDA FAMILY PHYSICIANS |
| NPI Number: | 1043550452 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASVENDAR SINGH NANDRA (OWNER) |
| Mailing Address: | 255 Citrus Tower Blvd Suite 206 Clermont |
| State: | FL US |
| Postal Code: | 347112756 |
| Phone Number: | 3522429600 |
| Fax Number: | 3522429605 |
| NPI Enumeration Date: | 02/21/2013 |
| NPI Last Update Date: | 02/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ME85696 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |