| Organization Name: | FAMILY PRACTICE,DR.ASSEFA LLC |
| NPI Number: | 1083913842 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IRENA MARIA ASSEFA (MANAGER) |
| Mailing Address: | 6100 Saint Johns Ave Ste 4 Palatka |
| State: | FL US |
| Postal Code: | 321776859 |
| Phone Number: | 3863293939 |
| Fax Number: | 3863298990 |
| NPI Enumeration Date: | 03/19/2011 |
| NPI Last Update Date: | 06/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ME67444 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |