Provider Demographics
NPI:1053593855
Name:FAMILY CARE DOCTORS GROUP LLC
Entity type:Organization
Organization Name:FAMILY CARE DOCTORS GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-382-4217
Mailing Address - Street 1:10244 E COLONIAL DR
Mailing Address - Street 2:STE 102
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4374
Mailing Address - Country:US
Mailing Address - Phone:407-382-4217
Mailing Address - Fax:
Practice Address - Street 1:10244 E COLONIAL DR
Practice Address - Street 2:STE 102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4374
Practice Address - Country:US
Practice Address - Phone:407-382-4217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty