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Organization
ADVANTAGE FAMILY MEDICAL CARE INC
Active
Organization
ADVANTAGE FAMILY MEDICAL CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW ALEXANDER FETCHIK D.O. (VICE PRESIDEN)
(727) 569-7777
Entity
Organization
Contact information
Practice address
5006 STATE ROAD 54, NEW PORT RICHEY, FL 34652-5908
(727) 569-7777
Mailing address
PO BOX 1547, TARPON SPRINGS, FL 34688-1547
(727) 569-7777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS6553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40171
BLUE CROSS BLUE SHIELD
FL
01
—
RAIL ROAD MEDICARE
08077651
FL
Enumeration date
09/25/2006
Last updated
02/04/2011
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