# FAMILY MEDICAL PRACTICE MANAGEMENT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366687923
- **Authorized official:** JOHN A LEVIN (SECRETARY)
- **Authorized official phone:** (386) 258-5476

## Contact information

- **Practice address:** 645 RIDGEWOOD AVE, HOLLY HILL, FL 32117-3617
- **Practice address phone:** (386) 258-5476
- **Mailing address:** 645 RIDGEWOOD AVE, HOLLY HILL, FL 32117-3617
- **Mailing address phone:** (386) 258-5476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | NULL | — |
| 2083X0100X | Occupational Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 12/11/2008
- **Last updated:** 12/11/2008