# FAMILY PRACTICE OUTREACH, INC

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

## Provider details

- **NPI number:** 1639344591
- **Authorized official:** MIMI COSENTINO (DIRECT OF OPS)
- **Authorized official phone:** (520) 631-9585

## Contact information

- **Practice address:** 7739 E BROADWAY BLVD \# 360, TUCSON, AZ 85710-3941
- **Practice address phone:** (520) 631-9585
- **Mailing address:** 7739 E BROADWAY BLVD \# 360, TUCSON, AZ 85710-3941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 05/07/2008