# FLORIDA FAMILY PRIMARY CARE CENTERS OF PINELLAS, LLC

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

## Provider details

- **NPI number:** 1861817108
- **Authorized official:** OCTAVIO 'BUTCH' BRAVO (CEO)
- **Authorized official phone:** (305) 905-1399

## Contact information

- **Practice address:** 6245 66TH ST N, PINELLAS PARK, FL 33781-5025
- **Practice address phone:** (727) 873-3891
- **Practice address fax:** (727) 873-3892
- **Mailing address:** 6245 66TH ST N, PINELLAS PARK, FL 33781-5025
- **Mailing address phone:** (727) 873-3891
- **Mailing address fax:** (727) 873-3892

## Taxonomy

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

## Other

- **Enumeration date:** 02/24/2014
- **Last updated:** 02/25/2014