Organization
ADVANCED FAMILY MEDICINE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE R LOPS M.D. (OWNER/PHYSICIAN)
(850) 423-0761
Entity
Organization
Contact information
Practice address
327 MEDCREST DRIVE, UNIT A, CRESTVIEW, FL 32536
(850) 423-0761
(855) 793-3568
Mailing address
327 MEDCREST DRIVE, UNIT A, CRESTVIEW, FL 32536
(850) 423-0761
(855) 793-3568
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME89643
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184803830
AETNA
FL
01
—
1184805830
TRICARE
FL
01
—
37798
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/23/2007
Last updated
04/17/2020
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