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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