Southern Divine Family Medical Center LLC

NPI #1104456920 in Altoona, Alabama

Provider Information

NPI Number
1104456920
Entity Type
Organization
Organization Name
Southern Divine Family Medical Center LLC
Primary Specialty
Internal Medicine
Enumeration Date
Jan 21, 2020
Last Updated
Apr 9, 2022

Practice Location

Address
7130 6TH AVE
State
Alabama
ZIP Code
35952-9052
Phone
(205) 589-1092

Authorized Official

Name
ENRICO D GASPAR, MD
Title
OWNER
Phone
(256) 840-8181

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - Acute CareAcute Care
Nurse Practitioner - Adult HealthAdult Health
Nurse Practitioner - FamilyFamily
Internal Medicine

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