Florida Clinical Practice Association INC

NPI #1629138292 in Old Town, Florida

Provider Information

NPI Number: 1629138292
Entity Type: Organization
Organization Name: Florida Clinical Practice Association INC
Primary Specialty: Family Medicine
Enumeration Date: Dec 12, 2006
Last Updated: Dec 28, 2015

Practice Location

Address: 25827 SE HIGHWAY 19
City: Old Town
State: Florida
ZIP Code: 32680-3997
Phone: (352) 265-7922

Authorized Official

Name: WILLIAM W THARP
Title: EXECUTIVE VICE PRESIDENT
Phone: (352) 265-8017

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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