Provider Demographics
NPI:1033070339
Name:EUSTIS FAMILY MEDICINE
Entity type:Organization
Organization Name:EUSTIS FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ASHCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-396-2126
Mailing Address - Street 1:127 N GROVE ST STE B
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-3483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:127 N GROVE ST STE B
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-3483
Practice Address - Country:US
Practice Address - Phone:352-234-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care