Provider Demographics
NPI:1215964598
Name:ALL FLORIDA FAMILY CARE INC
Entity type:Organization
Organization Name:ALL FLORIDA FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SREELATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRUPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-344-6200
Mailing Address - Street 1:3301 66TH ST N
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1538
Mailing Address - Country:US
Mailing Address - Phone:727-344-6200
Mailing Address - Fax:727-344-6222
Practice Address - Street 1:3301 66TH ST N
Practice Address - Street 2:SUITE A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1538
Practice Address - Country:US
Practice Address - Phone:727-344-6200
Practice Address - Fax:727-344-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83332207R00000X
FLARNP1918522363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K9783Medicare ID - Type Unspecified