Provider Demographics
NPI:1285930727
Name:AMERICAN FAMILY MEDICAL LLC
Entity type:Organization
Organization Name:AMERICAN FAMILY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-351-4634
Mailing Address - Street 1:1805 SE 16TH AVE
Mailing Address - Street 2:SUTIE 1201
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4672
Mailing Address - Country:US
Mailing Address - Phone:352-351-4634
Mailing Address - Fax:351-351-1900
Practice Address - Street 1:1805 SE 16TH AVE
Practice Address - Street 2:SUTIE 1201
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4672
Practice Address - Country:US
Practice Address - Phone:352-351-4634
Practice Address - Fax:351-351-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty