Provider Demographics
NPI:1851187421
Name:FAMCARE MEDICAL CENTER LLC
Entity type:Organization
Organization Name:FAMCARE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEVRY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:469-638-3162
Mailing Address - Street 1:10200 SW 8TH CT UNIT 103
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1720
Mailing Address - Country:US
Mailing Address - Phone:469-638-3162
Mailing Address - Fax:
Practice Address - Street 1:1817 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-5805
Practice Address - Country:US
Practice Address - Phone:469-638-3162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty