Family Care Center of Brooksville, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

OS0007621 Issued in FL

Legal business name

FAMILY CARE CENTER OF BROOKSVILLE, PA

Doing business as

Family Care Center

Practice address

14540 Cortez Blvd
Suite 118
Brooksville, FL 34613-6056

Phone

(352) 596-4482

Fax

(352) 596-2241

NPI assigned

Jan 18, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jerry R Jacobs, D O

Title

Owner

Phone

(352) 596-4482

Specialties & licenses 1

Addresses

Other names 1

• Family Care Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1720359045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14540 CORTEZ BLVD",
            "address_2": "SUITE 118",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346136056",
            "telephone_number": "352-596-4482",
            "fax_number": "352-596-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 CORTEZ BLVD",
            "address_2": "SUITE 118",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346136056",
            "telephone_number": "352-596-4482",
            "fax_number": "352-596-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE CENTER OF BROOKSVILLE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-596-4482",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D O"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS0007621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edwin Obiajulu Ezekwu-Elendu, MD
• Juan C Fabrega, DMD
• Maryam Fahda, MD
• Zane Faillace-Garren
• Oluwatosin Mariam Falomo, PMHNP
• Family Chiropractic Health Centers Corp
• Family Chiropractic Health Centers Corp
• Farhan Siddiqi, MD PA.
• Mildred Veronica Farmer, M.D.
• Teresa Renee Fassetta

• Primary Care Clinic/Center in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.