Advanced Family Care Inc
Organization Active NPI Family Medicine Physician · Debary, FL
NPI 1821279597 · NPPES record last updated Mar 11, 2014
Key facts
- NPI
- 1821279597
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME94332 (FL)
- Legal business name
- ADVANCED FAMILY CARE INC
- Practice address
- 2836 Enterprise Rd
Suite 4
Debary, FL 32713-5210 - Phone
- (386) 951-4538
- Fax
- (386) 259-3689
- NPI assigned
- Nov 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Magued Ibrahim, MD
- Title
- Owner President
- Phone
- (386) 951-4538
Practitioners 1
-
Magued Ibrahim, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1074555 | Advanced Family Care | Certificate of waiver | Sep 30, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080314000218 | FL | Part B Supplier - Clinic/Group Practice | 0244315281 |
Receives reassigned benefits from 1 practitioner Practice locations: Debary, FL; Lake Mary, FL |
National Provider Directory
Locations
2836 Enterprise Rd
Ste 4
Debary, FL 32713
Phone (386) 668-9600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | ME94332 | FL | Yes |
Addresses
Primary practice location
2836 Enterprise Rd
Suite 4
Debary, FL 32713-5210
Mailing address
PO Box 741240
Health Ledger Services
Orange City, FL 32774-1240
Phone (386) 951-4538
Other providers in Debary, FL
- 28 Trans, LLC
- Accurate Healthcare Debary Inc.
- Acupuncture and Healing Arts
- Advance Bariatric Counseling
- Advanced Scripts LLC
- Advantacare Multi-Specialty Group, LLC
- Advantacare of Florida LLC
- Vinita Agaberg
- Maria Jose Aguerre de Sosa
All providers in Debary, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.