Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Divine Family Medical Center LLC

Organization Internal Medicine Physician · NPI 1104456920

Southern Divine Family Medical Center LLC is an Internal Medicine Physician in Altoona, Alabama. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

7130 6th Ave
Altoona, AL 35952-9052
Phone: (205) 589-1092
Fax: (205) 589-1096
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Acute Care Nurse Practitioner Taxonomy 363LA2100X
Adult Health Nurse Practitioner Taxonomy 363LA2200X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1104456920
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Enrico Gaspar — Owner · (256) 840-8181
Other names United Doctors Family Medical Center - Altoona
NPI enumeratedJanuary 21, 2020
Last updated in NPPESApril 9, 2022
Certification dateApril 9, 2022
Mailing addressPo Box 35, Altoona, AL 35952-0035

Other providers in Altoona