MEDICARE: FAMILY FIRST HEALTHCARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1770259632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FIRST HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	8911 REGENTS PARK DR STE 540
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3400
Country	:	US
Telephone Number	:	919-816-6636
Fax Number	:

Provider Business Practice Location Address
First Line	:	8911 REGENTS PARK DR STE 540
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3400
Country	:	US
Telephone Number	:	919-816-6636
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RODNEY RICHARDS
Credential	:
Telephone Number	:	352-428-4026

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	08/11/2022

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