Healthcare Provider Details

I. General information

NPI: 1033021415
Provider Name (Legal Business Name): FAMILY FIRST DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2928 LICHEN LN UNIT D
CLEARWATER FL
33760-1536
US

IV. Provider business mailing address

13700 LITTLE RD # 1020
HUDSON FL
34667-8024
US

V. Phone/Fax

Practice location:
  • Phone: 813-725-5375
  • Fax: 813-725-4452
Mailing address:
  • Phone: 813-725-5375
  • Fax: 813-725-4452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: LISA MARTINEZ-FARGAS
Title or Position: MEMBER
Credential: CPT (ASPT)
Phone: 813-725-5375