Healthcare Provider Details

I. General information

NPI: 1952579344
Provider Name (Legal Business Name): FLORIDA FAMILY MEDICAL CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 CHESTNUT ST
CLEARWATER FL
33756-5642
US

IV. Provider business mailing address

818 CHESTNUT ST
CLEARWATER FL
33756-5642
US

V. Phone/Fax

Practice location:
  • Phone: 727-443-7478
  • Fax: 727-446-0999
Mailing address:
  • Phone: 727-443-7478
  • Fax: 727-446-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO GARRIDO
Title or Position: CEO
Credential:
Phone: 813-240-3388