Healthcare Provider Details

I. General information

NPI: 1740966902
Provider Name (Legal Business Name): FIRSTLINE HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 41ST ST STE 100
MIAMI BEACH FL
33140-3627
US

IV. Provider business mailing address

300 W 41ST ST STE 100
MIAMI BEACH FL
33140-3627
US

V. Phone/Fax

Practice location:
  • Phone: 305-857-7273
  • Fax:
Mailing address:
  • Phone: 305-857-7273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MURRAY A ERICKSON
Title or Position: MEMBER
Credential:
Phone: 305-857-7273