Healthcare Provider Details

I. General information

NPI: 1639860109
Provider Name (Legal Business Name): FIRST CLASS MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 NW 151ST ST STE 207
MIAMI LAKES FL
33014-2476
US

IV. Provider business mailing address

12792 SW 45TH DR
MIRAMAR FL
33027-6046
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-5748
  • Fax: 786-590-2125
Mailing address:
  • Phone: 786-558-5748
  • Fax: 786-590-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YAILIN MARTIN LOPEZ
Title or Position: OWNER
Credential:
Phone: 786-263-1198