Healthcare Provider Details

I. General information

NPI: 1497945109
Provider Name (Legal Business Name): FLORIDA MEDICAL RESOURCES MANANGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2007
Last Update Date: 07/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 SW 30TH CT
MIAMI FL
33133-3616
US

IV. Provider business mailing address

2990 SW 30TH CT
MIAMI FL
33133-3616
US

V. Phone/Fax

Practice location:
  • Phone: 305-305-2532
  • Fax:
Mailing address:
  • Phone: 305-305-2532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFRREY T KING
Title or Position: CEO
Credential: RN
Phone: 305-305-2532