Healthcare Provider Details

I. General information

NPI: 1972270403
Provider Name (Legal Business Name): FAMILIES FIRST OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 08/24/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 EISENHOWER BLVD STE 315
TAMPA FL
33634-6344
US

IV. Provider business mailing address

4902 EISENHOWER BLVD STE 315
TAMPA FL
33634-6344
US

V. Phone/Fax

Practice location:
  • Phone: 813-290-8560
  • Fax:
Mailing address:
  • Phone: 813-290-8560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROLANNE PATRIACO
Title or Position: CEO
Credential:
Phone: 813-290-8560