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General NPI Number Information
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NPI Number | 1649353400
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Entity Type | Organization
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Legal Business Name | FIRST HELP DIAGNOSTIC & TREATMENT CENTER, INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 290 1ST ST S
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3271
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Country | US
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Telephone | 863-875-4864
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Fax | 863-293-8450
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Provider Business Mailing Address
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Address Line | 290 1ST ST S
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3271
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Country | US
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Telephone | 863-875-4864
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Fax | 863-293-8450
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/CEO
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Name | DR. TOMMY LEE LOUISVILLE
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Credential | M.D.
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Telephone | 863-875-4864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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