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General NPI Number Information
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NPI Number | 1902944747
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Entity Type | Organization
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Legal Business Name | FLORIDA FAMILY RURAL HEALTH CARE LLC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 2398 HARTFORD DR
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City | AVON PARK
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State | FL
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Zip | 33825-9523
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Country | US
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Telephone | 863-453-2500
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Fax | 863-453-0745
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Provider Business Mailing Address
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Address Line | 2398 HARTFORD DR
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City | AVON PARK
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State | FL
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Zip | 33825-9523
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Country | US
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Telephone | 863-453-2500
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Fax | 863-453-0745
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL RAY KARR
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Credential | P.A.-C
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Telephone | 863-453-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PA1725
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME 91882
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License Number State | FL
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