1609218098 NPI number — HEALTH FIRST PRIMARY CARE, L.L.C

Table of content: (NPI 1609218098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609218098 NPI number — HEALTH FIRST PRIMARY CARE, L.L.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH FIRST PRIMARY CARE, L.L.C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609218098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8000 SW 117TH AVE STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33183-4809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-273-9100
Provider Business Mailing Address Fax Number:
305-273-9900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7747 W HILLSBOROUGH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33615-4715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-603-4289
Provider Business Practice Location Address Fax Number:
888-393-0869
Provider Enumeration Date:
07/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
WALTER
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
305-808-9839

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 022305600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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