Organization Name: | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC |
NPI Number: | 1609037944 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FRANK MAZZEO (PRESIDENT CEO) |
Mailing Address: | 930 S Main St Suite B Labelle |
State: | FL US |
Postal Code: | 339354444 |
Phone Number: | 2393320417 |
Fax Number: | 8636751346 |
NPI Enumeration Date: | 06/19/2008 |
NPI Last Update Date: | 07/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |