Provider Demographics
NPI:1487055588
Name:FLORIDA FAMILY CARE SERVICES
Entity type:Organization
Organization Name:FLORIDA FAMILY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELBA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR/OWNER
Authorized Official - Phone:239-823-0629
Mailing Address - Street 1:3717 DEL PRADO BLVD S
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7144
Mailing Address - Country:US
Mailing Address - Phone:239-542-4442
Mailing Address - Fax:239-945-5033
Practice Address - Street 1:3717 DEL PRADO BLVD S
Practice Address - Street 2:SUITE # 6
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7144
Practice Address - Country:US
Practice Address - Phone:239-542-4442
Practice Address - Fax:239-945-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000155203Medicaid
FL000155200Medicaid