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FLORIDA FAMILY RURAL HEALTH CARE LLC NPI 1902944747


NPI Information

NPI: 1902944747
Provider Name: FLORIDA FAMILY RURAL HEALTH CARE LLC

Doing Business As: AVON MEDICAL CENTER

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 10D0990848

Address:
2398 HARTFORD DR
AVON PARK, FL
ZIP 33825
Phone: (863) 453-2500
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FLORIDA FAMILY RURAL HEALTH CARE LLC is a clinic center in Avon Park, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FLORIDA FAMILY RURAL HEALTH CARE LLC NPI is 1902944747. The provider is registered as an organization entity type.
The provider Is Doing Business As Avon Medical Center.

The provider's business location address is:

2398 HARTFORD DR
AVON PARK, FL
ZIP 33825-523
Phone: (863) 453-2500
Fax: (863) 453-0745

The provider's authorized official is Michael Ray Karr .
The authorized official title is President and has the following contact phone number (863) 453-2500.

The CLIA number assigned to this NPI record is 10D0990848 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 9/12/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterPA1725FLORIDANo
2261Q00000XClinic/CenterME 91882FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1660069700MEDICAIDFLORIDA
2I23901MEDICARE UPINFLORIDA
3290263000MEDICAIDFLORIDA
4103905MEDICARE OSCAR/CERTIFICATIONFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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