Provider Demographics
NPI:1093597270
Name:FAMILY FIRST MEDICAL RESEARCH CENTER
Entity Type:Organization
Organization Name:FAMILY FIRST MEDICAL RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-487-3987
Mailing Address - Street 1:10550 NW 77TH CT STE 401
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2073
Mailing Address - Country:US
Mailing Address - Phone:786-665-9374
Mailing Address - Fax:888-269-3859
Practice Address - Street 1:10550 NW 77TH CT STE 401
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2073
Practice Address - Country:US
Practice Address - Phone:786-665-9374
Practice Address - Fax:888-269-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch