Provider Demographics
NPI:1114467933
Name:AFFINITY HEALTHCARE SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:AFFINITY HEALTHCARE SOLUTIONS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WYATT
Authorized Official - Middle Name:IRVIN
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-251-5688
Mailing Address - Street 1:600 1ST AVE N
Mailing Address - Street 2:SUITE:303
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3609
Mailing Address - Country:US
Mailing Address - Phone:850-251-5688
Mailing Address - Fax:
Practice Address - Street 1:600 1ST AVE N
Practice Address - Street 2:SUITE:303
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3609
Practice Address - Country:US
Practice Address - Phone:850-251-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty