Provider Demographics
NPI:1114977329
Name:FAMILY HEALTHCARE PLUS GROUP
Entity Type:Organization
Organization Name:FAMILY HEALTHCARE PLUS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-935-0566
Mailing Address - Street 1:801 W OAK ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 W OAK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6614
Practice Address - Country:US
Practice Address - Phone:407-935-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6893173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN