Provider Demographics
NPI:1295409324
Name:FAMILIES FIRST OF FLORIDA, LLC
Entity Type:Organization
Organization Name:FAMILIES FIRST OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRIACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-290-8560
Mailing Address - Street 1:4902 EISENHOWER BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6344
Mailing Address - Country:US
Mailing Address - Phone:813-290-8560
Mailing Address - Fax:
Practice Address - Street 1:1701 NE 42ND AVE STE 301
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-8026
Practice Address - Country:US
Practice Address - Phone:813-290-8560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016021700Medicaid