Provider Demographics
NPI:1407011711
Name:MIGRANT FARMWORKERS CLINIC INC
Entity Type:Organization
Organization Name:MIGRANT FARMWORKERS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:G
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-559-4550
Mailing Address - Street 1:PO BOX 3488
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-3488
Mailing Address - Country:US
Mailing Address - Phone:229-259-9490
Mailing Address - Fax:229-259-9491
Practice Address - Street 1:224 J FRANK CULPEPPER ROAD
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:GA
Practice Address - Zip Code:31636
Practice Address - Country:US
Practice Address - Phone:229-559-4550
Practice Address - Fax:229-559-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health