Provider Demographics
NPI: | 1437708153 |
---|---|
Name: | CFY MEDICAL LLC |
Entity Type: | Organization |
Organization Name: | CFY MEDICAL LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | NURSE |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | STEPHANIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CORTES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 787-948-1616 |
Mailing Address - Street 1: | 1441 MANOTAK AVE APT 1811 |
Mailing Address - Street 2: | |
Mailing Address - City: | JACKSONVILLE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32210-1025 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-948-1616 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1441 MANOTAK AVE APT 1811 |
Practice Address - Street 2: | |
Practice Address - City: | JACKSONVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32210-1025 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-948-1616 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-09-05 |
Last Update Date: | 2019-09-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Single Specialty | |
No | 163WA2000X | Nursing Service Providers | Registered Nurse | Administrator | Group - Single Specialty |
No | 163WC1600X | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development | Group - Single Specialty |
No | 163WF0300X | Nursing Service Providers | Registered Nurse | Flight | Group - Single Specialty |
No | 163WG0000X | Nursing Service Providers | Registered Nurse | General Practice | Group - Single Specialty |
No | 163WG0600X | Nursing Service Providers | Registered Nurse | Gerontology | Group - Single Specialty |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Single Specialty |
No | 163WP0000X | Nursing Service Providers | Registered Nurse | Pain Management | Group - Single Specialty |
No | 163WP0807X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health, Child & Adolescent | Group - Single Specialty |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Single Specialty |
No | 163WP0809X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health, Adult | Group - Single Specialty |
No | 163WP2201X | Nursing Service Providers | Registered Nurse | Ambulatory Care | Group - Single Specialty |
No | 163WR0006X | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant | Group - Single Specialty |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Single Specialty |