Provider Demographics
NPI:1629465299
Name:THE KEY CENTER OF FLORIDA
Entity Type:Organization
Organization Name:THE KEY CENTER OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANALANG
Authorized Official - Suffix:
Authorized Official - Credentials:LCP
Authorized Official - Phone:571-313-8750
Mailing Address - Street 1:9850 STIRLING RD STE 102
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8068
Mailing Address - Country:US
Mailing Address - Phone:571-313-8750
Mailing Address - Fax:571-313-8749
Practice Address - Street 1:21155 WHITFIELD PL 206
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165
Practice Address - Country:US
Practice Address - Phone:571-313-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9217302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization