Provider Demographics
NPI:1760666549
Name:INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS
Entity Type:Organization
Organization Name:INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TYRRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-615-9975
Mailing Address - Street 1:PO BOX 1162
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32115-1162
Mailing Address - Country:US
Mailing Address - Phone:386-248-1162
Mailing Address - Fax:
Practice Address - Street 1:945 N HALIFAX AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-3732
Practice Address - Country:US
Practice Address - Phone:386-248-1162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical PharmacologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBD975Medicare PIN