Provider Demographics
NPI:1811033012
Name:FIRST HELP DIAGNOSTIC & TREATMENT CENTER
Entity Type:Organization
Organization Name:FIRST HELP DIAGNOSTIC & TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOUISVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-293-0800
Mailing Address - Street 1:290 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3271
Mailing Address - Country:US
Mailing Address - Phone:863-293-0800
Mailing Address - Fax:863-293-8450
Practice Address - Street 1:290 1ST ST S
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3271
Practice Address - Country:US
Practice Address - Phone:863-293-0800
Practice Address - Fax:863-293-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q0449Medicare PIN