Provider Demographics
NPI:1932669702
Name:FLORIDA FIRST HEALTH, LLC
Entity Type:Organization
Organization Name:FLORIDA FIRST HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-769-3191
Mailing Address - Street 1:233 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2205
Mailing Address - Country:US
Mailing Address - Phone:850-640-2319
Mailing Address - Fax:
Practice Address - Street 1:1514 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-2905
Practice Address - Country:US
Practice Address - Phone:850-640-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA FIRST HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
X7B55OtherBLUE CROSS BLUE SHIELD