Provider Demographics
NPI:1942462908
Name:FAMILY CARE NURSE REGISTRY, INC.
Entity Type:Organization
Organization Name:FAMILY CARE NURSE REGISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANNETT
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:TAYLOR-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-322-6237
Mailing Address - Street 1:6151 MIRAMAR PKWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3970
Mailing Address - Country:US
Mailing Address - Phone:954-322-6237
Mailing Address - Fax:954-322-6238
Practice Address - Street 1:6151 MIRAMAR PKWY
Practice Address - Street 2:SUITE 125
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3970
Practice Address - Country:US
Practice Address - Phone:954-322-6237
Practice Address - Fax:954-322-6238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211075251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL685144496Medicaid
FL685144498Medicaid
FL686916500Medicaid