Provider Demographics
NPI:1942692975
Name:FAMILY ADVOCATES OF FLORIDA
Entity Type:Organization
Organization Name:FAMILY ADVOCATES OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O., SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHURIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-403-8145
Mailing Address - Street 1:7200 LAKE ELLENOR DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7200 LAKE ELLENOR DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5700
Practice Address - Country:US
Practice Address - Phone:407-308-1633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management