Provider Demographics
NPI:1942736426
Name:FL CLINICAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:FL CLINICAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FHTEACHIA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:407-270-1957
Mailing Address - Street 1:13750 W COLONIAL DR
Mailing Address - Street 2:SUITE 350, #219
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4204
Mailing Address - Country:US
Mailing Address - Phone:407-270-1957
Mailing Address - Fax:
Practice Address - Street 1:13750 W COLONIAL DR
Practice Address - Street 2:SUITE 350, #219
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4204
Practice Address - Country:US
Practice Address - Phone:407-270-1957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9454635363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty