Provider Demographics
NPI:1134417124
Name:KEY WEST FAMILY PRACTICE, PLLC
Entity type:Organization
Organization Name:KEY WEST FAMILY PRACTICE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RABECCA
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-296-5358
Mailing Address - Street 1:3420 DUCK AVE
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4427
Mailing Address - Country:US
Mailing Address - Phone:305-296-5358
Mailing Address - Fax:305-293-1146
Practice Address - Street 1:3420 DUCK AVE
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4427
Practice Address - Country:US
Practice Address - Phone:305-296-5358
Practice Address - Fax:305-293-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP922171100000X
FLMA25088225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC0426OtherFL BLUE MASSAGE ID
FLE7R4IOtherFL BLUE GROUP ID