Provider Demographics
NPI:1184161010
Name:FIRST SERVICES FACILITY INC
Entity type:Organization
Organization Name:FIRST SERVICES FACILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:PORTALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-571-9615
Mailing Address - Street 1:7811 CORAL WAY
Mailing Address - Street 2:SUITE134
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7811 CORAL WAY
Practice Address - Street 2:SUITE134
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6540
Practice Address - Country:US
Practice Address - Phone:786-571-9615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUAN CARLOS PORTALES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy