Provider Demographics
NPI:1740966902
Name:FIRSTLINE HEALTH CLINIC
Entity type:Organization
Organization Name:FIRSTLINE HEALTH CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-857-7273
Mailing Address - Street 1:300 W 41ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3627
Mailing Address - Country:US
Mailing Address - Phone:305-857-7273
Mailing Address - Fax:
Practice Address - Street 1:300 W 41ST ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3627
Practice Address - Country:US
Practice Address - Phone:305-857-7273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRSTLINE HEALTH CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty