Provider Demographics
NPI:1770651366
Name:FCR ENTERPRISES INC
Entity type:Organization
Organization Name:FCR ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIRANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-642-2928
Mailing Address - Street 1:PO BOX 144176
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4176
Mailing Address - Country:US
Mailing Address - Phone:305-642-2928
Mailing Address - Fax:305-642-5638
Practice Address - Street 1:1313 SW 27 AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1232
Practice Address - Country:US
Practice Address - Phone:305-642-2928
Practice Address - Fax:305-642-5638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4981261QM1300X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Not Answered261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40747Medicare ID - Type Unspecified