Provider Demographics
NPI:1215220421
Name:FLORIDA FIRST CARE, INC.
Entity type:Organization
Organization Name:FLORIDA FIRST CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ENGELBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-579-3932
Mailing Address - Street 1:1536 KINGSLEY AVE STE 127
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4525
Mailing Address - Country:US
Mailing Address - Phone:904-579-3932
Mailing Address - Fax:904-579-3954
Practice Address - Street 1:1536 KINGSLEY AVE STE 127
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4525
Practice Address - Country:US
Practice Address - Phone:904-579-3932
Practice Address - Fax:904-579-3954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103174Medicare PIN