Provider Demographics
NPI:1528749827
Name:FIREFLY HEALTH PLLC
Entity type:Organization
Organization Name:FIREFLY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-205-2100
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-0039
Mailing Address - Country:US
Mailing Address - Phone:615-205-2100
Mailing Address - Fax:
Practice Address - Street 1:421 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-1750
Practice Address - Country:US
Practice Address - Phone:615-205-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty