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Organization
MARIANNA FAMILY CARE CENTER LLC
Active
Organization
MARIANNA FAMILY CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HORACIO JORGE RODRIGUEZ-JIMENEZ MD (MEDICAL DIRECTOR)
(850) 526-3555
Entity
Organization
Contact information
Practice address
2928 DANIELS STREET, MARIANNA, FL 32446
(850) 526-3555
(850) 526-3570
Mailing address
2928 DANIELS ST, MARIANNA, FL 32446-2912
(850) 526-3555
(850) 526-3570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME61655
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255784300
—
FL
01
—
45283
BCBS
FL
01
—
DC0337
RR MEDICARE
FL
Enumeration date
09/21/2006
Last updated
01/26/2011
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