Organization
FAMILY FIRST MEDICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYAM KRISHNA IYER M.D. (MANAGER)
(727) 443-4242
Entity
Organization
Contact information
Practice address
1012 DRUID RD E, SUITE 100, CLEARWATER, FL 33756-5606
(727) 443-4242
(727) 441-1158
Mailing address
1012 DRUID RD E, SUITE 100, CLEARWATER, FL 33756-5606
(727) 443-4242
(727) 441-1158
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME44742
FL
207Q00000X
Family Medicine Physician
Primary
ME26372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC110
MEDICARE GROUP PROVIDER NUMBER
FL
Enumeration date
02/06/2007
Last updated
06/11/2008
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