Organization
ONE FAMILY CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN MARTINEZ (PRESIDENT)
(786) 817-2138
Entity
Organization
Contact information
Practice address
1840 W 49TH ST STE 700, HIALEAH, FL 33012-2962
(786) 817-2138
Mailing address
1840 W 49TH ST STE 700, HIALEAH, FL 33012-2962
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC11137
AHCA
FL
Enumeration date
10/16/2017
Last updated
10/16/2017
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