Functional Fluidics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FUNCTIONAL FLUIDICS LLC

Practice address

440 Burroughs St Ste 641
Detroit, MI 48202-3474

Phone

(313) 482-9435

NPI assigned

Feb 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick Hines

Title

Ceo

Phone

(313) 482-9435

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1972137560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 BURROUGHS ST STE 641",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023474",
            "telephone_number": "313-482-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BURROUGHS ST STE 641",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023474",
            "telephone_number": "313-482-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL FLUIDICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-482-9435"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Fultz, CPRM
• Talena Fultz
• Fun Day Adult Day Care
• Keoshia Funches
• Functional Fluidics Inc
• Gina Fundaro, M.D.
• Gerald R. Funderburg Jr., NONE
• Brent Funk, PSY.D.
• Shardaya Fuquay
• Darlene Lashell Fussell

• Clinical Medical Laboratory in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.